The Ability of Two Chewing Simulation Devices in Emulating the Clinical Deterioration of Anterior Composite Restorations in Severely Worn Teeth.

PURPOSE: This study investigated the ability of two chewing simulation devices to emulate in vitro the clinical deterioration observed in anterior composite restorations in severe tooth-wear patients. MATERIALS AND METHODS: Advanced tooth wear was simulated in bovine incisors, which were restored with palatal and buccal direct composite veneer restorations. The incisal edges of restorations were subjected to 960K cycles of either compressive loading (Biocycle-V2; 125 N at 2 Hz) or wear and mechanical loading (Rub and Roll; 30 N at 20 rpm). Surface degradation was rated using FDI scores to compare the chewing devices (Fisher's test, a = 0.05). Topography and deterioration of restorations was analyzed using SEM. The ability to emulate the deterioration was investigated by comparing the surface degradation observed in vitro with the clinical degradation observed in restorations placed in severe tooth-wear patients after 3.5 years. RESULTS: Distinct degradation patterns were observed between the simulation devices: Biocycle-V2 generated deterioration that was not comparable to the clinical situation, including contact damage, minor wear, and localized roughening. The degradation caused by Rub and Roll was more similar to the in vivo situation, including wear facets, chipping, delamination, staining, and marginal ditching. The FDI scores were different between the chewing devices for surface/marginal staining, material/retention, and marginal adaptation (p = 0.003). SEM analysis showed microcracking at the interface between composite layers at the incisal edges. CONCLUSIONS: The Rub and Roll chewing device was able to emulate the clinical deterioration observed in anterior restorations in severe tooth-wear patients and thus may be used as an oral-cavity simulation method, contributing to translational research.