J Oral Rehabil. 2018;45:539–544. wileyonlinelibrary.com/journal/joor
© 2018 John Wiley & Sons Ltd
1 | INTRODUCTION
Tooth wear is a multifactorial condition, leading to the loss of the
dental hard tissues such as enamel and dentin.
Clinically, tooth wear
is characterised by the loss of anatomic contour of teeth. Pindborg
classified the loss of hard tissues as erosion, attrition or abrasion.
Erosion is chemical wear, not caused by caries, as a result of intrin-
sic or extrinsic acids.
Attrition is intrinsic mechanical wear caused
by two- body interactions.
Abrasion is extrinsic mechanical wear
as a result of other factors than function and/or parafunction, such
as oral hygiene procedures and habits such as nail biting and pen
Both types of mechanical wear occur in the mouth during
daily functions such as mastication, mouth care or parafunctions.
Loss of a considerable amount of tooth substance results in aes-
thetic and functional problems, and even tooth sensitivity might be
Therefore, restoration of the dentition is often needed.
Resin composites are used for a variety of applications, including
the restoration of tooth wear.
Wear of currently used composites
is no longer considered a major concern when applied in small and
medium- sized cavities, whereas larger posterior restorations are still
at risk for extensive wear, especially in bruxers.
In contrast, accord-
ing to a retrospective clinical study, treatments with direct hybrid
Accepted: 3 April 2018
Comparison of wear between occlusal splint materials and
resin composite materials
| R. H. Kuijs
| A. Werner
| C. J. Kleverlaan
| F. Lobbezoo
Department of Oral Kinesiology, Academic
Centre for Dentistry Amsterdam
(ACTA), University of Amsterdam and Vrije
Universiteit Amsterdam, Amsterdam, The
Department of Dental Materials
Science, Academic Centre for Dentistry
Amsterdam (ACTA), University of
Amsterdam and Vrije Universiteit
Amsterdam, Amsterdam, The Netherlands
Frank Lobbezoo, Department of Oral
Kinesiology, Academic Centre for Dentistry
Amsterdam (ACTA), Amsterdam, The
Tooth wear in bruxing patients often results in a need for treatment with composite
restorations. In some cases, bruxing patients receive an occlusal splint as a protective
means as well. However, the wear between these opposing materials has not been
investigated yet. The aim of this in vitro study was to assess the wear of different
splint materials against resin composite materials. A two- body wear test was con-
ducted using the ACTA wear machine. The materials selected for this study were
three composites used for direct restorations (Filtek Z250, CLEARFIL AP- X, and
Filtek Supreme XT) and four occlusal splints materials, viz. a polyamide resin
(ThermoSens) an conventional (hand- processed), milled and printed polymethyl-
methacrylate (PMMA). As antagonistic materials, stainless steel, Filtek Supreme XT
and CLEARFIL AP- X were used. The wear rate of the seven materials was determined
after 200 000 cycles, using a profilometry. The rates were analysed using two- way
ANOVA and post hoc Tukey’s tests. The wear rates were significantly higher for the
conventional and milled PMMA materials than for all other materials (P < .001). The
wear rates of printed PMMA and the polyamide resin were comparable to composite
wear rates. The antagonist materials have minor or no influence on the amount of
wear of the various splint materials (P < .001). In conclusion, different splint materials
yielded different wear rates for all antagonist materials tested. Keeping in mind that
this study is an experimental in vitro study, this finding enables practitioners to
choose the splint material necessary according to their patients’ needs.
attrition, bruxism, PMMA, splint, tooth wear