The frictional coefficients and associated wear resistance of novel low-shrink resin-based composites.

OBJECTIVES: Frictional forces play a major role in the oral wear process of dental resin-based composites (RBCs) and it would be of interest to consider how the energy from friction is dissipated at the material surface. Consequently, the micromechanical wear properties of conventional methacrylate compared with novel oxirane RBCs were assessed. METHOD: The frictional coefficient (mu), volume loss and Vickers hardness number (VHN) of oxirane (EXL596 and H1) and methacrylate RBCs (Z100 and Filtek Z250) were evaluated. Archard's wear equation was implemented to obtain the wear coefficient (K) and expressed as a 'fraction of friction' (K/micro) to indicate the dissipation of frictional energy that resulted in wear. Scanning electron microscopy (SEM) was used to qualitatively asses the wear facets of each RBC following 50000-cycles. RESULTS: The mean frictional coefficients observed between the oxirane and methacrylate RBCs were not significantly different (P > 0.05). However, the volume loss of EXL596 and H1 (5.9 +/- 0.4 and 4.7 +/- 0.3 x 10(-2) mm(3)) was significantly increased compared with Z100 and Filtek Z250 (1.7 +/- 0.2 and 2.3 +/- 0.3 x 10(-2) mm(3)). The VHN of EXL596 and H1 was either significantly greater (P = 0.021) or similar (P = 0.089) to Filtek Z250, respectively. An increase in K/micro was reported for EXL596 and H1 (34.7 +/- 4.1 and 22.8+ /- 2.4 x 10(-4)) compared with Z100 and Filtek Z250 (8.50 +/- 0.7 x 10(-4) and 8.62 +/- 1.0 x 10(-4)) (P < 0.05). SEM images of the oxirane RBCs exhibited increased surface fatigue and delamination of the surface layers compared with the methacrylate RBC specimens following 50,000-cycles. CONCLUSION: The significant decrease in wear resistance of the oxirane compared with methacrylate RBCs was unexpected since frictional coefficients and/or surface hardness were statistically similar. The decreased wear resistance of EXL596 and H1 compared with Z100 and Filtek Z250 was further explained by the increase in K/micro from wear theory and the associated increase in surface fatigue identified from SEM. The simplistic testing procedure combined with SEM utilized in the current investigation provided a greater insight into the wear mechanism by considering the effect of frictional energy at the specimen surface which may benefit the development of improved wear resistance for experimental RBC materials.

Elasticity of alveolar bone near dental implant-bone interfaces after one month's healing.

Information is scarce about Young's modulus of healing bone surrounding an implant. The purpose of this preliminary study is to quantify elastic properties of pig alveolar bone that has healed for 1 month around titanium threaded dental implants, using the nanoindentation method. Two 2-year-old Sinclair miniswine were used for the study. Nanoindentation tests perpendicular to the bucco-lingual cross section were performed on harvested implant-bone blocks using the Hysitron TriboScope III. Nomarski differential interference contrast microscopy was used to identify pyramidal indentation measurements that were from bone. Reduced moduli, averaged for all anatomical regions, were found to start low (6.17 GPa) at the interface and gradually increase (slope=0.014) to a distance of 150 microm (7.89 GPa) from the implant surface, and then flatten to a slope of 0.001 from 150 to 1500 microm (10.13 GPa). Mean reduced modulus and its relationship to distance did not differ significantly by anatomic location (e.g., coronal, middle, and apical third; P>/=0.28 for all relevant tests) at 1 month after implantation.

Effects of implant healing time on crestal bone loss of a controlled-load dental implant.

The universally accepted concept of delay-loaded dental implants has recently been challenged. This study hypothesizes that early loading (decreased implant healing time) leads to increased bone formation and decreased crestal bone loss. We used 17 minipigs to study implants under a controlled load, with non-loaded implants for comparison. Radiographic and histological assessments were made of the osseointegrated bone changes for 3 healing times (between implant insertion and loading), following 5 months of loading. The effect of loading on crestal bone loss depended on the healing time. Early loading preserved the most crestal bone. Delayed loading had significantly more crestal bone loss compared with the non-loaded controls (2.4 mm vs. 0.64 mm; P < 0.05). The histological assessment and biomechanical analyses of the healing bone suggested that loading and bioactivities of osteoblasts exert a synergistic effect on osseointegration that is likely to support the hypothesis that early loading produces more favorable osseointegration.

Accuracy of a system for creating 3D computer models of dental arches.

Three-dimensional imaging of dental tissues will have a major impact in dentistry if the images are accurate. The purpose of this study was to measure the accuracy and precision of a system for creating three-dimensional images of dental arches. Using vinyl polysiloxane impression materials and improved dental stone, we made 10 stone casts of a "dental" standard with known dimensions. The impressions and casts were scanned by means of a Comet 100 optical scanner. Custom software created three-dimensional images (computer models) from the scanned data. Accuracy was defined as the average of the absolute differences between the computer models and the standard. Precision was the standard deviation of accuracy over 10 repeated measures. Software processing improved the accuracy of the scanner data. Accuracy +/- precision for the casts and impressions was 0.024 +/- 0.002 mm and 0.013 +/- 0.003 mm, respectively. The system produced computer models with sufficient accuracy for clinical application.

Fracture toughness and microhardness of a composite: do they correlate?

OBJECTIVES: Chipping and bulk fracture are major contributors in clinical failures of composite restorations. Fracture toughness (K(Ic)) quantifies susceptibility for fracture, but experimental determination is complicated. It would be beneficial for the dental community if a relatively simple experiment, such as microhardness (HK), could be used to screen composites for fracture resistance. This study explores a possible correlation between K(Ic) and HK. METHODS: Composite cylinders (4mm diameter and approximately 7 mm long) were cured for five combinations of light intensity (I, microm W/cm(2)) and curing time (T, s) to achieve a range of different total light energy densities (I x T=100 x 10, 100 x 20, 300 x 20, 300 x 40, and 700 x 60 microm W s/cm(2)). A chevron-notch was cut in the median plane of the cylinders for the fracture toughness test, which was executed in a displacement control mode at 6 micro m/s cross-head speed (sample size 4). Knoop hardness was determined at the median plane of the cylinders (sample size 6). The tests were performed 15 min and 24h after curing. RESULTS: Both the K(Ic) and HK increased with increased light energy density and storage time. Linear regression analysis indicated a strong correlation between HK and K(Ic) tested at the same time period (R(2)=0.97 and 0.90 for 15 min and 24h, respectively). The correlation became weaker between the different storage times (R(2)=0.71), indicating a change in fracture toughness and/or microhardness mechanisms. CONCLUSION: Fracture toughness of a composite cannot be simply extrapolated from microhardness.

Comparing maximum intercuspal contacts of virtual dental patients and mounted dental casts.

STATEMENT OF PROBLEM: Quantitative measures of occlusal contacts are of paramount importance in the study of chewing dysfunction. A tool is needed to identify and quantify occlusal parameters without occlusal interference caused by the technique of analysis. PURPOSE: This laboratory simulation study compared occlusal contacts constructed from 3-dimensional images of dental casts and interocclusal records with contacts found by use of conventional methods. MATERIALS AND METHODS: Dental casts of 10 completely dentate adults were mounted in a semi-adjustable Denar articulator. Maximum intercuspal contacts were marked on the casts using red film. Intercuspal records made with an experimental vinyl polysiloxane impression material recorded maximum intercuspation. Three-dimensional virtual models of the casts and interocclusal records were made using custom software and an optical scanner. Contacts were calculated between virtual casts aligned manually (CM), aligned with interocclusal records scanned seated on the mandibular casts (C1) or scanned independently (C2), and directly from virtual interocclusal records (IR). Sensitivity and specificity calculations used the marked contacts as the standard. Contact parameters were compared between method pairs. Statistical comparisons used analysis of variance and the Tukey-Kramer post hoc test (P=<.05). RESULTS: Sensitivities (range 0.76-0.89) did not differ significantly among the 4 methods (P=.14); however, specificities (range 0.89-0.98) were significantly lower for IR (P=.0001). Contact parameters of methods CM, C1, and C2 differed significantly from those of method IR (P<.02). The ranking based on method pair comparisons was C2/C1 > CM/C1 = CM/C2 > C2/IR > CM/IR > C1/IR, where ">" means "closer than." CONCLUSIONS: Within the limits of this study, occlusal contacts calculated from aligned virtual casts accurately reproduce articulator contacts.

Helical axis errors affect computer-generated occlusal contacts.

A helical axis describing mandibular motion can be calculated from two distinct positions of the mandible; however, as these positions come closer together, calculation errors increase. This study investigated the effects of errors in the calculated helical axis on simulated mandibular motion by the measurement of changes in occlusal contacts. A standard helical axis was calculated from a simulated lateral movement. A series of digital interocclusal records from centric to a 5 degree mandibular rotation about the standard helical axis was created. Digital dental cast models were aligned to the interocclusal records. Helical axis parameters and occlusal contacts calculated with the use of the aligned digital models were compared with those of the standard. Helical axes calculated from mandibular positions separated by 1.5 degrees to 5.0 degrees yielded equivalent occlusal contacts. Qualitatively, contacts for helical axes calculated from jaw rotations of 0.7 degrees or larger were nearly identical to those of the standard.

Interaction between bioactive glasses and human dentin.

This study explores the interaction between bioactive glasses and dentin from extracted human teeth in simulated oral conditions. Bioactive glasses in the Na(2)O-CaO-P(2)O(5)-SiO(2) and MgO-CaO-P(2)O(5)-SiO(2) systems were prepared as polished disks. Teeth were prepared by grinding to expose dentin and etching with phosphoric acid. A layer of saliva was placed between the two, and the pair was secured with an elastic band and immersed in saliva at 37 degrees C for 5, 21 or 42 days. The bioactive glasses adhered to dentin, while controls showed no such interaction. A continuous interface between the bioactive glass and dentin was imaged using cryogenic-scanning electron microscopy (SEM). However, after alcohol dehydration and critical point drying, fracture occurred due to stresses from dentin shrinkage. SEM investigations showed a microstructurally different material at the fractured interface. Chemical analyses revealed that ions from the glass penetrated into the dentin and that the surface of the glass in contact with the dentin was modified. Microdiffractometry showed the presence of apatite at the interface. Bonding appears to be due to an affinity of collagen for the glass surface and chemical interaction between the dentin and glass, leading to apatite formation at the interface.

Factors influencing optical 3D scanning of vinyl polysiloxane impression materials.

PURPOSE: Future growth in dental practice lies in digital imaging enhancing many chairside procedures and functions. This revolution requires the fast, accurate, and 3D digitizing of clinical records. One such clinical record is the chairside impression. This study investigated how surface angle and surface roughness affect the digitizing of vinyl polysiloxane impression materials. MATERIALS AND METHODS: Seventeen vinyl polysiloxane impression materials were digitized with a white light optical digitizing system. Each sample was digitized at 3 different angles: 0 degrees, 22.5 degrees, and 45 degrees, and 2 digitizer camera f-stops. The digitized images were rendered on a computer monitor using custom software developed under NIH/NIDCR grant DE12225. All the 3D images were rotated to the 0 degrees position, cropped using Corel Photo-Paint 8 (Corel Corp, Ottawa, Ontario, Canada), then saved in the TIFF file format. The impression material area that was successfully digitized was calculated as a percentage of the total sample area, using Optimas 5.22 image processing software (Media Cybernetics, LP, Silver Spring, MD). The dependent variable was a Performance Value calculated for each material by averaging the percentage of area that digitized over the 3 angles. New samples with smooth and rough surfaces were made using the 7 impression materials with the largest Performance Values. These samples were tested as before, but with the additional angle of 60 degrees. Silky-Rock die stone (Whip Mix Corp, Louisville, KY) was used as a control. RESULTS: The Performance Values for the 17 impression materials ranged from 0% to 100%. The Performance Values for the 7 best materials were equivalent to the control at f/11 out to a surface angle of 45 degrees; however, only Examix impression material (GC America Inc, Alsip, IL) was equivalent to the control at f/11/\16. At the 60 degrees surface angle with f/11/\16, the Performance Values were 0% for all the impression materials, whereas that for the control was 90%. The difference in the Performance Values for the smooth and rough surface textures was 7%, which was not significant. CONCLUSIONS: The digitizing performance of vinyl polysiloxane impression materials is highly material and surface angle-dependent and is significantly lower than the die stone control when angles to 60 degrees are included. It is affected to a lesser extent by surface texture.

Nondestructive, in vitro quantification of crown margins.

STATEMENT OF PROBLEM: It is important that artificial crowns fit the prepared tooth accurately, as marginal deficiencies are predisposed to plaque accumulation and lead to increased risk of periodontal disease. Various methods of evaluation for marginal fit are described in the literature, but most approaches are limited by destructive methods of assessment and/or small points of measurement. PURPOSE: This study compared, in vitro, the marginal fit of 4 types of complete crowns on human premolar teeth with the use of nondestructive profilometry. This method determined whether fit was influenced by type of crown or surface morphology of the tooth, namely, grooved or ungrooved surfaces. MATERIAL AND METHODS: Four groups of specimens were prepared for complete crowns: group BA, bonding alloy with chamfer finish line; group G, gold alloy with chamfer finish line; group PC, porcelain with a chamfer finish line; and group PS, porcelain with a shoulder finish line. Two profiles of grooved mesial and ungrooved distal surfaces of the teeth were performed: (1) teeth prepared for each type of crown and (2) teeth with crowns seated but not cemented. Marginal fit (absolute marginal discrepancy) from the finish line edge of the tooth preparations to crown edges (CE) and leading edges (LE) of crowns were measured. RESULTS: A 2-way analysis of variance for crown type and tooth surface morphology revealed significant differences between crown types for all measurement parameters, except vertical LE. The effect of surface morphology was not significant, except for vertical LE (P<.05). For all parameters, except vertical LE, the ranking of marginal fit discrepancies from greatest to least was as follows: group PC, G, BA, and PS. For vertical LE distances, the ranking was PS, BA, G, and PC (P<.05). CONCLUSION: Profilometry was used as a nondestructive, accurate method of evaluating the absolute marginal fit of different types of crowns. Marginal fits varied continuously around the circumference of each crown and made clinical assessment of fit accuracy subjective and arduous.

Atherosclerotic plaque rupture: a fatigue process?

The mechanism of atherosclerotic plaque rupture is not known. Current theories focus on the acute triggers of plaque rupture and myocardial infarction such as increased shear or circumferential stress, rupture of the vasa vasorum and vasospasm. We hypothesize that a critical mechanism causing plaque rupture is fatigue failure, the catastrophic rupture of a material following exposure to high-cycle, low-amplitude repetitive stress. Comparisons between material fatigue and plaque rupture demonstrate that this hypothesis is consistent with known physiologic and epidemiologic data on plaque rupture.

Correlation of noncarious cervical lesion size and occlusal wear in a single adult over a 14-year time span.

STATEMENT OF PROBLEM: Noncarious cervical lesions are described as having a multifactorial cause, with occlusal trauma and toothbrush abrasion frequently mentioned as major factors. Finite element modeling studies have demonstrated a relocalization of occlusal stresses to the cervical area due to flexure of the crown. This may cause microcracking, especially under tensile stresses, that will lead to a loss of enamel and dentin in the cervical region. Clinical confirmation of an occlusal cause for noncarious cervical lesions has been difficult to obtain. PURPOSE: This study investigated whether occlusal wear was correlated with an increase in the size of noncarious cervical lesions. MATERIAL AND METHODS: Loss of contour at occlusal and cervical sites on 3 teeth of a single individual was measured using digital and visualization techniques at 3 time intervals over a 14-year time span. The 1983 baseline casts and 1991, 1994, and 1997 clinical impressions of a single adult patient with existing noncarious cervical lesions were replicated in epoxy. Surfaces of all replicas were digitized with a contact digitizing system. Sequential digitized surfaces were fit together and analyzed using AnSur-NT surface analysis software. Clinical losses of surface contour by volume and depth of the left mandibular first molar and first and second premolars were recorded. RESULTS: Nine measurements of cervical volume loss (range 0.9 to 11.5 mm(3)) and 9 corresponding measurements of occlusal volume loss (range 0.39 to 7.79 mm(3)) were made. The correlation between occlusal and cervical volume loss was strong (r(2)=0.98) and significant (P<.0001). CONCLUSION: For the single adult patient in this study, there was a direct correlation between occlusal wear and the growth of noncarious cervical lesions.

Optical scattering power for characterization of mineral loss.

Mineral loss in early caries cannot be measured without invasive procedures. To quantify mineral loss without sectioning the tooth, one must determine the optical scattering of the enamel. Using enamel white-spot lesions, we hypothesize that the optical scattering power (Sp) of the demineralized enamel would provide a quantitative estimate of mineral loss. Enamel slabs were demineralized to produce artificial white spots. The data were acquired by means of a Charge-Coupled Device (CCD) camera and image-processing software. For the purpose of comparison, mineral loss (deltaZ) of the demineralized samples was determined by the use of a microhardness approach after the samples were sectioned. The scattering power correlated well with deltaZ (r2 = 0.82). In contrast, simple reflectance of the demineralized samples correlated poorly with deltaZ (r2 = 0.22). The validity of using scattering power to measure demineralization has been confirmed by a three-dimensional Monte Carlo Simulation.

Nominal shear or fracture mechanics in the assessment of composite-dentin adhesion?

This study addresses the anticipated problem of discriminating among high-performing dentin adhesives. The simplicity of the nominal shear bond test, despite being heavily criticized, has made it a routine procedure for the determination of bonding efficacy. A fracture mechanics approach has been suggested as a better assessment of bonding efficacy (Versluis et al., 1997). However, experimental complexity is a major limitation. It is hypothesized that a new, simplified interfacial fracture toughness test (Lin, 1994) will evaluate bonding agents differently if compared with the traditional shear bond test. Therefore, the objective of this study was to compare the performances of six dentin bonding agents subjected to the interfacial fracture toughness test (critical plane strain energy release rate) or to the nominal shear bond test (shear bond strength). Their performances were also characterized by scanning electron micrography of the fracture surfaces for evidence of dentin cohesive failure. Statistical analyses showed only marginal differences between these determinants of the two tests. However, when the analysis was applied only to the materials that had 100% frequency of dentin cohesive failure in shear testing, which also had high bonding efficacy, the difference in adhesive strengths between the two tests became significant. The reliability of the nominal shear test is questioned when dentin cohesive failure occurs, which usually is associated with high bonding efficacy. Since it is expected that bonding efficacy will increase further, the interfacial fracture toughness test is the preferred methodology to distinguish among high-performing dentin adhesives.

In vitro inhibition of enamel demineralization by a polymerizable amphiphilic film.

An amphiphilic coating is configured as a substantive film that has a tendency for an in-plane two-dimensional polymerization. This coating is hypothesized to protect enamel from in vitro acid decalcification, assessed through the following artificial caries model. Three regions on labial enamel of eight bovine incisors were treated with an acid resistant varnish (A), the amphiphilic coating (B), or left undisturbed (C), and the teeth were immersed for 3 wk in lactic acid gel. Mineral loss (deltaZ-value) was determined by a cross-sectional microhardness technique. deltaZ-values (mean +/- SD; volume percent mineral-microm) were: -4 +/- 24 (A), 29 +/- 69 (B), and 7,372 +/- 1,766 (C). deltaZ-value of the uncoated enamel (C) was significantly different from the other groups. Scanning electron microscopy showed enamel etched pattern from citric acid, and the coating firmly attached on enamel surface. This amphiphilic coating can inhibit enamel decalcification under the present experimental condition.

Cumulative effects of successive restorative procedures on anterior crown flexure: intact versus veneered incisors.

OBJECTIVE: When successive restorative procedures (e.g., porcelain veneers, interdental resin composite restorations, and endodontic treatment) are carried out on the same tooth, significant effects on crown flexure can be expected. METHOD AND MATERIALS: Dentin-bonded porcelain veneers (experimental group) were assessed in vitro using functional and cyclic thermal loads. They were compared to natural teeth (control group) with respect to 2 parameters: coronal flexure (investigated using experimental strain gauges) and morphology of the tooth-restoration interface (scanning electron microscopic evaluation). For both veneered and natural teeth, crown deformation was recorded at 5 sequential experimental steps: intact tooth (baseline), Class III cavities, Class III resin composite restorations, endodontic treatment, and endodontic restoration (without posts). RESULTS: No significant differences in crown flexure were found between natural and veneered incisors when compared across experimental steps. The main effect for experimental steps was highly significant. When averaged across all specimens (natural and veneered teeth), the endodontic treatment step resulted in the highest crown flexure (1.55x the baseline value). The unrestored Class III cavities and the endodontic restoration were next highest (1.30x and 1.28x the baseline value, respectively). The lowest crown flexures were found after restoration of the Class III cavities (1.13x the baseline value). No measurable microleakage or gaps were detected at the ceramic-resin, resin-enamel, or resin-dentin interfaces (Optibond FL, Kerr). CONCLUSION: Each subsequent reduction in tooth structure resulted in a substantial increase in crown flexibility, even after restoration. Endodontic procedures were responsible for most of the loss in crown stiffness. Extensive proximal cutting and restorations seemed to minimally affect crown flexure. Porcelain veneers showed perfect biomimetic behavior, because cumulated restoration procedures had the same effect on natural and veneered incisors.

Interdental design of porcelain veneers in the presence of composite fillings: finite element analysis of composite shrinkage and thermal stresses.

PURPOSE: This study was conducted to optimize the interdental design (wraparound) of porcelain laminates bonded to teeth in the presence of preexisting composite fillings. MATERIALS AND METHODS: A finite element model (2-dimensional mesh generated from a horizontal cross section of a maxillary incisor) was used to evaluate the effects of luting composite shrinkage and thermal changes on the stress distribution within the ceramic. The mesh included 3 restorative designs (3 degrees of interdental wrapping) and a Class III composite filling. Curing contraction of the luting composite was simulated at baseline temperature (37 degrees C). Thermal loads from 37 to 60 degrees C and from 37 to 5 degrees C were assessed with and without preexisting composite shrinkage. Surface tangential stresses were calculated at the ceramic surface and interface. RESULTS: Curing contraction alone generated mostly compressive stresses (peaks at 15 MPa) at both the ceramic surface and interface. Stresses remained compressive (peaks at 20 MPa) when thermal changes were added, except for the conservative veneer with minimum wraparound, the margins of which showed potentially harmful tensile stress peaks (approximately 7 MPa). Deformation of the tooth-restoration complex tended to be more uniform for veneers with maximum wraparound. In the presence of thermal loads alone, opposite effects were observed on the restoration surface and the interface, with compressive stresses on one side (up to 13 MPa) and tensile stresses on the other (up to 9 MPa). This effect of proximal bending (explained by the nearby expansion/contraction of the composite filling) was attenuated by the significant reduction of the bulk of the preexisting interdental composite by the overlapping veneer. CONCLUSION: In the finite element environment, the negative effect of the nearby expanding/contracting composite fillings can be minimized by extending the veneer over the preexisting interdental restoration. Because of the precompressed state resulting from composite shrinkage, ceramics showed lower temperature-induced tensile stresses.

Dentine bonding systems: 1. Mode of action.

The achievement of a reliable bond to dentine has been more difficult than bonding to enamel, due principally to the anatomy of the dentine substrate. The mechanisms of bonding are now much better understood than a decade ago and clinically-viable bond strengths to dentine are now achieved with many dentine bonding systems.

Dentine bonding systems: 2. Clinical uses.

As the reliability of dentine bonding agents has improved, the clinical uses of these systems has increased and now include the bonding of directly and indirectly constructed restorations, amalgam bonding and treatment of dentinal sensitivity. Areas of potential use which require further evaluation include pulp capping and the attachment of fractured tooth fragments.

Comparison of two measurement techniques for clinical wear.

OBJECTIVES: Clinical wear of restorations is generally evaluated by marginal integrity over time. In this study, both a subjective and an objective method for wear assessment are compared, and the relative advantages and disadvantages of each are considered. METHODS: A surface evaluation technique for quantitative measurement of wear, as developed at the University of Minnesota (UMN) has been compared to the commonly employed method of wear assessment used by Leinfelder (LF). Measurements were made by comparing suitable casts of restored teeth before and after clinical function. Semi-quantitative wear assessment was studied in comparison with detailed quantitative information about the topology of the pre- and post-wear occlusal surfaces obtained from stylus profilometry and processed by imaging techniques. Fourteen model sets of baseline, 2, 3 and 5 year old Class II composite restorations from a Danish clinical trial were evaluated using both techniques. RESULTS: In general, after 5 years of function, the digitizing method (UMN) generated wear values that were twice as high, indicating that general wear of restorative materials is underestimated by the LF-method. CONCLUSIONS: The comparison clearly revealed the advantages and limitations of each technique. Evaluation of wear by means of the LF technique provides global semi-quantitative data on restoration margins relative to enamel, underestimating general wear of the restorative material. Advanced 3-D measuring techniques such as the UMN method provide extensive quantitative data regarding wear patterns of the entire occlusal surface, i.e. restoration and enamel. Such a highly accurate technique is capable of differentiation between wear behavior of restorative materials early on in clinical studies. In addition, through its digital alignment procedure, the UMN method provides data on accuracy of the replication process used in clinical studies.