Wear evaluation of CAD-CAM dental ceramic materials by chewing simulation

PURPOSE: To evaluate the wear of computer-aided design/computer-aided manufacturing (CAD-CAM) dental ceramic materials opposed by enamel as a function of increased chewing forces. MATERIALS AND METHODS: The enamel cusps of healthy human third molar teeth (n = 40) opposed by materials from CAD-CAM dental ceramic groups (n = 10), including Vita Enamic® (ENA), a polymer-infiltrated ceramic network (PICN); GC Cerasmart® (CERA), a resin nano-ceramic; Celtra® Duo (DUO), a zirconia-reinforced lithium silicate (ZLS) ceramic; and IPS e.max ZirCAD (ZIR), a polycrystalline zirconia, were exposed to chewing simulation (1,200,000 cycles; 120 N load; 1 Hz frequency; 0.7 mm lateral and 2 mm vertical motion). The wear of both enamel cusps and materials was quantified using a 3D laser scanner, and the wear mechanisms were evaluated by scanning electron microscopy (SEM). The results were analysed using Welch ANOVA and Kruskal Wallis test (α = .05). RESULTS: ZIR showed lower volume loss (0.02 ± 0.01 mm(3)) than ENA, CERA and DUO (P = .001, P = .018 and P = .005, respectively). The wear of cusp/DUO [0.59 mm(3) (0.50-1.63 mm(3))] was higher than cusp/CERA[0.17 mm(3) (0.04-0.41 mm(3))] (P = .007). ZIR showed completely different wear mechanism in SEM. CONCLUSION: Composite structured materials such as PICN and ZLS ceramic exhibit more abrasive effect on opposing enamel due to their loss against wear, compared to uniform structured zirconia. The resin nano-ceramic causes the lowest enamel wear thanks to its flexible nano-ceramic microstructure. While zirconia appears to be an enamel-friendly material in wear volume loss, it can cause microstructural defects of enamel.