Desgaste dental contemporâneo de restaurações em resina composta

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Desgaste dental contemporâneo de restaurações em resina composta: uma revisão de literatura 
Objetivo: apresentar as visões modernas sobre os mecanismos de desgaste das resinas compostas, e comparar a resistência ao 
desgaste entre diferentes tipos de materiais usados na prática clínica atualmente. 
 Resina composta: material polimérico composto por matriz orgânica e cristais ou partículas de carga, que são unidos 
pelos agentes de união/selantes 
As resinas compostas são as mais utilizadas para restaurações diretas, em dentes anteriores e posteriores, 
principalmente devido às suas características mecânicas e estéticas. Promovem preparos bastante conservadores, 
preservando a estrutura dental sadia (odontologia minimamente invasiva) 
São muito estéticas, tem de diversas cores e marcas para se adaptar ao dente do paciente, o que atualmente é uma das 
principais questões para o paciente 
 
 O material restaurador deve ter propriedades de desgaste semelhantes às dos tecidos dentais: o desgaste fisiológico do 
esmalte é de aproximadamente 0,02-0,04mm vertical ao ano. Se essa quantidade mencionada ocorrer em menos tempo 
ou desgaste for maior dentro de um ano, a perda passa a ser patológica e pode ser grave 
 
 Avanço tecnológico das resinas compostas: ocorreu devido a 3 motivos (demanda estética crescente dos pacientes; 
preocupação com o amalgama (tóxico); melhorias nas propriedades mecânicas (foi sendo aprimorada aos poucos)) 
Com o aumento da popularidade muitas melhorias foram implementadas (carga de reforço; matriz orgânica; agentes 
de acoplamento) 
A redução da carga de reforço foi uma das mais importantes, produzindo um material com uma superfície de melhor 
polimento e resistente ao desgaste (porque a carga de reforço confere a dureza do material) 
 
 A que se deve o desgaste da resina composta? FENÔMENO MULTIFATORIAL 
 Característica do dente 
 Tipo de material 
 Tamanho da cavidade 
 Fisiologia da oclusão 
 Natureza dos dentes opostos 
 
 O desgaste da dentina pode ser avaliado de 2 maneiras: 
 Clínica: DIRETO: observação realizada por um avaliador treinado 
INDIRETO: observação realizada através da fabricação de moldes 
 Laboratório: através da ISSO/TS 14569 perfilometria após simulação do processo de mastigação 
OBS: o desgaste das restaurações em resina composta ainda é um importante problema a ser resolvido 
 Desgaste é a perda ou deformação gradual e prejudicial de um material em superfícies sólidas. Resultado da interação 
física/química com outra superfície em movimento relativo. Provoca degradação das superfícies funcionais, levando a 
uma falha do material e perda da funcionalidade 
 
TRIBOLOGIA: estudo dos desgastes. 
 
 TAXA DE DESGASTE: magnitude do desgaste em função do tempo (é afetada pelo tipo de carga, tipo de movimento, 
temperatura e lubrificação da superfície). Existem 3 estágios para essa taxa de desgaste: 
1. Primário ou inicial: as superfícies se adaptam umas às outras e a taxa pode variar entre baixo e alto; 
 
2. Secundário ou de meia idade: o desgaste constante pode ser observado. A maior parte da vida da resina 
é gasta nesse estágio; (pode ser encurtado por mudanças nas condições ambientais, como altas 
temperaturas e tensões) modo de vida e cuidado do paciente que vai determinar o tempo de vida da 
restauração na boca do paciente 
 
3. Terciário ou de velhice: as superfícies estão sujeitas às falhas devido a uma alta taxa de desgaste 
 
 Devemos levar em consideração 3 fatores: 
 Estrutura do material 
 Condições em que o material entra em contato com o agente abrasivo 
 Ambiente do material em relação à natureza da superfície 
Desgaste abrasivo: perda do material devido as protuberâncias ou partículas duras que são forçadas, e se movem contra uma 
superfície sólida. Pode ser classificado de duas maneiras: 
1. Tipo de contato: 2 corpos (areias ou partículas duras removem o material da superfície oposta); 3 corpos (as partículas 
estão livres para deslizar e rolar para baixo de uma superfície) 
2. Ambiente de contato: aberto (superfícies estão suficientemente deslocadas para serem independentes); fechado 
(superfícies estão unidas) 
 
 Mecanismos do desgaste abrasivo: 
ARAGEM: formação de ranhuras e cristas que podem ser removidas com a passagem de partículas abrasivas 
CORTE: o material é separado da superfície na forma de detritos primários 
FRAGMENTAÇÃO: depois do corte, ocorre fratura tópica do material de desgaste 
OBS: o desgaste abrasivo causado pela escovação afeta todas as superfícies dos dentes, enquanto o causado pelas forças oclusais 
ocorre nas superfícies de contato 
Mastigação: dois tipos de desgaste (2 e 3 corpos) 
 Como o desgaste abrasivo é afetado? 
• Enchimento de reforço: tamanho, forma, conteúdo, orientação e distribuição 
• Monômeros: tipo (afetando o grau de polimerização e, por isso, a dureza da superfície) 
• Ligação entre as substancias orgânicas e inorgânicas: se for fraca, leva um desprendimento de 
partículas de enchimento na superfície do material 
OBS: se a resina é mais dura que a superfície abrasiva, o desgaste é menor. Todos os fatores serão afetados pelas forças 
mastigatórias 
 
Desgaste adesivo: ocorre entre duas superfícies durante o contato de fricção. O deslocamento e fixação dos detritos do desgaste 
ocorre de uma superfície para outra. Pode acontecer de 2 maneiras: 
 Causado pelo movimento relativo: deposição de detritos de desgaste e material de uma superfície para outra 
 Forças coesivas: as duas superfícies ficam unidas, com ou sem contato e detritos (na hora de separar acaba levando uma 
parte da restauração) 
 
 O desgaste adesivo pode levar a um aumento da rugosidade da superfície e criação de saliências na resina. 
 Na mastigação, as superfícies oclusais dos dentes antagonistas entram em contato e podem causar soldagem nos pontos 
de contato entre as superfícies (na separação, as forças de cisalhamento são aplicadas nesses pontos de soldagem, 
podendo levar ao desprendimento de detritos e microfraturas na superfície da resina 
 O desgaste adesivo não parece contribuir significativamente para a abrasão da resina composta porque a saliva atua 
como lubrificante e mitiga significativamente a abrasão 
 
Desgaste de fadiga: o material resinoso é enfraquecido pelos contatos cíclicos repetidos. As partículas são destacadas da 
superfície do material por causa dessas forças cíclicas, ocorrendo microfissuras superficiais ou abaixo da superfície. 
 As rachaduras que são causadas podem se aglutinar e remover partículas da superfície, causando desgaste abrasivo de 
3 corpos 
(SUPERFICIE CONTRA A OUTRA – ZONA DE COMPRESSÃO NA FRENTE/ ZONA DE TENSÃO ATRAS – REPETIÇÃO – DESGASTE POR 
FADIGA) 
 
Desgaste corrosivo: a corrosão é causada pela superfície desgastada e o meio corrosivo. Ocorre em superfícies lubrificadas por 
uma ação sinérgica de estresse tribológicos. As restaurações são expostas a substancias corrosivas: alimentos, bebidas, bactérias 
Todas essas substancias são capazes de reduzir a dureza e aumentar a rugosidade da superfície, aumentando a suscetibilidade 
ao desgaste 
 A saliva atua de maneira protetora, reduzindo a acidez dos alimentos e a atividade microbiana (através do 
tamponamento) 
Desgaste da resina composta em diferentes materiais: a resistência ao desgaste depende do tipo e composição do material da 
resina composta: 
 Restaurações diretas: colocada na cavidade em uma consulta ao dentista 
RESINA COMPOSTA NANOHIBRIDA: possuem enchimento de reforço em nano-tamanho (nanômetros); o 
conteúdo das cargas de reforço é de 80% de volume; boas propriedades mecânicas; menor contração de 
polimerização; mais homogêneas; maior superfície de contato com a matriz orgânica 
Estudos revelaram que as resinas compostas nanoparticuladas apresentam maior resistência ao desgaste 
(justamente pelos benefícios acima) 
 
RESINA COMPOSTA FLUIDA: assim que foi lançada, possuía desvantagem devidoao baixo teor de carga de 
reforço (baixa viscosidade e alta concentração de polimerização – piores propriedades físicas e mecânicas). As 
formulações avançadas melhoraram essas propriedades, aumentando o teor de carga de reforço e gerando 
modificações no tamanho da carga. 
Resinas compostas fluidas e convencionais mostram comportamento semelhante em restaurações classe I. 
A resistência ao desgaste da fluida e da nanoparticulada é semelhante 
 
 Restaurações indiretas: colocada na cavidade em, ao menos, 2 consultas ao dentista, e com o auxílio de tecnologias e 
ferramentas 
PORQUE A RESTAURAÇÃO INDIRETA É MELHOR? São fabricadas em laboratórios com luz, temperatura, umidade, 
pressão e tempo adequados (isso gera um maior grau de polimerização, menor tensão de contração de 
polimerização e melhores propriedades mecânicas) 
Mesmo com grandes vantagens sobre a restauração direta, sua eficácia na pratica é questionável 
OBS: a taxa de sobrevivência das restaurações posteriores é semelhante em resinas diretas e indiretas. Nos estudos in vitro, não 
houve diferença significativa na resistência ao desgaste entre os dois tipos 
 
Desgaste de materiais CAD/CAM: são materiais de design/manufatura auxiliados por computador. Os materiais CAD/CAM 
apresentam menor desgaste do que as resinas compostas para restauração direta 
 Aumentam a resistência ao desgaste e estética das restaurações 
 Facilitam a colocação deixando-as mais rápidas e precisas 
 As restaurações são feitas por fresadoras 
 A qualidade é alta devido a precisão da tecnologia digital avançada 
Desvantagem: precisa de treinamento e é caro 
 
Conclusão: o desgaste é uma realidade complexa e difícil de lidar pelos diversos mecanismos de ação. Vale considerar que todos 
os resultados obtidos por estudos in vitro devem ser cautelosamente considerados, já que as condições na cavidade bucal são 
dificilmente reproduzidas. 
Os estudos futuros para o aprimoramento das resinas compostas devem voltar-se ao avanço e aperfeiçoamento dos materiais 
já existentes, para que fiquem ainda mais resistentes ao desgaste 
 
 
 
 
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ABSTRACT
Composite resins are the most commonly used dental restorative materials after minimally 
invasive dental procedures, and they offer an aesthetically pleasing appearance. An ideal 
composite restorative material should have wear properties similar to those of tooth tissues. 
Wear refers to the damaging, gradual loss or deformation of a material at solid surfaces. 
Depending on the mechanism of action, wear can be categorized as abrasive, adhesive, 
fatigue, or corrosive. Currently used composite resins cover a wide range of materials with 
diverse properties, offering dental clinicians multiple choices for anterior and posterior 
teeth. In order to improve the mechanical properties and the resistance to wear of composite 
materials, many types of monomers, silane coupling agents, and reinforcing fillers have been 
developed. Since resistance to wear is an important factor in determining the clinical success 
of composite resins, the purpose of this literature review was to define what constitutes 
wear. The discussion focuses on factors that contribute to the extent of wear as well as to the 
prevention of wear. Finally, the behavior of various types of existing composite materials such 
as nanohybrid, flowable, and computer-assisted design/computer-assisted manufacturing 
materials, was investigated, along with the factors that may cause or contribute to their wear.
Keywords: CAD/CAM materials; Composite resins; Reinforcing fillers; Resistance to wear
INTRODUCTION
Composite resins are the most commonly used dental restorative materials, following the 
principles of minimally invasive dentistry and offering an aesthetically pleasing appearance. 
Various types of composite restorations in the oral cavity have occlusal contact with each 
other, and continuous mastication forces inevitably lead to composite wear. An ideal 
composite restorative material should have wear properties similar to those of tooth tissues 
[1]. Under physiological conditions, enamel wear is approximately 0.02–0.04 mm of vertical 
loss per year [2]. If this amount of tooth wear increases and the wear rate accelerates, 
then pathological surface loss is defined as occurring, which poses a challenge for dental 
practitioners, as the impact of pathological surface loss could be severe and may influence 
patients' quality of life.
Restor Dent Endod. 2021 May;46(2):e18
https://doi.org/10.5395/rde.2021.46.e18
pISSN 2234-7658·eISSN 2234-7666
Review Article
Received: Jul 28, 2020
Revised: Sep 8, 2020
Accepted: Oct 10, 2020
Dionysopoulos D, Gerasimidou O
*Correspondence to
Dimitrios Dionysopoulos, PhD, MSc, DDS
Assistant Professor, Department of Operative 
Dentistry, Faculty of Dentistry, School of 
Health Sciences, Aristotle University of 
Thessaloniki, Thessaloniki 54124, Greece.
E-mail: ddionys@dent.auth.gr
Copyright © 2021. The Korean Academy of 
Conservative Dentistry
This is an Open Access article distributed 
under the terms of the Creative Commons 
Attribution Non-Commercial License (https://
creativecommons.org/licenses/by-nc/4.0/) 
which permits unrestricted non-commercial 
use, distribution, and reproduction in any 
medium, provided the original work is properly 
cited.
Conflict of Interest
No potential conflict of interest relevant to this 
article was reported.
Author Contributions
Conceptualization: Dionysopoulos D; Data 
curation: Dionysopoulos D, Gerasimidou 
O; Formal analysis: Dionysopoulos D; 
Investigation: Dionysopoulos D, Gerasimidou 
O; Methodology: Dionysopoulos D, 
Gerasimidou O; Project administration: 
Dionysopoulos D; Resources: Dionysopoulos 
D; Software: Gerasimidou O; Supervision: 
Dionysopoulos D; Validation: Dionysopoulos 
D; Visualization: Dionysopoulos D; Writing - 
Dimitrios Dionysopoulos ,* Olga Gerasimidou 
Department of Operative Dentistry, Faculty of Dentistry, School of Health Sciences, Aristotle University of 
Thessaloniki, Thessaloniki, Greece
Wear of contemporary dental 
composite resin restorations: 
a literature review
https://creativecommons.org/licenses/by-nc/4.0/
https://creativecommons.org/licenses/by-nc/4.0/
https://orcid.org/0000-0001-5388-2201
https://orcid.org/0000-0001-8890-2831
http://crossmark.crossref.org/dialog/?doi=10.5395/rde.2021.46.e18&domain=pdf&date_stamp=2021-02-25
original draft: Dionysopoulos D, Gerasimidou 
O; Writing - review & editing: Dionysopoulos D, 
Gerasimidou O.
ORCID iDs
Dimitrios Dionysopoulos 
https://orcid.org/0000-0001-5388-2201
Olga Gerasimidou 
https://orcid.org/0000-0001-8890-2831
The technology of composite materials has advanced significantly in recent years, mainly due 
to the increased aesthetic demands of patients. Additionally, improvements in the physical 
and mechanical properties of composite materials, the increased familiarity of dental 
practitioners with these materials, and concerns regarding the use of amalgam have made 
composite resins more popular in dental practice [3,4]. Various changes in the composition 
of the composite resins have been implemented, including the use of reinforcing fillers, 
organic matrix, and coupling agents [3]. The most important modifications involve a reduced 
size of reinforcing fillers in order to produce composite materials with improved surface 
polishing and resistance to wear.
The wear of composite materials is a multifactorial phenomenon, as it depends on factors 
such as tooth characteristics, the type of material, the size of the cavity, the physiology of 
occlusion, and the nature of the opposing teeth [5]. Reinforcing fillers play a crucial role in 
restorative material, in terms of size, distribution, and volume content. Water absorption 
is an important parameter that negatively affects the strength of composite resin materials 
because it causes plasticization of the organic matrix and weakens the bonding of the 
reinforcing fillers with theorganic matrix. As a result, the structure of the composite 
materials is degraded, which leads to faster hydrolytic decomposition due to the action of the 
enzymes in saliva [5,6].
Wear of composite resin restorations can be evaluated both in clinical and laboratory 
conditions. In clinical conditions, the methods of wear evaluation are further classified as 
direct and indirect [7]. Direct methods include observation of composite restorations in the 
oral cavity by a trained evaluator, mainly based on the United States Public Health Service 
criteria. Indirect methods require impressions of the restored teeth and fabrication of casts. 
Subsequently, the casts are evaluated by either qualitative methods such as Leinfelder and 
Moffa-Lugassy scales or quantitative methods through measurements of properties such 
as surface topography, surface roughness, material loss, and fractal dimension. These 
properties can be measured by mechanical (stylus profilometry and atomic force microscopy) 
or optical (laser scanning microscopy and white-light optical profilometry) systems. In 
laboratory conditions, the wear evaluation of composite restorations follows ISO/TS 14569 
and is mainly conducted using profilometry after simulation of the mastication process [8].
Despite improvements in the mechanical properties of composite resins, wear is still a major 
problem, especially in patients with parafunctional activities, such as bruxism [9]. It has 
been estimated that in 2015 alone, 800 million composite resin restorations were placed 
worldwide, of which 80% were located on posterior teeth [10]. The same research also 
estimated that at least 5% of the restorations placed on posterior teeth failed due to fracture 
and 12% presented significant wear over a period of 10 years. About 77 million composite 
resin restorations on posterior teeth worldwide were likely to show significant wear, while 
approximately 32 million composite resin restorations placed in 2015 will need to be repaired 
or replaced due to fracture during the next 10 years [11].
Therefore, the aim of this literature review was to present modern views on the mechanisms 
of wear of composite resin materials and to compare the resistance to wear between different 
types of composite materials currently used in clinical practice.
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Wear of composite resin restorations
https://orcid.org/0000-0001-5388-2201
https://orcid.org/0000-0001-5388-2201
https://orcid.org/0000-0001-8890-2831
https://orcid.org/0000-0001-8890-2831
TYPES OF WEAR OF COMPOSITE MATERIALS
Wear is the damaging, gradual loss or deformation of a material at solid surfaces. It is the 
result of the mechanical and/or chemical interactions with another surface in relative motion 
[12]. The study of wear and related processes is referred to as tribology. Together with other 
processes such as fatigue and creep, wear causes functional surfaces to degrade, leading to 
material failure or loss of functionality.
The magnitude of wear as a function of time is the wear rate, which is affected by factors 
such as the type of loading, type of motion, temperature, and lubrication of the surfaces [13]. 
There are 3 different stages of wear rate of a material:
1. The primary or early stage, where surfaces adapt to each other and the wear rate might 
vary between high and low.
2. The secondary or mid-age stage, where steady wear can be observed. Most of the 
component's operational life is spent in this stage.
3. The tertiary or old-age stage, where surfaces are subjected to rapid failure due to a high 
rate of wear.
Of note, the wear rate is significantly affected by the operating conditions and the formation 
of tribofilms. The secondary stage is shortened by changes in environmental conditions, 
such as higher temperatures, strain rates, and stresses [14]. Although the wear of materials 
is usually quantified in terms of weight loss and the wear rate, previous studies reported that 
the wear coefficient is more suitable because it takes the wear rate, the applied load, and 
the hardness of the wear pin into account [15]. The wear coefficient K in an abrasive model 
is defined as: K= 3HW/PLρ, where H is the Brinell hardness, W is the weight loss, P is the 
normal load, L is the sliding distance, and ρ is the density of the material [15].
The wear of the surface of a material depends mainly on 3 factors: a) the structure of the 
material, b) the conditions under the material comes in contact with the abrasive agent, 
and c) the environment of the material in relation with the nature of the surface [16-19]. 
Depending on the mechanism of action, wear can be categorized as 1) abrasive, 2) adhesive, 
3) fatigue, and 4) corrosive [20].
Abrasive wear
According to the American Society for Testing and Materials (ASTM) International, abrasive 
wear is the loss of a material due to hard protuberances or hard particles that are forced 
against and move along a solid surface [21]. During abrasive wear, the surface of the material 
is scraped off another surface, either by a hard protrusion or by hard particles between the 2 
surfaces [22] (Figure 1).
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Abrasive wear
Figure 1. Schematic representation of the mechanism of abrasive wear.
Abrasive wear can be classified in terms of the type of contact and the contact environment 
[23]. The type of contact indicates the 2 modes of abrasive wear. The first type is called 2-body 
abrasive wear, while the second is called 3-body abrasive wear [24]. Two-body wear occurs 
when grit or hard particles remove material from the opposite surface. Three-body wear occurs 
when the particles are not constrained, and are free to roll and slide down a surface. The 
contact environment can be defined as open or closed. An open contact environment occurs 
when the surfaces are sufficiently displaced to be independent of one another.
The mechanisms of abrasive wear include a) plowing, b) cutting, and c) fragmentation. 
Plowing results in the formation of grooves, but cannot directly remove the material's 
volume. The displaced material creates ridges besides grooves, which may be removed by 
subsequent passage of abrasive particles. Cutting occurs when a material is separated from 
the surface in the form of primary debris without displacement to the sides of the grooves. 
Fragmentation takes place when a material is separated from a surface by a cutting process 
and the indenting abrasive induces topical fracture of the wear material [23].
Abrasive wear can be measured as loss of mass by the Taber abrasion test according to ISO 
9352 or ASTM D 4060 [24,25]. The wear volume (V) for single-abrasive wear can be described 
by the following equation: V = K × WL/H, where K is the wear coefficient, W is the load, L is 
the sliding distance, and H is the hardness of the material.
In clinical conditions, the abrasive wear caused by tooth brushing affects all exposed surfaces 
of a composite resin restoration, while abrasion caused by occlusal forces is limited to 
contact surfaces [26]. During mastication, both modes of abrasive wear are present; some 
areas of the opposing occlusal surfaces are scraped off between them (2-body abrasive wear), 
while others are scraped off by food particles that are inserted between the opposing teeth 
(3-body abrasive wear). It should also be noted that 2-body abrasive wear between opposing 
teeth involves the occlusal surface of a restoration with another tooth or restoration surface 
and should not be confused with attrition, which is the wear of occlusal surfaces of teeth as a 
result of functional or malfunctional tooth-to-tooth contact [26].
The abrasive wear observed in composite resin restorations is affected by various factors, 
such as the size, shape, content, orientation, and distribution of the reinforcing fillers, the 
type of monomers, which affect the degree ofpolymerization and as a result the hardness of 
the surface, as well as the bond between the organic and inorganic substances; if it is weak, 
it may lead to detachment of filler particles from the composite surface. All these factors are 
affected by the forces applied to the composite resin material during mastication, making the 
whole system very complicated [27].
Previous investigations demonstrated that the abrasive wear of a composite resin is reduced 
when the size of the fillers and the distance between them are reduced, when the degree of 
polymerization of the resin is increased, and when the strength of the bond between the 
fillers and the organic matrix is increased [16,28]. The properties of the surface and the 
particles that cause abrasion also play an important role in the wear rate. If the composite 
resin is harder than the abrasive surface, the wear is much lower [29]. It is interesting to 
mention that in 2-body abrasive wear, angular protrusions cause more abrasion than rounded 
ones, even if they are less hard [30].
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Wear of composite resin restorations
Adhesive wear
Adhesive wear occurs between 2 surfaces during frictional contact when unwanted 
displacement and attachment of wear debris or material compounds takes place from one 
surface to another [31] (Figure 2).
Adhesive wear can be classified into 2 types. The first type occurs when adhesive wear is 
caused by relative motion, and direct contact and plastic deformation result in the deposition 
of wear debris and material from one surface to another. The second type takes place when 
cohesive forces hold 2 surfaces together, although they are not in contact, with or without any 
actual disposition of material. Adhesive wear may lead to an increase in surface roughness 
and the creation of protrusions on the composite surface [32]. A simple model of the wear 
volume for adhesive wear can be described by the same equation as abrasive wear.
When the occlusal surfaces of antagonist teeth come in contact during mastication, welding 
may occur at the contact points of the surfaces [31]. When attempting to separate the 2 surfaces, 
shear forces are applied to the welding points, which can lead to the detachment of components 
from the composite resin surface and the induction of surface micro-fractures. The detached 
particles may be left loose on the surface or moved to the other surface. Small particles often 
form larger clusters, which may contribute to the abrasion of the surface (abrasive wear). 
Adhesive wear does not seem to contribute significantly to the abrasion of composite resin 
materials because saliva acts as a lubricant and significantly mitigates abrasion [33].
Fatigue wear
Fatigue wear occurs when a material is weakened by cycling loading. In particular, particles 
are detached from the material's surface after the application of cyclic forces, leading to the 
growth of microcracks, which may be either superficial or below the surface [34] (Figure 3).
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Wear of composite resin restorations
Adhesive wear
Figure 2. Schematic representation of the mechanism of adhesive wear.
Fatigue wear
Figure 3. Schematic representation of the mechanism of fatigue wear.
As these cracks propagate, they can coalesce and remove small particles from the surface, 
which can cause 3-body abrasive wear. In clinical conditions, this abrasion is considered to 
occur during mastication, where opposing teeth come into contact repeatedly [35]. It has 
been argued that when a surface is rubbed against another, a compression zone is created 
ahead of the direction of movement and a tension zone is created behind the direction of 
movement. Repetition of these stresses on a material can cause fatigue wear [36].
Corrosive wear
Corrosion is caused by a chemical reaction between a worn surface and the corroding 
medium [32] (Figure 4).
Corrosion occurs on both lubricated and dry surfaces by a synergistic action of tribological 
stresses. In the oral cavity, restorations are exposed to a variety of corrosive substances 
derived from food, beverages, bacteria, and saliva [19]. It has been claimed that all these 
corrosive substances are able to reduce surface hardness and increase the surface roughness 
of composite resins, resulting in increased susceptibility to abrasive wear [6]. In this 
aggressive environment, saliva works protectively by reducing the acidity of food and 
microbial activity through its buffering properties [6].
WEAR OF DIFFERENT DENTAL COMPOSITE RESIN 
MATERIALS
Modern dental composite materials have a wide variety of properties, and today they are 
almost the only aesthetic materials used for direct restorations of both anterior and posterior 
teeth [37]. Many laboratory studies have found that resistance to wear depends on the type 
and composition of the composite resin material. Composite resin materials include organic 
matrix, which consists of various monomers, a coupling agent, which bonds the fillers to the 
organic matrix, and various types of inorganic fillers. Restorations using composite resin 
materials are classified as direct and indirect restorations based on the method of placement. 
In direct restorations, the composite resin is placed in the cavity in 1 session by the dentist, 
while indirect restorations usually involve 2 sessions because the restoration is fabricated in 
the laboratory and then is placed on the tooth [37].
WEAR OF DIRECT COMPOSITE RESIN RESTORATIONS
It has been reported that the ratio of reinforcing fillers plays a very important role in the 
resistance to wear of conventional composite resin materials and that a higher content of 
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Corrosive wear
Figure 4. Schematic representation of the mechanism of corrosive wear.
fillers reduces wear. It has been demonstrated that although the wear of composite resins 
is mainly affected by the properties of the reinforcing fillers, the composition of the resin 
monomers also influences wear, which means that wear is a complex and multifactorial 
process [38]. The complexity of the mechanisms of wear has also been reported by more 
recent studies [39,40].
Nanohybrid composite resins have a significant percentage of nano-sized (nm) reinforcing 
fillers. They contain a mixture of colloidal silicon particles (20–60 nm) with larger metal 
particles (100–2,500 nm). Another type of composite resins is referred to as nanofilled 
resins, which contain a more uniform size distribution of nano-particles (5–75 nm) and 
also agglomerated nano-particles (nanoclusters, sized 0.6–1.4 μm) [3,5,41]. The content of 
reinforcing fillers in nanohybrid and nanofilled composite resins is up to 80 vol%. Nanofilled 
composite resins present good mechanical properties, improved surface characteristics, and 
less polymerization shrinkage [42,43]. The distribution of the fillers in nanofilled composite 
resins exhibits great homogeneity within the mass of the resin, and the small size of the 
fillers provides a greater contact surface between them and the organic matrix [44].
During mastication, the rigid fillers deliver the mastication forces to the more elastic organic 
matrix [45]. This may increase the tension at the bonding interface between the fillers and the 
organic matrix, which may lead to the displacement of the fillers and exposure of the more 
vulnerable organic matrix, resulting in wear of the material [46]. Clinical trials performed 
on posterior teeth restorations found no significant difference in the wear rate between 
conventional and nanofilled composite resins. On the contrary, in vitro studies reported that 
some nanofilled composite resins may present greater resistance to wear [45,46].
In 1996 a new type of composite resins was introduced with low viscosity, known as 
“flowable” composite resins. In early years,these materials presented many disadvantages 
attributable to a very low content of reinforcing fillers ranging between 25 and 30 vol%, 
which resulted in low viscosity, but also in high polymerization shrinkage and less favorable 
physical and mechanical properties. Advanced formulations of flowable composite resins 
have improved their physical and mechanical properties due to changes in the composition of 
the organic matrix, increased content of reinforcing fillers (45–65 vol%) and modifications of 
the filler size [47]. As a result, contemporary flowable composite resins are indicated even for 
conservative restorations of posterior teeth [48].
A recent clinical study found that conventional and flowable composite resins showed similar 
clinical behavior after 2 years, when placed in occlusal class I cavities where the isthmus 
width was less than one-half of the intercuspal distance [49]. Moreover, an in vitro study 
comparing a flowable and a nanofilled composite resin found that the resistance to wear of 
both materials was similar [50]. In another study, the authors concluded that in contrast 
to the conventional composite resins, the size of the reinforcing fillers of the flowable 
composite resins may play a more important role in the magnitude of wear than the physical 
properties of the organic matrix [51].
In recent years, novel composite resins have been developed, such as those reinforced 
with synthetic fibers, bulk fill composite resins, silorane-based composite materials, and 
ormocers [52-55]. Nevertheless, there is insufficient information regarding their behavior in 
the oral environment and their resistance to wear in order to make credible conclusions.
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WEAR OF INDIRECT COMPOSITE RESIN RESTORATIONS
Direct restorations with composite resin materials are completed in 1 visit, which is an 
advantage compared to indirect restorations, which require at least 2 visits. However, a major 
disadvantage of direct composite restorations is their shrinkage during polymerization, 
which is around 2–4%. In contrast, in indirect restorations the contraction stresses 
are limited to a small surface occupied by the luting cement between the tooth and the 
restoration [3]. Another disadvantage of direct restorations is the internal stresses created 
during polymerization shrinkage, which tend to detach the composite material from the 
walls of the cavity and may be 13 times larger than those of indirect restorations [56].
Contemporary indirect composite restorations are fabricated in laboratories with light, 
temperature, humidity, pressure, and time control systems that are able to provide an 
increased degree of polymerization, lower polymerization shrinkage stresses, and improved 
mechanical properties [57-59]. Although in vitro studies reported that indirect composite 
restorations exhibited superior mechanical properties than direct composite restorations, 
their effectiveness in clinical practice is questionable. Indeed, it has been found that the 
survival rate of direct posterior composite restorations is similar to that of indirect restorations 
[60-62]. In a recent in vitro study, the authors compared the resistance to wear of composite 
resins for indirect restorations with that for direct restorations. The results showed that there 
were no significant differences in wear resistance among the different types of composite 
resins [63]. The longevity of indirect composite restorations is a very important factor for the 
choice of treatment. The choice of a resin cement for the bonding of the composite materials 
to the tooth structures is crucial and it has been claimed that an increased resistance of the 
cement to wear contributes to the survival rates of restorations [64-67].
WEAR OF COMPOSITE CAD/CAM MATERIALS
A special category of composite resin materials for indirect restorations is computer-aided 
design/computer-aided manufacturing (CAD/CAM) materials, the clinical application 
of which has increased significantly in recent years [68-70]. CAD/CAM technology was 
developed to improve the strength and aesthetics of tooth restorations, as well as to make the 
techniques easier, faster, and more accurate [71]. In particular, digital impressions are taken 
with a special scanning camera and the restoration is constructed by a milling machine. CAD/
CAM machines can mill restorations comprising both composite resin and ceramic materials. 
The quality of CAD/CAM restorations is high because measurements and construction are 
very accurate due to the advanced digital technology [72]. Nevertheless, there are also some 
shortcomings, such as the cost of the equipment and training [73].
CAD/CAM composites can be categorized into composite resins with dispersed fillers 
and polymer infiltrated ceramic networks (PICN) [74]. The first category contains basic 
monomers such as Bis-GMA, UDMA, and TEGDMA and dispersed fillers such as silica, 
zirconia, and barium glass [75]. PICN materials consist of a 3-dimensional ceramic network 
that is infiltrated with a monomer mixture, presenting a higher Weibull modulus and making 
the material less brittle than glass ceramics [76].
CAD/CAM composite materials are manufactured with polymerization under high pressure 
and high temperature, resulting in improved mechanical properties [76]. It has been found 
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Wear of composite resin restorations
that the wear of CAD/CAM composite materials was less than that of ceramic materials, 
and they induced less enamel abrasion of the opposing teeth than ceramic materials [77]. 
Additionally, CAD/CAM composite materials present lower wear than composite resins for 
direct restorations [78,79].
There is now a need for composite resin materials with higher wear resistance in order to 
maintain their morphology for a longer period of time. This goal can be achieved through 
more research focusing on the development of improved and more durable monomers 
leading to better polymerization rates [80]. Research should also be directed towards 
technologies to manufacture reinforcing fillers with better distribution and shape, more 
stable bonds with the organic matrix [81], and self-repairing abilities [82].
CONCLUSIONS
Dealing with the wear of composite resin materials is challenging due to a lack of adequate 
knowledge and complexity of the mechanisms of action. The results of in vitro studies of 
composite resin wear should be considered with caution because wear in the oral cavity 
is a complex phenomenon that is very difficult to reproduce in laboratory conditions. 
Furthermore, future studies should focus more on improving the wear resistance of 
composite materials by changing their properties to be more similar to tooth tissues. The 
development of new adhesive strategies such as universal adhesive systems may contribute to 
this goal.
REFERENCES
 1. Gwon B, Bae EB, Lee JJ, Cho WT, Bae HY, Choi JW, Huh JB. Wear characteristics of dental ceramic CAD/
CAM materials opposing various dental composite resins. Materials (Basel) 2019;12:1839. 
PUBMED | CROSSREF
 2. Lambrechts P, Braem M, Vuylsteke-Wauters M, Vanherle G. Quantitative in vivo wear of human enamel. J 
Dent Res 1989;68:1752-1754. 
PUBMED | CROSSREF
 3. Ferracane JL. Resin composite--State of the art. Dent Mater 2011;27:29-38. 
PUBMED | CROSSREF
 4. Burke FJ. Amalgam to tooth-coloured materials--implications for clinical practice and dental education: 
governmental restrictions and amalgam-usage survey results. J Dent 2004;32:343-350. 
PUBMED | CROSSREF
 5. Kakaboura A, Vougiouklakis G. Basic principles of operative dentistry. Athens: Paschalidis; 2012.
 6. de Gee AJ, Wendt SL, Werner A, Davidson CL. Influence of enzymes and plaque acids on in vitro wear of 
dental composites. Biomaterials 1996;17:1327-1332. 
PUBMED | CROSSREF
 7. Turssi CP, De Moraes Purquerio B, Serra MC.Wear of dental resin composites: insights into underlying 
processes and assessment methods--a review. J Biomed Mater Res B Appl Biomater 2003;65:280-285. 
PUBMED | CROSSREF
 8. Tsujimoto A, Barkmeier WW, Fischer NG, Nojiri K, Nagura Y, Takamizawa T, Latta MA, Miazaki M. Wear 
of resin composites: current insights into underlying mechanisms, evaluation methods and influential 
factors. Jpn Dent Sci Rev 2018;54:76-87. 
PUBMED | CROSSREF
 9. Ferracane JL. Is the wear of dental composites still a clinical concern? Is there still a need for in vitro wear 
simulating devices? Dent Mater 2006;22:689-692. 
PUBMED | CROSSREF
9/13https://rde.ac https://doi.org/10.5395/rde.2021.46.e18
Wear of composite resin restorations
http://www.ncbi.nlm.nih.gov/pubmed/31174298
https://doi.org/10.3390/ma12111839
http://www.ncbi.nlm.nih.gov/pubmed/2600255
https://doi.org/10.1177/00220345890680120601
http://www.ncbi.nlm.nih.gov/pubmed/21093034
https://doi.org/10.1016/j.dental.2010.10.020
http://www.ncbi.nlm.nih.gov/pubmed/15193781
https://doi.org/10.1016/j.jdent.2004.02.003
http://www.ncbi.nlm.nih.gov/pubmed/8805981
https://doi.org/10.1016/0142-9612(96)88679-0
http://www.ncbi.nlm.nih.gov/pubmed/12687721
https://doi.org/10.1002/jbm.b.10563
http://www.ncbi.nlm.nih.gov/pubmed/29755618
https://doi.org/10.1016/j.jdsr.2017.11.002
http://www.ncbi.nlm.nih.gov/pubmed/16563492
https://doi.org/10.1016/j.dental.2006.02.005
 10. Heintze SD, Ilie N, Hickel R, Reis A, Loguercio A, Rousson V. Laboratory mechanical parameters of 
composite resins and their relation to fractures and wear in clinical trials-A systematic review. Dent Mater 
2017;33:e101-e114. 
PUBMED | CROSSREF
 11. Heintze SD, Rousson V. Clinical effectiveness of direct class II restorations - a meta-analysis. J Adhes Dent 
2012;14:407-431.
PUBMED
 12. McCabe JF, Molyvda S, Rolland SL, Rusby S, Carrick TE. Two-and three-body wear of dental restorative 
materials. Int Dent J 2002;52:406-416. 
CROSSREF
 13. Popov VL. Is tribology approaching its golden age? Grand challenges in engineering education and 
tribological research. Front Mech Eng 2018;4:16. 
CROSSREF
 14. Blau PJ, Bayer RG. Wear of materials. Amsterdam: Elsevier; 2003.
 15. Yang LJ. Wear coefficient equation for aluminium-based matrix composites against steel disc. Wear 
2003;255:579-592. 
CROSSREF
 16. Nihei T, Dabanoglu A, Teranaka T, Kurata S, Ohashi K, Kondo Y, Yoshino N, Hickel R, Kunzelmann KH. 
Three-body-wear resistance of the experimental composites containing filler treated with hydrophobic 
silane coupling agents. Dent Mater 2008;24:760-764. 
PUBMED | CROSSREF
 17. Ghazal M, Kern M. Wear of human enamel and nano-filled composite resin denture teeth under different 
loading forces. J Oral Rehabil 2009;36:58-64. 
PUBMED | CROSSREF
 18. Turssi CP, Ferracane JL, Serra MC. Abrasive wear of resin composites as related to finishing and polishing 
procedures. Dent Mater 2005;21:641-648. 
PUBMED | CROSSREF
 19. de Paula AB, Fucio SB, Ambrosano GM, Alonso RC, Sardi JC, Puppin-Rontani RM. Biodegradation and 
abrasive wear of nano restorative materials. Oper Dent 2011;36:670-677. 
PUBMED | CROSSREF
 20. Mair LH, Stolarski TA, Vowles RW, Lloyd CH. Wear: mechanisms, manifestations and measurement. 
Report of a workshop. J Dent 1996;24:141-148. 
PUBMED | CROSSREF
 21. American Society for Testing and Materials. Standard terminology relating to wear and erosion. In: 
Annual book of ASTM standards. Vol 03.02. West Conshohocken, PA: American Society for Testing and 
Materials; 1987. p243-250. 
 22. Ferracane JL. Materials in dentistry: principle and application. Philadelphia, PA: Lippincott Williams & 
Wilkins; 2001.
 23. ASM Handbook Committee. ASM handbook. Volume 18: Friction, lubrication and wear technology. 
Almere: ASM International; 2002.
 24. ISO 9352: Plastics—Determination of resistance to wear by abrasive wheels. Geneve: International 
Organization for Standardization; 2012. 
 25. ASTM D4060: Standard test method for abrasion resistance of organic coatings by the taber abraser. West 
Conshohocken, PA: American Society for Testing and Materials; 2019. 
 26. Cavalcante LM, Masouras K, Watts DC, Pimenta LA, Silikas N. Effect of nanofillers' size on surface 
properties after toothbrush abrasion. Am J Dent 2009;22:60-64.
PUBMED
 27. Han JM, Zhang H, Choe HS, Lin H, Zheng G, Hong G. Abrasive wear and surface roughness of 
contemporary dental composite resin. Dent Mater J 2014;33:725-732. 
PUBMED | CROSSREF
 28. Turssi CP, Ferracane JL, Vogel K. Filler features and their effects on wear and degree of conversion of 
particulate dental resin composites. Biomaterials 2005;26:4932-4937. 
PUBMED | CROSSREF
 29. Manhart J, Kunzelmann KH, Chen HY, Hickel R. Mechanical properties and wear behavior of light-cured 
packable composite resins. Dent Mater 2000;16:33-40. 
PUBMED | CROSSREF
 30. Krejci I, Albert P, Lutz F. The influence of antagonist standardization on wear. J Dent Res 1999;78:713-719. 
PUBMED | CROSSREF
10/13https://rde.ac https://doi.org/10.5395/rde.2021.46.e18
Wear of composite resin restorations
http://www.ncbi.nlm.nih.gov/pubmed/27993372
https://doi.org/10.1016/j.dental.2016.11.013
http://www.ncbi.nlm.nih.gov/pubmed/23082310
https://doi.org/10.1111/j.1875-595X.2002.tb00730.x
https://doi.org/10.3389/fmech.2018.00016
https://doi.org/10.1016/S0043-1648(03)00191-1
http://www.ncbi.nlm.nih.gov/pubmed/17964643
https://doi.org/10.1016/j.dental.2007.09.001
http://www.ncbi.nlm.nih.gov/pubmed/18976262
https://doi.org/10.1111/j.1365-2842.2008.01904.x
http://www.ncbi.nlm.nih.gov/pubmed/15978273
https://doi.org/10.1016/j.dental.2004.10.011
http://www.ncbi.nlm.nih.gov/pubmed/21913859
https://doi.org/10.2341/10-221-L
http://www.ncbi.nlm.nih.gov/pubmed/8636486
https://doi.org/10.1016/0300-5712(95)00043-7
http://www.ncbi.nlm.nih.gov/pubmed/19281115
http://www.ncbi.nlm.nih.gov/pubmed/25007731
https://doi.org/10.4012/dmj.2013-339
http://www.ncbi.nlm.nih.gov/pubmed/15769527
https://doi.org/10.1016/j.biomaterials.2005.01.026
http://www.ncbi.nlm.nih.gov/pubmed/11203521
https://doi.org/10.1016/S0109-5641(99)00082-2
http://www.ncbi.nlm.nih.gov/pubmed/10029471
https://doi.org/10.1177/00220345990780021201
 31. Stachowiak GW, Batchelor AW. Engineering tribology. Burlington: Elsevier Butterworth-Heinemann; 2005.
 32. Yap AU, Teoh SH, Hastings GW, Lu CS. Comparative wear ranking of dental restorative materials utilizing 
different wear simulation modes. J Oral Rehabil 1997;24:574-580. 
PUBMED | CROSSREF
 33. Mandel ID. The functions of saliva. J Dent Res 1987;66 Spec No:623-627. 
PUBMED | CROSSREF
 34. Mair LH. Subsurface compression fatigue in seven dental composites. Dent Mater 1994;10:111-115. 
PUBMED | CROSSREF
 35. McCabe JF, Wang Y, Braem M. Surface contact fatigue and flexural fatigue of dental restorative materials. J 
Biomed Mater Res 2000;50:375-380. 
PUBMED | CROSSREF
 36. Söderholm KJ, Richards ND. Wear resistance of composites: a solved problem? Gen Dent 1998;46:256-263.
PUBMED
 37. Ilie N, Hickel R. Resin composite restorative materials. Aust Dent J 2011;56(Supplement 1):59-66. 
PUBMED | CROSSREF
 38. Finlay N, Hahnel S, Dowling AH, Fleming GJ. The in vitro wear behavior of experimental resin-based 
composites derived from a commercial formulation. Dent Mater 2013;29:365-374. 
PUBMED | CROSSREF
 39. Barkmeier WW, Erickson RI, Latta MA, Wilwerding TM. Wear rates of resin composites. Oper Dent 
2013;38:226-233. 
PUBMED | CROSSREF
 40. Barkmeier WW, Takamizawa T, Erickson RL, Tsujimoto A, Latta M, Miyazaki M. Localized and 
generalized simulated wear of resin composites. Oper Dent 2015;40:322-335. 
PUBMED | CROSSREF
 41. Mitra SB, Wu D, Holmes BN. An application of nanotechnology in advanced dental materials. J Am Dent 
Assoc 2003;134:1382-1390. 
PUBMED | CROSSREF
 42. Egilmez F, Ergun G, Cekic-Nagas I, Vallittu PK, Lassila LV. Estimation of the surface gloss of dental nano 
composites as a function of color measuring geometry. Am J Dent 2012;25:220-226.
PUBMED
 43. Sideridou ID, KarabelaMM, Vouvoudi EC. Physical properties of current dental nanohybrid and nanofill 
light-cured resin composites. Dent Mater 2011;27:598-607. 
PUBMED | CROSSREF
 44. Ilie N, Rencz A, Hickel R. Investigations towards nano-hybrid resin-based composites. Clin Oral Investig 
2013;17:185-193. 
PUBMED | CROSSREF
 45. Hahnel S, Schultz S, Trempler C, Ach B, Handel G, Rosentritt M. Two-body wear of dental restorative 
materials. J Mech Behav Biomed Mater 2011;4:237-244. 
PUBMED | CROSSREF
 46. Oliveira GU, Mondelli RF, Charantola Rodrigues M, Franco EB, Ishikiriama SK, Wang L. Impact of filler 
size and distribution on roughness and wear of composite resin after simulated toothbrushing. J Appl 
Oral Sci 2012;20:510-516. 
PUBMED | CROSSREF
 47. Takahashi H, Finger WJ, Endo T, Kanehira M, Koottathape N, Komatsu M, Balkenhol M. Comparative 
evaluation of mechanical characteristics of nanofiller containing resin composites. Am J Dent 2011;24:264-270.
PUBMED
 48. Seemann R, Pfefferkorn F, Hickel R. Behaviour of general dental practitioners in Germany regarding 
posterior restorations with flowable composites. Int Dent J 2011;61:252-256. 
PUBMED | CROSSREF
 49. Lawson NC, Radhakrishnan R, Givan DA, Ramp LC, Burgess JO. Two-year randomized, controlled 
clinical trial of a flowable and conventional composite in class I restorations. Oper Dent 2015;40:594-602. 
PUBMED | CROSSREF
 50. Sumino N, Tsubota K, Takamizawa T, Shiratsuchi K, Miyazaki M, Latta MA. Comparison of the wear 
and flexural characteristics of flowable resin composites for posterior lesions. Acta Odontol Scand 
2013;71:820-827. 
PUBMED | CROSSREF
 51. Shinkai K, Taira Y, Suzuki S, Suzuki M. In vitro wear of flowable resin composite for posterior restorations. 
Dent Mater J 2016;35:37-44. 
PUBMED | CROSSREF
11/13https://rde.ac https://doi.org/10.5395/rde.2021.46.e18
Wear of composite resin restorations
http://www.ncbi.nlm.nih.gov/pubmed/9291250
https://doi.org/10.1046/j.1365-2842.1997.00528.x
http://www.ncbi.nlm.nih.gov/pubmed/3497964
https://doi.org/10.1177/00220345870660S103
http://www.ncbi.nlm.nih.gov/pubmed/7758846
https://doi.org/10.1016/0109-5641(94)90050-7
http://www.ncbi.nlm.nih.gov/pubmed/10737879
https://doi.org/10.1002/(SICI)1097-4636(20000605)50:3<375::AID-JBM11>3.0.CO;2-R
http://www.ncbi.nlm.nih.gov/pubmed/9693539
http://www.ncbi.nlm.nih.gov/pubmed/21564116
https://doi.org/10.1111/j.1834-7819.2010.01296.x
http://www.ncbi.nlm.nih.gov/pubmed/23333236
https://doi.org/10.1016/j.dental.2012.12.005
http://www.ncbi.nlm.nih.gov/pubmed/22856679
https://doi.org/10.2341/12-112-L
http://www.ncbi.nlm.nih.gov/pubmed/25706614
https://doi.org/10.2341/13-155-L
http://www.ncbi.nlm.nih.gov/pubmed/14620019
https://doi.org/10.14219/jada.archive.2003.0054
http://www.ncbi.nlm.nih.gov/pubmed/23082386
http://www.ncbi.nlm.nih.gov/pubmed/21477852
https://doi.org/10.1016/j.dental.2011.02.015
http://www.ncbi.nlm.nih.gov/pubmed/22392162
https://doi.org/10.1007/s00784-012-0689-1
http://www.ncbi.nlm.nih.gov/pubmed/21316610
https://doi.org/10.1016/j.jmbbm.2010.06.001
http://www.ncbi.nlm.nih.gov/pubmed/23138735
https://doi.org/10.1590/S1678-77572012000500003
http://www.ncbi.nlm.nih.gov/pubmed/22165452
http://www.ncbi.nlm.nih.gov/pubmed/21995372
https://doi.org/10.1111/j.1875-595X.2011.00068.x
http://www.ncbi.nlm.nih.gov/pubmed/26237643
https://doi.org/10.2341/15-038-C
http://www.ncbi.nlm.nih.gov/pubmed/23638859
https://doi.org/10.3109/00016357.2012.734405
http://www.ncbi.nlm.nih.gov/pubmed/26843441
https://doi.org/10.4012/dmj.2015-080
 52. Tsujimoto A, Barkmeier WW, Takamizawa T, Latta MA, Miyazaki M. Mechanical properties, volumetric 
shrinkage and depth of cure of short fiber-reinforced resin composite. Dent Mater J 2016;35:418-424. 
PUBMED | CROSSREF
 53. Dionysopoulos D, Tolidis K, Gerasimou P. Polymerization efficiency of bulk-fill dental resin composites 
with different curing modes. J Appl Polym Sci 2016;133:43392. 
CROSSREF
 54. Magno MB, Nascimento GC, Rocha YS, Ribeiro BD, Loretto SC, Maia LC. Silorane-based composite resin 
restorations are not better than conventional composites – a meta-analysis of clinical studies. J Adhes 
Dent 2016;18:375-386.
PUBMED
 55. Torres C, Augusto MG, Mathias-Santamaria IF, Di Nicoló R, Borges AB. Pure ormocer vs methacrylate 
composites on posterior teeth: a double-blinded randomized clinical trial. Oper Dent 2020;45:359-367. 
PUBMED | CROSSREF
 56. Dejak B, Młotkowski A. A comparison of stresses in molar teeth restored with inlays and direct 
restorations, including polymerization shrinkage of composite resin and tooth loading during 
mastication. Dent Mater 2015;31:e77-e87. 
PUBMED | CROSSREF
 57. Tanoue N, Murakami M, Koizumi H, Atsuta M, Matsumura H. Depth of cure and hardness of an indirect 
composite polymerized with three laboratory curing units. J Oral Sci 2007;49:25-29. 
PUBMED | CROSSREF
 58. Yamamoto T, Nakamura Y, Nishide A, Kubota Y, Momoi Y. Contraction stresses in direct and indirect 
composite restorations compared by crack analysis. J Adhes Dent 2013;15:47-54.
PUBMED
 59. Hirata M, Koizumi H, Tanoue N, Ogino T, Murakami M, Matsumura H. Influence of laboratory light 
sources on the wear characteristics of indirect composites. Dent Mater J 2011;30:127-135. 
PUBMED | CROSSREF
 60. Ferracane JL, Condon JR. Post-cure heat treatments for composites: properties and fractography. Dent 
Mater 1992;8:290-295. 
PUBMED | CROSSREF
 61. Angeletaki F, Gkogkos A, Papazoglou E, Kloukos D. Direct versus indirect inlay/onlay composite 
restorations in posterior teeth. A systematic review and meta-analysis. J Dent 2016;53:12-21. 
PUBMED | CROSSREF
 62. da Veiga AM, Cunha AC, Ferreira DM, da Silva Fidalgo TK, Chianca TK, Reis KR, Maia LC. Longevity of 
direct and indirect resin composite restorations in permanent posterior teeth: a systematic review and 
meta-analysis. J Dent 2016;54:1-12. 
PUBMED | CROSSREF
 63. Mandikos MN, McGivney GP, Davis E, Bush PJ, Carter JM. A comparison of the wear resistance and 
hardness of indirect composite resins. J Prosthet Dent 2001;85:386-395. 
PUBMED | CROSSREF
 64. Furuichi T, Takamizawa T, Tsujimoto A, Miyazaki M, Barkmeier WW, Latta MA. Mechanical properties 
and sliding-impact wear resistance of self-adhesive resin cements. Oper Dent 2016;41:E83-E92. 
PUBMED | CROSSREF
 65. Tsujimoto A, Barkmeier WW, Takamizawa T, Watanabe H, Johnson WW, Latta MA, Miyazaki M. 
Simulated localized wear of resin luting cements for universal adhesive systems with different curing 
mode. J Oral Sci 2018;60:29-36. 
PUBMED | CROSSREF
 66. Takamizawa T, Barkmeier WW, Latta MA, Berry TP, Tsujimoto A, Miyazaki M. Simulated wear of self-
adhesive resin cements. Oper Dent 2016;41:327-338. 
PUBMED | CROSSREF
 67. Tsujimoto A, Barkmeier WW, Takamizawa T, Latta MA, Miayazaki M. Relationship between simulated 
gap wear and generalized wear of resin luting cements. Oper Dent 2017;42:E148-E158. 
PUBMED | CROSSREF
 68. Miyazaki T, Hotta Y. CAD/CAM systems available for the fabrication of crown and bridge restorations. 
Aust Dent J 2011;56(Supplement 1):97-106. 
PUBMED | CROSSREF
 69. Yoshida F, Tsujimoto A, Ishii R, Nojiri K, Takamizawa T, Miyazaki M, Latta MA. Influence of surface 
treatment of contaminated lithium disilicate and leucite glass ceramics on surface free energy and bond 
strength of universal adhesives. Dent Mater J 2015;34:855-862. 
PUBMED | CROSSREF
12/13https://rde.ac https://doi.org/10.5395/rde.2021.46.e18
Wear of composite resin restorations
http://www.ncbi.nlm.nih.gov/pubmed/27251997
https://doi.org/10.4012/dmj.2015-280
https://doi.org/10.1002/app.43392
http://www.ncbi.nlm.nih.gov/pubmed/27695714
http://www.ncbi.nlm.nih.gov/pubmed/32053457
https://doi.org/10.2341/19-079-C
http://www.ncbi.nlm.nih.gov/pubmed/25544104
https://doi.org/10.1016/j.dental.2014.11.016
http://www.ncbi.nlm.nih.gov/pubmed/17429179
https://doi.org/10.2334/josnusd.49.25
http://www.ncbi.nlm.nih.gov/pubmed/23534000
http://www.ncbi.nlm.nih.gov/pubmed/21415552
https://doi.org/10.4012/dmj.2010-043
http://www.ncbi.nlm.nih.gov/pubmed/1303369https://doi.org/10.1016/0109-5641(92)90102-I
http://www.ncbi.nlm.nih.gov/pubmed/27452342
https://doi.org/10.1016/j.jdent.2016.07.011
http://www.ncbi.nlm.nih.gov/pubmed/27523636
https://doi.org/10.1016/j.jdent.2016.08.003
http://www.ncbi.nlm.nih.gov/pubmed/11319537
https://doi.org/10.1067/mpr.2001.114267
http://www.ncbi.nlm.nih.gov/pubmed/26918929
https://doi.org/10.2341/15-033-L
http://www.ncbi.nlm.nih.gov/pubmed/29375099
https://doi.org/10.2334/josnusd.16-0815
http://www.ncbi.nlm.nih.gov/pubmed/26669501
https://doi.org/10.2341/14-227-L
http://www.ncbi.nlm.nih.gov/pubmed/28829931
https://doi.org/10.2341/16-270-L
http://www.ncbi.nlm.nih.gov/pubmed/21564120
https://doi.org/10.1111/j.1834-7819.2010.01300.x
http://www.ncbi.nlm.nih.gov/pubmed/26632235
https://doi.org/10.4012/dmj.2015-123
 70. Kömürcüoğlu MB, Sağırkaya E, Tulga A. Influence of different surface treatments on bond strength of 
novel CAD/CAM restorative materials to resin cement. J Adv Prosthodont 2017;9:439-446. 
PUBMED | CROSSREF
 71. Alamoush RA, Silikas N, Salim N, Al-Nasrawi S, Satterthwaite JD. Effect of the composition of CAD/CAM 
composite blocks on mechanical properties. Biomed Res Int 2018;2018:4893143. 
PUBMED | CROSSREF
 72. Papadopoulos C, Dionysopoulos D, Tolidis K, Kouros P, Koliniotou-Koumpia E, Tsitrou EA. Structural 
integrity evaluation of large MOD restorations fabricated with a bulk-fill and a CAD-CAM resin composite 
material. Oper Dent 2019;44:312-321. 
PUBMED | CROSSREF
 73. Magne P, Dietschi D, Holz J. Esthetic restorations for posterior teeth: practical and clinical 
considerations. Int J Periodontics Restorative Dent 1996;16:104-119.
PUBMED
 74. Ilie N, Bucuta S, Draenert M. Bulk-fill resin-based composites: an in vitro assessment of their mechanical 
performance. Oper Dent 2013;38:618-625. 
PUBMED | CROSSREF
 75. Wassell RW, Walls AW, McCabe JF. Direct composite inlays versus conventional composite restorations: 
5-year follow-up. J Dent 2000;28:375-382. 
PUBMED | CROSSREF
 76. Ruse ND, Sadoun MJ. Resin-composite blocks for dental CAD/CAM applications. J Dent Res 
2014;93:1232-1234. 
PUBMED | CROSSREF
 77. Lawson NC, Bansal R, Burgess JO. Wear, strength, modulus and hardness of CAD/CAM restorative 
materials. Dent Mater 2016;32:e275-e283. 
PUBMED | CROSSREF
 78. Lauvahutanon S, Takahashi H, Shiozawa M, Iwasaki N, Asakawa Y, Oki M, Finger WJ, Arksornnukit M. 
Mechanical properties of composite resin blocks for CAD/CAM. Dent Mater J 2014;33:705-710. 
PUBMED | CROSSREF
 79. Tsujimoto A, Barkmeier WW, Takamizawa T, Latta MA, Miyazaki M. Influence of thermal cycling on 
flexural properties and simulated wear of computer-aided design/computer-aided manufacturing resin 
composites. Oper Dent 2017;42:101-110. 
PUBMED | CROSSREF
 80. Papadopoulos K, Pahinis K, Saltidou K, Dionysopoulos D, Tsitrou E. Evaluation of the surface 
characteristics of dental CAD/CAM materials after different surface treatments. Materials (Basel) 
2020;13:981. 
PUBMED | CROSSREF
 81. Dionysopoulos D. Smart materials in dentistry. Stoma (Thessaloniki) 2016;44:83-92.
 82. Althaqafi KA, Satterthwaite J, Silikas N. A review and current state of autonomic self-healing 
microcapsules-based dental resin composites. Dent Mater 2020;36:329-342. 
PUBMED | CROSSREF
13/13https://rde.ac https://doi.org/10.5395/rde.2021.46.e18
Wear of composite resin restorations
http://www.ncbi.nlm.nih.gov/pubmed/29279763
https://doi.org/10.4047/jap.2017.9.6.439
http://www.ncbi.nlm.nih.gov/pubmed/30426009
https://doi.org/10.1155/2018/4893143
http://www.ncbi.nlm.nih.gov/pubmed/30444690
https://doi.org/10.2341/18-013-L
http://www.ncbi.nlm.nih.gov/pubmed/9084299
http://www.ncbi.nlm.nih.gov/pubmed/23570302
https://doi.org/10.2341/12-395-L
http://www.ncbi.nlm.nih.gov/pubmed/10856800
https://doi.org/10.1016/S0300-5712(00)00013-0
http://www.ncbi.nlm.nih.gov/pubmed/25344335
https://doi.org/10.1177/0022034514553976
http://www.ncbi.nlm.nih.gov/pubmed/27639808
https://doi.org/10.1016/j.dental.2016.08.222
http://www.ncbi.nlm.nih.gov/pubmed/25273052
https://doi.org/10.4012/dmj.2014-208
http://www.ncbi.nlm.nih.gov/pubmed/27802120
https://doi.org/10.2341/16-046-L
http://www.ncbi.nlm.nih.gov/pubmed/32098305
https://doi.org/10.3390/ma13040981
http://www.ncbi.nlm.nih.gov/pubmed/31883618
https://doi.org/10.1016/j.dental.2019.12.005
	Wear of contemporary dental composite resin restorations: 
a literature review
	INTRODUCTION
	TYPES OF WEAR OF COMPOSITE MATERIALS
	Abrasive wear
	Adhesive wear
	Fatigue wear
	Corrosive wear
	WEAR OF DIFFERENT DENTAL COMPOSITE RESIN MATERIALS
	WEAR OF DIRECT COMPOSITE RESIN RESTORATIONS
	WEAR OF INDIRECT COMPOSITE RESIN RESTORATIONS
	WEAR OF COMPOSITE CAD/CAM MATERIALS
	CONCLUSIONS
	REFERENCES