RESEARCH AND EDUCATION

Friction and wear behavior of chairside CAD-CAM materials

against different types of antagonists: An in vitro study
Beyza Zaim, DDS,a Tugba Serin Kalay, DDS, PhD,b and Gencaga Purcek, PhDc

Wear is the loss of material ABSTRACT

from the surface that occurs Statement of problem. Studies on the friction and wear behavior of recently introduced chairside
when that surface is exposed computer-aided design and computer-aided manufacture (CAD-CAM) restorative materials are
to another surface or chemical lacking.
substance.1,2 Tribology clas-
Purpose. The purpose of this in vitro study was to evaluate the wear behavior of chairside CAD-
sifies wear as adhesive wear, CAM materials against different types of antagonists (human tooth enamel, composite resin, and
abrasive wear, fatigue, or cor- feldspathic porcelain).
rosive wear according to its
Material and methods. Specimens (14×14×2 mm) of different CAD-CAM materials (Brilliant Crios,
mechanisms.3 In dentistry, Lava Ultimate, Vita Enamic, Vita Suprinity) were obtained by using a low-speed precision cutter
wear is a physiological process (n=10). Wear tests were performed with a 20-N load, 2.5-mm/s sliding speed, 1-mm sliding
that occurs from the contact of distance, and 1500 cycles via a tribometer according to ASTM-G133. The coefficient of friction
teeth. Nonphysiological wear (CoF) of the material pairs was measured and recorded by using a special software program.
can negatively affect both the Surface roughness (Ra), maximum wear depth, and mean maximum wear depth were measured
function and esthetics of with a profilometer, and values were analyzed by using 2-way ANOVA and the Bonferroni
occlusal relationships. 2 ,4 correction. Vickers hardness of CAD-CAM specimens was determined with a microhardness
tester. Microhardness values were analyzed by using 1-way ANOVA and Tukey post hoc tests.
Testing the friction and wear Worn surfaces were observed by scanning electron microscopy and a 3D noncontact
of restorative materials has profilometer to determine the wear pattern and primary wear mechanisms.
mostly been performed with
Results. Significant differences were found in the interactions between CAD-CAM materials and
tests of pin-on-disk type.5-9
different types of antagonists (P<.001) for maximum wear depth, mean maximum wear depth,
For in vitro friction and wear CoF, and Ra values.
tests, 2 accepted models have
been identified: 2-body friction Conclusions. Vita Suprinity exhibited superior wear resistance and Ra against all antagonists
compared with other CAD-CAM materials. However, Vita Suprinity increased the destructive
and wear and 3-body friction
effects on antagonists. The safety of CAD-CAM materials is best determined when the wear
and wear. An abrasive slurry is behavior of materials and their effect on the antagonist are evaluated together. (J Prosthet Dent
used between the specimen 2021;-:---)
and the antagonist in 3-body
tests.10 The wear behavior of materials depends on development of computer-aided design and computer-
factors such as elastic modulus, fracture toughness, aided manufacture (CAD-CAM) systems, newly devel-
hardness, filler size, filler volume, and filler hardness,11-16 oped esthetic materials have been introduced, and
and clinically the antagonist may be of porcelain, gold indirect esthetic restorations are commonly produced at
alloy, composite resin, or enamel.17,18 With the the chairside.19,20

Supported by Karadeniz Technical University Coordination Unit of Scientific Research Project No. 2019-8358.
a
Research Assistant, Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
b
Assistant Professor, Department of Restorative Dentistry, Faculty of Dentistry, Karadeniz Technical University, Trabzon, Turkey.
c
Professor, Department of Mechanical Engineering, Karadeniz Technical University, Trabzon, Turkey.

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Clinical Implications
The type of antagonist and the structure of the
material are important factors in friction and wear
behavior. Resin-containing CAD-CAM materials
exhibit greater wear depth but may cause less
damage to the antagonist.
Lava Ultimate (3M ESPE) is a resin nanoceramic
material that contains 80% nanosilica and nanozirconia
particles embedded in a 20% resin matrix. Vita Enamic
(Vita Zahnfabrik) is a polymer-infiltrated ceramic
network that contains an 86% porous feldspathic ceramic
matrix infiltrated with a 14% polymer.21,22 Brilliant Crios
(Coltène) is a recently introduced composite resin ma-
terial with amorphous silica and glass ceramic particles in
a cross-linked methacrylate matrix.23 Vita Suprinity (Vita
Zahnfabrik) is a zirconia-reinforced lithium silicate
ceramic.24 The manufacturer claims that this material
combines the positive characteristics of zirconia and glass
ceramic.25,26
Studies on the friction and wear behavior of recently
introduced chairside CAD-CAM restorative materials are
lacking. In vitro studies have evaluated the wear behavior
of different CAD-CAM materials, but generally against a
single type of antagonist such as tooth enamel,5,27-30
zirconia,2,19 or alumina.31 The friction and wear
behavior against different antagonist types is important
for determining restoration survival and antagonist
health.32 Thus, further studies are needed. The purpose
of this in vitro study was to evaluate the 2-body wear
behavior of commercially available chairside CAD-CAM
materials against different types of antagonists. The null
hypothesis was that no difference would be found in the
wear behavior of CAD-CAM materials.
MATERIAL AND METHODS
This study was approved by the Ethical Research Com-
mittee of the Karadeniz Technical University (2019/41).
The characteristic features of CAD-CAM and antagonist
materials used in this study are shown in Table 1. The
CAD-CAM specimens (14×14×2 mm) were obtained by
using a low-speed precision cutter (Micracut 125 Low-
Speed Precision Cutter; Metkon) under water-cooling
(n=10). Vita Suprinity specimens were final crystallized
in a furnace (Programat P300; Ivoclar Vivadent AG) ac-
cording to the manufacturer’s recommendations. Then,
all specimens were attached to the device with autopo-
lymerizing acrylic resin (SC; Imicryl Dental). Additionally,
specimens were polished with 800-, 1000-, 1200-, and
2000-grit SiC paper in a polishing machine (Beta Grinder
Polisher; Buehler).
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Table 1. Characteristic features of materials tested
Material Composition Manufacturers Lot.
Brilliant Crios - 70.7% Amorphous silica (<20 nm), Coltène 60019987
barium glass (<1 mm)
- 29.3% Cross-linked methacrylate
(Bis-GMA, Bis-EMA, TEGDMA)
Lava Ultimate - 80% SiO2 (20 nm), ZrO2 (4-11 nm) 3M ESPE N894216
- 20% Resin Matrix (Bis-GMA, UDMA,
Bis-EMA, TEGDMA)
Vita Enamic - 86% Feldspathic porcelain Vita 78440
(3.5-10 mm) Zahnfabrik
SiO2 (58%-63%), Al2O3 (20%-23%),
Na2O (6%-11%), K2O (4%-6%)
- 14% Polymer (UDMA, TEGDMA)
Vita Suprinity - 56%-64% SiO2, 1%-4% Al2O3, 15%- Vita 79911
2% 1 Li2O, 8%-12% ZrO2, 1%-4% K2O Zahnfabrik
(w0.5 mm)
Composite - 84.5% Zirconia/silica; 0.01-3.5 mm 3M ESPE NA26590
resin, Filtek 16.5% Resin (Bis-GMA, UDMA, Bis-
Z250 EMA)
Feldspathic - Sodium potassium aluminosilicate Dentsply 18002652
porcelain, - Tin oxide Sirona
Ceramco 3
Al2O3, aluminum oxide; Bis-EMA, ethoxylated bisphenol-A dimethacrylate; Bis-GMA,
bisphenyl glycidyl dimethacrylate; K2O, potassium oxide; Li2O, lithium oxide; Na2O,
sodium oxide; SiO2, silicon dioxide; TEGDMA, triethylene glycol dimethacrylate; UDMA,
urethane dimethacrylate; ZrO2, zirconium dioxide.
Enamel antagonists were obtained from the palatal
cusps of impacted human maxillary third molars. Com-
posite resin and porcelain antagonists were prepared by
using a standard antagonist design that had a slightly
conical shape with a round Ø3-mm tip. The composite
resin was filled into a Teflon mold in increments of 2 mm,
and each layer was polymerized for 20 seconds (Elipar
S10; 3M ESPE). Feldspathic porcelain was prepared ac-
cording to the manufacturer’s instructions. The antago-
nists were embedded in acrylic resin to adapt to the
wear-testing machine.
The surface roughness (Ra) of each specimen was
measured with a profilometer (MarSurf PS 10; Mahr)
before and after the wear tests. Three measurements per
specimen were made over a transverse length (Lt) of 4.8
mm with a cutoff value of 0.8 mm and a stylus speed of
0.1 mm/s.
The Vickers hardness (Hv) of the CAD-CAM speci-
mens was measured with a microhardness tester
(Duramin Microhardness Tester; Struers) under a normal
load of 1.96 N and dwell time of 15 seconds. Three
separate tests were performed for each specimen, and
their mean values were used as the final measurement.
A pin-on-disk-type tribometer (Tribolog; UTS
Design) was used for the 2-body friction and wear tests.
All tests were performed according to ASTM G133 under
a 20-N load, 2.5-mm/s sliding speed, 1-mm sliding dis-
tance (stroke), and 1500 cycles.3,33 Room-temperature
distilled water was used as the lubricant. The coefficient
of friction (CoF) was measured and recorded by using a
software program (TriboSoft-m; UTS Design). Wear track
profiles were obtained with a profilometer (MarSurf PS
Zaim et al
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Table 2. Two-way analysis of variance for surface roughness, coefficient Table 3. Mean values and standard deviations for surface roughness (Ra)
of friction, maximum depth, and mean maximum depth Antagonist
Type III After Wear Test
CAD-CAM
Sum of Mean
Material Before Wear Test Composite Enamel Porcelain
Parameter Source Squares df Square F P
Brilliant Crios 0.10 ±0.01Aa 0.28 ±0.05Aa 1.19 ±0.28Ab 1.42 ±0.28Ac
Surface CAD-CAM 6.694 3 2.231 48.196 <.001
roughness Lava Ultimate 0.09 ±0.03Aa 0.39 ±0.02ABb 1.13 ±0.41Ac 1.43 ±0.43Ad
Antagonists 34.847 3 11.616 250.884 <.001
Vita Enamic 0.17 ±0.02Aa 0.54 ±0.11Bb 1.09 ±0.25Ac 1.69 ±0.33Bd
CAD- 4.684 9 0.520 11.241 <.001
CAM×Antagonists Vita Suprinity 0.04 ±0.02Aa 0.31 ±0.03Ab 0.37 ±0.08Bb 0.62 ±0.13Cc
Error 6.667 144 0.046 - - CAD-CAM, computer-aided design and computer-aided manufacturing. Different
Total 127.542 160 - - - uppercase superscript letters indicate statistically significant difference between CAD-
CAM materials (P<.05). Different lowercase superscript letters indicate statistically
Coefficient CAD-CAM 2.264 3 0.755 226.287 <.001
significant difference between antagonist type (P<.05).
of friction Antagonists 1.086 2 0.543 162.759 <.001
CAD- 0.249 6 0.041 12.435 <.001
CAM×Antagonists
Error 0.360 108 0.003 - - are shown in Table 2. The 2-way ANOVA showed that
Total 35.993 120 - - - the factors CAD-CAM materials and antagonists signif-
Maximum depth CAD-CAM 10896.870 3 3632.290 34.421 <.001 icantly affected the Ra, CoF, maximum depth, and mean
Antagonists 49497.734 2 24748.867 234.527 <.001
maximum wear depth (P<.001). The mean Ra values and
CAD- 7262.123 6 1210.354 11.470 <.001
CAM×Antagonists standard deviation before and after the wear test for all
Error 11396.900 108 105.527 - - tested materials are shown in Table 3. No significant
Total 269376.506 120 - - - difference was found between the initial Ra values of the
Mean maximum CAD-CAM 8424.385 3 2808.128 27.141 <.001 CAD-CAM materials (P>.05). All CAD-CAM materials
depth Antagonists 38528.194 2 19264.097 186.190 <.001 exhibited the highest Ra values after wear against por-
CAD- 7378.439 6 1229.740 11.886 <.001 celain (P<.05). Vita Enamic generally showed the highest
CAM×Antagonists
Ra values, while Vita Suprinity generally had the lowest
Error 11174.207 108 103.465 - -
Ra values.
Total 218680.879 120 - - -
The 1-way ANOVA showed a significant difference in
CAD-CAM, computer-aided design and computer-aided manufacturing.
the microhardness values between the CAD-CAM ma-
terials (df=3, F=855.466, P<.001). Vita Suprinity displayed
10; Mahr) after the tests. The transverse length was set as
the highest microhardness value (P<.05), while Brilliant
1.5 mm during this scan. Five measurements were per-
Crios showed the lowest value. No significant difference
formed for each specimen. The maximum depth and
was found between Brilliant Crios and Lava Ultimate
mean maximum depth wear values were calculated by
(P=.478). The microhardness, CoF, maximum depth, and
using wear profiles.34
mean maximum depth values and standard deviations
Surface characterization and wear pattern were eval-
for all materials are shown in Table 4.
uated by scanning electron microscopy (SEM) (EVO
All CAD-CAM materials showed the highest CoF
LS10; Zeiss) and a 3D noncontact optical profilometer
value against porcelain and the lowest CoF value against
(mscan; Nanofocus). One specimen from each group was
composite resin (P<.05). Brilliant Crios and Lava Ultimate
selected for SEM surface analysis. The specimens were
exhibited no significant difference in the CoF values
gold sputter-coated (SPI-Module Sputter Coater; Struc-
during wear against composite resin (P=.124) and the
ture Probe Inc), and then their surfaces were examined
enamel (P=.396). Furthermore, no significant difference
by using the secondary electron mode. Additionally, the
was found between Vita Enamic and Vita Suprinity
topography of the wear surfaces and wear tracks was
against the same antagonists (P=.375; P=.060).
evaluated with the 3D noncontact profilometer.
All CAD-CAM materials exhibited the lowest
Statistical analysis was performed with a statistical
maximum depth and mean maximum depth values after
software program (SPSS Statistics for Windows, v17.0;
wear against composite resin. No significant difference
SPSS Inc). The normality of the data was evaluated with
was found between the maximum depth values after the
the Shapiro-Wilk test. Maximum wear depth, mean
wear test against enamel and feldspathic porcelain in
maximum wear depth, CoF, and Ra values were analyzed
Brilliant Crios (P=.721).
by using 2-way ANOVA and Bonferroni correction, and
SEM images of the CAD-CAM materials before and
microhardness values were also analyzed by using 1-way
after the wear test are shown in Figure 1, and the SEM
ANOVA and Tukey post hoc tests (a=.05).
images of the antagonists after the wear test are shown in
Figure 2. From these micrographs, Brilliant Crios, Lava
RESULTS
Ultimate, and Vita Enamic were observed to have minor
From the analysis of variance, the CAD-CAM materials, pitting after wear against composite resin but generally
antagonists, and the interaction between these 2 factors smooth surfaces (Fig. 1B, 1F, 1J). The composite resin

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Table 4. Mean values and standard deviations for maximum depth, mean maximum depth, coefficient of friction, and microhardness
Material Antagonists Maximum Depth (mm) Mean Maximum Depth (mm) Coefficient of Friction (CoF) Microhardness (Hv)
Brilliant Crios Composite 9.43 ±1.64Aa 8.13 ±1.73Aa 0.26 ±0.03Aa 76.73 ±4.14*
Ab Ab
Enamel 61.89 ±15.48 59.93 ±16.33 0.42 ±0.06Ab
Porcelain 63.53 ±13.71Ab 52.28 ±11.60Ab 0.45 ±0.04Ab
Lava Ultimate Composite 13.22 ±2.04ABa 11.72 ±2.05Aa 0.22 ±0.01Aa 92.68 ±2.76*
Enamel 42.74 ±12.45Bb 39.77 ±11.32Bb 0.39 ±0.08Ab
Porcelain 71.22 ±20.34ABc 63.37 ±19.98Bc 0.51 ±0.05Bc
Vita Enamic Composite 19.15 ±3.41 Ba
16.64 ±3.49 Aa
0.56 ±0.02Ba 154.36 ±12.88†
Bb Bb Ba
Enamel 47.14 ±9.17 42.53 ±10.79 0.57 ±0.06
Porcelain 78.39 ±11.04Bc 69.79 ±10.57Bc 0.86 ±0.06Cb
Vita Suprinity Composite 11.50 ±2.01ABa 10.56 ±2.24Aa 0.58 ±0.04Ba 558.05 ±47.22§
Enamel 22.10 ±5.19Cb 20.01 ±6.05Cb 0.62 ±0.09Ba
Porcelain 37.53 ±3.69Cc 33.94 ±4.77Cc 0.72 ±0.04Db

CAD-CAM, computer-aided design and computer-aided manufacturing. Different uppercase superscript letters indicate statistically significant difference between different CAD-CAM materials-
same antagonist pair. Different lowercase superscript letters indicate statistically significant difference between same CAD-CAM materials-different antagonist. Different symbols (*, †, §)
indicate a statistically significant difference between microhardness values.

smeared onto the surface of the Vita Suprinity after wear
is shown in Figure 1N. Brilliant Crios, Lava Ultimate, and
Vita Enamic exhibited microcracking, microploughing,
and delamination after wear against enamel (Fig. 1C, 1G,
1K). Vita Suprinity showed thin grooves in the sliding
direction after wear against enamel (Fig. 1O). All CAD-
CAM materials exhibited parallel scratches and/or
grooves in the direction of sliding contact after wear
against porcelain (Fig. 1D, 1H, 1L, 1P). However, thinner
grooves were observed on worn surfaces of the Vita
Suprinity specimens (Fig. 1P).
Antagonist composite resins exhibited a relatively
smooth surface (Fig. 2A, 2D, 2G, 2J). The enamel against
Brilliant Crios showed few grooves and had the
smoothest surface among the antagonist enamels
(Fig. 2B). In contrast, the enamel against Vita Suprinity
showed cracks, delamination, and concave areas
(Fig. 2K). Grooves were seen in the porcelains against
Brilliant Crios, Lava Ultimate, and Vita Enamic (Fig. 2C,
2F, 2I). Cracks, delamination, and material loss were
observed in the porcelain against Vita Suprinity (Fig. 2L).
The 3D profilometer images of CAD-CAM materials
against various antagonists are shown in Figure 3. The
wear pattern and depth distributions in the worn areas
were observed and found to be consistent with the wear
profiles obtained from the surface and SEM analysis.
DISCUSSION
The 2-body wear behavior of Brilliant Crios, Lava Ulti-
mate, Vita Enamic, and Vita Suprinity was evaluated
against different types of antagonists with a pin-on-disk
test for friction and wear tests.1,5-9 The null hypothesis
that no difference would be found between the wear
behavior of CAD-CAM materials was rejected.
Tooth enamel, composite resin, and feldspathic por-
celain were used as antagonist alternatives to simulate
the oral cavity.2,4,8,18 For the pin-on-disk test
configuration, reciprocation (linear forward and back-
ward) sliding motion was chosen to simulate the motion
and sliding during mastication.3,33 Surface friction and
wear from tooth-to-tooth or tooth-to-restoration contact
has generally been considered 2-body friction and
wear.1,6 In the clinical situation, debris from materials
and the food bolus can act as a third body in the sys-
tem,10 contributing to small oscillations in the friction
coefficient.31
Microstructural parameters can affect the mechanical
and tribological properties of materials.12 Consistent with
a previous study,35 Brilliant Crios and Lava Ultimate
exhibited similar Ra and CoF values after wear tests,
which may be because of their similar microstructural
features.20 Larger particles embedded into the matrix
along with a porous structure13,21,22 may be the reason
that the Vita Enamic exhibited relatively greater rough-
ness and CoF values during the friction and wear tests
(Tables 3 and 4).
Consistent with the present study, Vita Suprinity has
been reported to show generally lower Ra than the other
CAD-CAM materials because of its relatively smaller
crystal size.24 Its relatively higher CoF value may be
related to the addition of zirconia particles, which may
influence friction behavior, especially in the running-in
period, as such particles can act as load-carrying parti-
cles inside the matrix of the ceramic.9,36 During the
subsequent sliding or running period, these particles
begin to migrate to the interface with an increasing
friction force.9
The Ra and CoF values of materials differed according
to the antagonist type. The higher values and increased
wear depth associated with the porcelain antagonist can
be attributed to its greater hardness and porous
structure.11,14,15
This study demonstrated that the maximum wear
depth values of Lava Ultimate and Brilliant Crios against
porcelain were similar to and slightly lower than that of

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Figure 1. Scanning electron microscope images of CAD-CAM materials. Original magnification ×2000. A, Brilliant Crios surface before wear. B, Brilliant
Crios against composite resin. C, Brilliant Crios against enamel. D, Brilliant Crios against porcelain. E, Lava Ultimate surface before wear. F, Lava Ultimate
against composite resin. G, Lava Ultimate against enamel. H, Lava Ultimate against porcelain. I, Vita Enamic surface before wear. J, Vita Enamic against
composite resin. K, Vita Enamic against enamel. L, Vita Enamic against porcelain.

Vita Enamic. Santos et al37 studied the wear mechanisms
of Vita Enamic and reported that Vita Enamic showed a
high wear rate because of degradation of its organic
binder phase, likely from fatigue. The study by Santos
et al37 was consistent with previous studies that reported
similar wear depth values for Lava Ultimate and Vita
Enamic against enamel.5,28 Brilliant Crios exhibited the
greatest maximum depth and mean maximum depth
values against enamel, possibly because it had the lowest
microhardness and filling ratio among the materials. The
higher loss in nanofill composite resins might be because
the nanosized filler particles are too small to provide
preferential load support and the small particles might be
swept away by the asperities on the antagonist.38
Vita Suprinity had the highest microhardness values
among the CAD-CAM materials and exhibited the
lowest maximum depth and the mean maximum depth
values after wear against enamel and feldspathic

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Figure 1. (Continued). M, Vita Suprinity surface before wear. N, Vita Suprinity against composite resin. O, Vita Suprinity against enamel. P, Vita Suprinity
against porcelain. CAD-CAM, computer-aided design and computer-aided manufacturing.

porcelain. Consistent with the present study, Matzinger
et al,20 evaluating the wear behavior of CAD-CAM blocks
against ceramic antagonists, reported that the lowest
maximum wear depth was also observed in Vita
Suprinity. The microstructure of Vita Suprinity consists of
a relatively homogeneous fine crystalline structure that
increases flexural strength and exhibits improved me-
chanical and tribological properties after
crystallization.25,26
The surfaces of the specimens were analyzed by SEM,
and the wear mechanisms were determined for all ma-
terials. Because the composite resin had a lower hardness
than Vita Suprinity, its wear mechanisms were associated
with plastic deformation on its surface and material
transference as smearing layers.32,38 Wear occurs as as-
perities on the surface of the antagonist and material,
causing reciprocal abrasive tracks. The ploughing,
grooves, cracks, ridges, and particles observed on the
CAD-CAM materials represent abrasive and adhesive
wear.39 In addition, fatigue wear occurred from repeated
loading on the material surface. Because the crystalline
structure in Vita Suprinity is very fine, tracks and grooves
are also thinner than those of other materials (Fig. 1P).
Consistent with the present study, Silva et al31 reported
the highest wear resistance for Vita Suprinity and the
absence of a debris layer on its surface during sliding
compared with Vita Enamic. In the SEM evaluation, tri-
bolayers were noticed on the CAD-CAM materials except
for Vita Suprinity, which may be the result of debris
adhesion through reciprocating sliding wear movement,
which contributes to the removal of material.32
In the present study, more surface damage was
observed on the antagonists against Vita Suprinity that
can be attributed to the high fracture toughness of Vita
Suprinity.16 Ludovichetti et al36 reported similar results
for the wear behavior of different CAD-CAM materials
against bovine enamel. Consistent with the results of the
present study, Yin et al40 reported that Vita Enamic
caused greater wear damage to the antagonist tooth than
Lava Ultimate. Lawson et al27 reported that composite

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Figure 2. Scanning electron microscope images of antagonists. Original magnification ×500. A, Composite resin antagonist against Brilliant Crios.
B, Enamel antagonist against Brilliant Crios. C, Porcelain antagonist against Brilliant Crios. D, Composite resin antagonist against Lava Ultimate.
E, Enamel antagonist against Lava Ultimate. F, Porcelain antagonist against Lava Ultimate. G, Composite resin antagonist against Vita Enamic. H, Enamel
antagonist against Vita Enamic. I, Porcelain antagonist against Vita Enamic. J, Composite resin antagonist against Vita Suprinity. K, Enamel antagonist
against Vita Suprinity. L, Porcelain antagonist against Vita Suprinity.

resins caused less antagonist enamel wear than infil-
trated ceramic and glass ceramics. Additionally, com-
posite resins containing quartz or zirconium silicate fillers
were reported to cause higher enamel wear than micro-
filled composite resins or those containing barium silicate
fillers.41
Limitations of this study included that quantitative
information about the wear depth of the antagonists was
lacking. In addition, it was performed under in vitro
conditions, and it remains unclear to what extent clini-
cally observed wear may differ. Future studies should
include clinical evaluation of the wear properties of these
materials.
Surface deformation can occur in all materials.
Therefore, intraoral repairability and the ability to
repolish the roughened surface are important for

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Figure 3. Three-dimensional profilometer images of CAD-CAM materials against antagonists. A, Brilliant Crios against composite resin. B, Brilliant Crios
against enamel. C, Brilliant Crios against porcelain. D, Lava Ultimate against composite resin. E, Lava Ultimate against enamel. F, Lava Ultimate against
porcelain.

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Figure 3. (Continued). G, Vita Enamic against composite resin. H, Vita Enamic against enamel. I, Vita Enamic against porcelain. J, Vita Suprinity against
composite resin. K, Vita Suprinity against enamel. L, Vita Suprinity against porcelain. CAD-CAM, computer-aided design and computer-aided
manufacturing.

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restoration survival.42 Excessive wear of restorative ma-
terials can lead to functional and esthetic prob-
lems.4,5,17,34 Additionally, there is some concern that
microsized and nanosized wear particles of restorative
materials can be swallowed or inhaled and then accu-
mulate in tissues.13 Further studies are needed to eval-
uate the effect of intraoral wear on anatomic tissues and
the effect of inhalation of the released ions on vital
tissues.
CONCLUSIONS
Based on the findings of this in vitro study, the following
conclusions were drawn:
1. The microstructural and mechanical properties of
the materials and antagonists are effective in con-
trolling the wear behavior of CAD-CAM materials.
2. Brilliant Crios and Lava Ultimate exhibited similar
Ra and CoF values after friction and wear tests. In
addition, Brilliant Crios caused less damage to the
antagonist enamel than other materials.
3. Vita Suprinity exhibited better wear resistance and
surface roughness than other CAD-CAM materials.
However, it had more destructive effects on
antagonists.
4. Brilliant Crios, Lava Ultimate, and Vita Enamic
materials can be considered safer when the wear
behavior of materials and their effect on the
antagonist are evaluated together. However, the
porous nature and large particle size of Vita Enamic
should be considered.
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42. Ruse ND, Sadoun MJ. Resin-composite blocks for dental CAD-CAM appli- Beyza Zaim: Conceptualization, Methodology, Validation, Investigation,
cations. J Dent Res 2014;93:1232-4. Writing e original draft, Visualization. Tugba Serin Kalay: Conceptualization,
Methodology, Writing e review & editing, Visualization, Project administration,
Corresponding author: Resources. Gencaga Purcek: Software, Methodology, Resources, Data curation,
Dr Tugba Serin Kalay Validation, Writing e review & editing.
Department of Restorative Dentistry
Faculty of Dentistry Copyright © 2021 by the Editorial Council for The Journal of Prosthetic Dentistry.
Karadeniz Technical University https://doi.org/10.1016/j.prosdent.2021.09.024

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