Journal of Prosthetic Dentistry

Fatigue resistance of composite resins and glass-ceramics on dentin and enamel

  • Paul de Kok
    Corresponding author: Dr Paul de Kok, Academic Centre for Dentistry Amsterdam (ACTA), Gustav Mahlerlaan 3004, 1081 LA Amsterdam, THE NETHERLANDS
    Assistant Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands

    Private practice, the Netherlands
    Search for articles by this author
  • Gustave F. Kanters
    Master student in Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
    Search for articles by this author
  • Cornelis J. Kleverlaan
    Full Professor, Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
    Search for articles by this author
Published:December 18, 2020DOI:


      Statement of problem

      Composite resins and glass-ceramics are both used to restore worn teeth. Which restoration material is more durable is unclear.


      The purpose of this in vitro study was to evaluate the load to failure of thin composite resins and glass-ceramic restorations on enamel and dentin under increasing repetitive loads.

      Material and methods

      Glass-ceramic blocks (IPS e.max CAD; Ivoclar AG) were shaped into cylinders (Ø4.0×1.0 mm), crystallized, and adhesively luted to bovine dentin and enamel substrates that were embedded in polymethyl methacrylate (n=20). Identical direct composite resin restorations (Clearfil AP-X; Kuraray Noritake Dental Inc) were made and directly applied on the same substrates (n=20). All specimens were tested in a pneumatic device with a stainless steel ball that provided a stepwise increase of the load (N) starting at 250 N and increasing by 50 N after every 10 000 cycles to a maximum of 1150 N. Failures were detected by a displacement sensor and defined by chipping of restorative material or catastrophic failure.


      On dentin, composite resin showed a significantly higher fatigue resistance than glass-ceramic. On enamel, no significant difference was found between the 2 materials.


      When bonded to dentin, thin direct composite resin restorations were more durable than glass-ceramics. When bonded to enamel, no difference was found.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Prosthetic Dentistry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Van’t Spijker A.
        • Rodriguez J.M.
        • Kreulen C.M.
        • Bronkhorst E.M.
        • Bartlett D.W.
        • Creugers N.H.
        Prevalence of tooth wear in adults.
        Int J Prosthodont. 2009; 22: 35-42
        • Kiliaridis S.
        • Kjellberg H.
        • Wenneberg B.
        • Engstrom C.
        The Relationship between maximal bite force, bite force endurance, and facial morphology during growth - a cross-sectional study.
        Acta Biomater Odontol Scand. 1993; 51: 323-331
        • Ferrario V.F.
        • Sforza C.
        • Zanotti G.
        • Tartaglia G.M.
        Maximal bite forces in healthy young adults as predicted by surface electromyography.
        J Dent. 2004; 32: 451-457
        • Muts E.J.
        • van Pelt H.
        • Edelhoff D.
        • Krejci I.
        • Cune M.
        Tooth wear: a systematic review of treatment options.
        J Prosthet Dent. 2014; 112: 752-759
        • Opdam N.J.
        • van de Sande F.H.
        • Bronkhorst E.
        • Cenci M.S.
        • Bottenberg P.
        • Pallesen U.
        • et al.
        Longevity of posterior composite restorations: a systematic review and meta-analysis.
        J Dent Res. 2014; 93: 943-949
        • van de Sande F.H.
        • Rodolpho P.A.
        • Basso G.R.
        • Patias R.
        • da Rosa Q.F.
        • Demarco F.F.
        • et al.
        18-year survival of posterior composite resin restorations with and without glass ionomer cement as base.
        Dent Mater. 2015; 31: 669-675
        • Guess P.C.
        • Strub J.R.
        • Steinhart N.
        • Wolkewitz M.
        • Stappert C.F.
        All-ceramic partial coverage restorations-midterm results of a 5-year prospective clinical splitmouth study.
        J Dent. 2009; 37: 627-637
        • Kramer N.
        • Frankenberger R.
        Clinical performance of bonded leucite-reinforced glass ceramic inlays and onlays after eight years.
        Dent Mater. 2005; 21: 262-271
        • Gehrt M.
        • Wolfart S.
        • Rafai N.
        • Reich S.
        • Edelhoff D.
        Clinical results of lithium-disilicate crowns after up to 9 years of service.
        Clin Oral Investig. 2013; 17: 275-284
        • Pieger S.
        • Salman A.
        • Bidra A.S.
        Clinical outcomes of lithium disilicate single crowns and partial fixed dental prostheses: a systematic review.
        J Prosthet Dent. 2014; 112: 22-30
        • Zhi L.
        • Bortolotto T.
        • Krejci I.
        Comparative in vitro wear resistance of CAD/CAM composite resin and ceramic materials.
        J Prosthet Dent. 2016; 115: 199-202
        • Vanoorbeek S.
        • Vandamme K.
        • Lijnen I.
        • Naert I.
        Computer-aided designed/computer-assisted manufactured composite resin versus ceramic single-tooth restorations: a 3-year clinical study.
        Int J Prosthodont. 2010; 23: 223-230
        • Gresnigt M.M.
        • Cune M.S.
        • Jansen L.
        • van der Made S.A.M.
        • Ozcan M.
        Randomized clinical trial of indirect resin composite and ceramic laminate veneers: up to 10-year findings.
        J Dent. 2019; 86: 102-109
        • Hamburger J.T.
        • Opdam N.J.
        • Bronkhorst E.M.
        • Roeters J.J.
        • Huysmans M.C.
        Effect of thickness of bonded composite resin on compressive strength.
        J Mech Behav Biomed Mater. 2014; 37: 42-47
        • de Kok P.
        • Pereira G.K.R.
        • Fraga S.
        • de Jager N.
        • Venturini A.B.
        • Kleverlaan C.J.
        The effect of internal roughness and bonding on the fracture resistance and structural reliability of lithium disilicate ceramic.
        Dent Mater. 2017; 33: 1416-1425
        • de Jager N.
        • Feilzer A.J.
        • Davidson C.L.
        The influence of surface roughness on porcelain strength.
        Dent Mater. 2000; 16: 381-388
        • de Kok P.
        • Kleverlaan C.J.
        • Kuijs R.H.
        • Oztoprak M.A.
        • Feilzer A.J.
        Influence of dentin and enamel on the fracture resistance of restorations at several thicknesses.
        Am J Dent. 2018; 31: 34-38
        • Lawson N.C.
        • Bansal R.
        • Burgess J.O.
        Wear, strength, modulus and hardness of CAD/CAM restorative materials.
        Dent Mater. 2016; 32: e275-e283
        • de Kok P.
        • Kleverlaan C.J.
        • de Jager N.
        • Kuijs R.
        • Feilzer A.J.
        Mechanical performance of implant-supported posterior crowns.
        J Prosthet Dent. 2015; 114: 59-66
        • Wendler M.
        • Belli R.
        • Petschelt A.
        • Mevec D.
        • Harrer W.
        • Lube T.
        • et al.
        Chairside CAD/CAM materials. Part 2: flexural strength testing.
        Dent Mater. 2017; 33: 99-109
        • Belli R.
        • Geinzer E.
        • Muschweck A.
        • Petschelt A.
        • Lohbauer U.
        Mechanical fatigue degradation of ceramics versus resin composites for dental restorations.
        Dent Mater. 2014; 30: 424-432
        • Magne P.
        • Carvalho A.O.
        • Bruzi G.
        • Giannini M.
        Fatigue resistance of ultrathin CAD/CAM complete crowns with a simplified cementation process.
        J Prosthet Dent. 2015; 114: 574-579
        • Schlichting L.H.
        • Maia H.P.
        • Baratieri L.N.
        • Magne P.
        Novel-design ultra-thin CAD/CAM composite resin and ceramic occlusal veneers for the treatment of severe dental erosion.
        J Prosthet Dent. 2011; 105: 217-226
        • Shembish F.A.
        • Tong H.
        • Kaizer M.
        • Janal M.N.
        • Thompson V.P.
        • Opdam N.J.
        • et al.
        Fatigue resistance of CAD/CAM resin composite molar crowns.
        Dent Mater. 2016; 32: 499-509
        • Magne P.
        • Schlichting L.H.
        • Maia H.P.
        • Baratieri L.N.
        In vitro fatigue resistance of CAD/CAM composite resin and ceramic posterior occlusal veneers.
        J Prosthet Dent. 2010; 104: 149-157
        • Ankyu S.
        • Nakamura K.
        • Harada A.
        • Hong G.
        • Kanno T.
        • Niwano Y.
        • et al.
        Fatigue analysis of computer-aided design/computer-aided manufacturing resin-based composite vs. lithium disilicate glass-ceramic.
        Eur J Oral Sci. 2016; 124: 387-395
        • Kelly J.R.
        Clinically relevant approach to failure testing of all-ceramic restorations.
        J Prosthet Dent. 1999; 81: 652-661
        • Malament K.A.
        • Socransky S.S.
        Survival of Dicor glass-ceramic dental restorations over 16 years. Part III: effect of luting agent and tooth or tooth-substitute core structure.
        J Prosthet Dent. 2001; 86: 511-519
        • Lawn B.R.
        • Deng Y.
        • Lloyd I.K.
        • Janal M.N.
        • Rekow E.D.
        • Thompson V.P.
        Materials design of ceramic-based layer structures for crowns.
        J Dent Res. 2002; 81: 433-438
        • Rhee Y.W.
        • Kim H.W.
        • Deng Y.
        • Lawn B.R.
        Contact-induced damage in ceramic coatings on compliant substrates: Fracture mechanics and design.
        J Am Ceram Soc. 2001; 84: 1066-1072
        • Thompson V.P.
        • Rekow D.E.
        Dental ceramics and the molar crown testing ground.
        J Appl Oral Sci. 2004; 12: 26-36
        • Xu H.H.
        • Smith D.T.
        • Jahanmir S.
        • Romberg E.
        • Kelly J.R.
        • Thompson V.P.
        • et al.
        Indentation damage and mechanical properties of human enamel and dentin.
        J Dent Res. 1998; 77: 472-480
        • Heintze S.D.
        • Cavalleri A.
        • Zellweger G.
        • Buchler A.
        • Zappini G.
        Fracture frequency of all-ceramic crowns during dynamic loading in a chewing simulator using different loading and luting protocols.
        Dent Mater. 2008; 24: 1352-1361
        • Chen C.
        • Trindade F.Z.
        • de Jager N.
        • Kleverlaan C.J.
        • Feilzer A.J.
        The fracture resistance of a CAD/CAM resin nano ceramic (RNC) and a CAD ceramic at different thicknesses.
        Dent Mater. 2014; 30: 954-962
        • Rojpaibool T.
        • Leevailoj C.
        Fracture resistance of lithium disilicate ceramics bonded to enamel or dentin using different resin cement types and film thicknesses.
        J Prosthodont. 2017; 26: 141-149
        • Sasse M.
        • Krummel A.
        • Klosa K.
        • Kern M.
        Influence of restoration thickness and dental bonding surface on the fracture resistance of full-coverage occlusal veneers made from lithium disilicate ceramic.
        Dent Mater. 2015; 31: 907-915
        • Burke F.J.
        Survival rates for porcelain laminate veneers with special reference to the effect of preparation in dentin: a literature review.
        J Esthet Restor Dent. 2012; 24: 257-265
        • van Dijken J.W.
        • Pallesen U.
        Long-term dentin retention of etch-and-rinse and self-etch adhesives and a resin-modified glass ionomer cement in non-carious cervical lesions.
        Dent Mater. 2008; 24: 915-922
        • Sarr M.
        • Mine A.
        • De Munck J.
        • Cardoso M.V.
        • Kane A.W.
        • Vreven J.
        • et al.
        Immediate bonding effectiveness of contemporary composite cements to dentin.
        Clin Oral Investig. 2010; 14: 569-577
        • de Kok P.
        • de Jager N.
        • Veerman I.A.
        • Hafeez N.
        • Kleverlaan C.J.
        • Roeters J.F.
        Effect of a retention groove on the shear bond strength of dentin-bonded restorations.
        J Prosthet Dent. 2016; 116: 382-388
        • Magne P.I.D.S.
        Immediate Dentin Sealing (IDS) for tooth preparations.
        J Adhes Dent. 2014; 16: 594
        • Gresnigt M.M.
        • Cune M.S.
        • de Roos J.G.
        • Ozcan M.
        Effect of immediate and delayed dentin sealing on the fracture strength, failure type and Weilbull characteristics of lithiumdisilicate laminate veneers.
        Dent Mater. 2016; 32: e73-e81
        • Kameyama A.
        • Bonroy K.
        • Elsen C.
        • Luhrs A.K.
        • Suyama Y.
        • Peumans M.
        • et al.
        Luting of CAD/CAM ceramic inlays: Direct composite versus dual-cure luting cement.
        Bio-Med Mater Eng. 2015; 25: 279-288
        • Gresnigt M.M.M.
        • Ozcan M.
        • Carvalho M.
        • Lazari P.
        • Cune M.S.
        • Razavi P.
        • et al.
        Effect of luting agent on the load to failure and accelerated-fatigue resistance of lithium disilicate laminate veneers.
        Dent Mater. 2017; 33: 1392-1401
        • Hamburger J.T.
        • Opdam N.J.
        • Bronkhorst E.M.
        • Huysmans M.C.
        Indirect restorations for severe tooth wear: fracture risk and layer thickness.
        J Dent. 2014; 42: 413-418
        • Guess P.C.
        • Schultheis S.
        • Wolkewitz M.
        • Zhang Y.
        • Strub J.R.
        Influence of preparation design and ceramic thicknesses on fracture resistance and failure modes of premolar partial coverage restorations.
        J Prosthet Dent. 2013; 110: 264-273
        • Soares F.Z.M.
        • Follak A.
        • da Rosa L.S.
        • Montanger A.F.
        • Lenzi T.L.
        • Rocha R.O.
        Bovine tooth is a substitute for human tooth on bond strength studies: A systematic review and meta-analysis of in vitro studies.
        Dent Mater. 2016; 32: 1385-1393
        • Fennis W.M.
        • Kuijs R.H.
        • Kreulen C.M.
        • Verdonschot N.
        • Creugers N.H.
        Fatigue resistance of teeth restored with cuspal-coverage composite restorations.
        Int J Prosthodont. 2004; 17: 313-317
        • Lohbauer U.
        • Belli R.
        • Ferracane J.L.
        Factors involved in mechanical fatigue degradation of dental resin composites.
        J Dent Res. 2013; 92: 584-591
        • DeLong R.
        • Douglas W.H.
        Development of an artificial oral environment for the testing of dental restoratives: bi-axial force and movement control.
        J Dent Res. 1983; 62: 32-36
        • Martin N.
        • Jedynakiewicz N.M.
        • Fisher A.C.
        Hygroscopic expansion and solubility of composite restoratives.
        Dent Mater. 2003; 19: 77-86
        • Zhang Y.J.
        • Xu J.W.
        Effect of immersion in various media on the sorption, solubility, elution of unreacted monomers, and flexural properties of two model dental composite compositions.
        J Mater Sci Mater Med. 2008; 19: 2477-2483
        • Kelly J.R.
        • Rungruanganunt P.
        • Hunter B.
        • Vailati F.
        Development of a clinically validated bulk failure test for ceramic crowns.
        J Prosthet Dent. 2010; 104: 228-238
        • Lohbauer U.
        • Frankenberger R.
        • Kramer N.
        • Petschelt A.
        Strength and fatigue performance versus filler fraction of different types of direct dental restoratives.
        J Biomed Mater Res B Appl Biomater. 2006; 76: 114-120