Journal of

Functional
Biomaterials

Review
Application of Tribology Concept in Dental Composites Field:
A Scoping Review
Giusy Rita Maria La Rosa 1, * , Luigi Generali 2 , Calogero Bugea 3 , Hani F. Ounsi 4 , Gergely Benyőcs 5 ,
Prasanna Neelakantan 6 and Eugenio Pedullà 1

1 Department of General Surgery and Medical Surgical Specialties, University of Catania, 95123 Catania, Italy
2 Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology
and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41125 Modena, Italy
3 Independent Researcher, 72100 Brindisi, Italy
4 Department of Endodontics, Faculty of Dental Medicine, Lebanese University, Beirut 1533, Lebanon
5 Private Practitioner, Precedent Dental Office, 1088 Budapest, Hungary
6 Discipline of Endodontology, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
* Correspondence: [email protected]

Abstract: Tribology is the discipline concerning the application of friction, lubrication, and wear
concepts of interacting surfaces in relative motion. A growing interest has developed in tribology
application in medical biomaterials, such as resin composites used in restorative dentistry. Yet, the
keywords “tribology” and “biotribology” are little applied in the pertinent publications. The aim of
this scoping review was to offer an overview of tribology application in dental composites research
and to identify knowledge gaps and address future research. A literature search was conducted
on Pubmed and Scopus databases and the studies investigating the tribological behavior of resin
composites were included for qualitative synthesis. The majority of studies on dental tribology
Citation: La Rosa, G.R.M.; Generali,
were published in the research areas of mechanical engineering/nanotechnology and differed in
L.; Bugea, C.; Ounsi, H.F.; Benyőcs,
G.; Neelakantan, P.; Pedullà, E. several methodological aspects. The preponderant engineering approach and the lack of standardized
Application of Tribology Concept in testing make the laboratory findings poorly informative for clinicians. Future research should focus
Dental Composites Field: A Scoping on the tribological behavior of dental materials composites by means of an integrated approach,
Review. J. Funct. Biomater. 2022, 13, i.e., engineering and clinical, for improving development and advancement in this field of research.
287. https://doi.org/10.3390/
jfb13040287 Keywords: biotribology; friction; dental resin composites; lubrication; scoping review; tribology; wear
Academic Editors: Jian Song,
Yuhong Liu, Benjamin Winkeljann
and Monica Yamauti
1. Introduction
Received: 16 October 2022
Tribology is the science of friction, lubrication, and wear applied on interacting sur-
Accepted: 6 December 2022
faces in relative motion [1]. Friction is defined as the rubbing of an object against another [2].
Published: 8 December 2022
It can be minimized by the application of substances able to make smooth the contact sur-
Publisher’s Note: MDPI stays neutral faces [3]. Wear is the gradual removal of material from surfaces as the result of mechanical
with regard to jurisdictional claims in or chemical injuries [3]. The concept of tribology has become popular in recent years,
published maps and institutional affil- mainly in its relationship with biology, which is known as biotribology. The use of med-
iations.
ical biomaterials in dentistry represents one of the most promising applications of the
biotribology concept [4,5].
Human teeth act as a tribological system being subject to friction, lubrication, and
wear phenomena during masticatory and phonetic functions. Furthermore, dental surfaces
Copyright: © 2022 by the authors.
undergo degradation processes including trauma, caries, and tooth tissue loss, often accel-
Licensee MDPI, Basel, Switzerland.
This article is an open access article
erated by ageing [6,7]. Thus, biocompatible materials and nontoxic materials have been
distributed under the terms and
proposed and developed to replace the dental tissue damaged. Dental composites consist
conditions of the Creative Commons of an inorganic filler (e.g., borosilicate glass, alumina, hydroxyapatite, and zirconia) im-
Attribution (CC BY) license (https:// mersed in a polymer resin matrix (e.g., bisphenol to glycidyl methacrylate (Bis-GMA) and
creativecommons.org/licenses/by/ triethylene glycol dimethacrylate (TEGDMA)) [8,9]. A coupling agent, typically a silane,
4.0/). enhances and stabilizes the chemical bond between the filler and the resin matrix [10,11].

J. Funct. Biomater. 2022, 13, 287. https://doi.org/10.3390/jfb13040287 https://www.mdpi.com/journal/jfb

J. Funct. Biomater. 2022, 13, 287 2 of 20

Composites are commonly used in restorative dentistry because of several benefits such as
suitable mechanical behavior and good aesthetics. Yet, they suffer the same phenomena of
physical and chemical wear described for dental issues [12–14].
To understand the wear pattern between the dental tissues and restorative materials,
the oral cavity is compared to a tribological model constituted of four elements, i.e., solid,
counter body, interfacial, and environmental elements. The first is the solid object repre-
sented by the tooth; the second can be a solid, liquid, or gas and, within dental model, is
comparable to the opposite tooth; the third is frequently a solid or a liquid, such as the food
bolus or saliva, respectively; finally, the air is the environmental element in which wear
process take place [6].
According to the contact material, two different patterns of abrasive wear are described:
two- and three-body abrasion [15,16]. The former is due to the friction generated by two
moving solids when their surfaces are in direct contact. It is common in hard but fragile
materials such as ceramics [15,17]. The latter occurs when solids are in mutual motion and
abrasive particles interpose between them [18]. The generalized or local occurrence of this
mechanism has been investigated in the oral cavity. When generalized, it is commonly
linked with the abrasive effects of alimentary particles during the chewing activity [19].
Tooth wear and consequent resin degradation are relevant clinical issues particularly
now that the average age of populations has risen significantly. Understanding the abrasion,
lubrication, and wear phenomena in dental apparatus by the application of tribology could
be extremely helpful in reducing causal factors and developing new high-performance
dental restorative materials [20–22].
For all these reasons, current research, mainly in conservative dentistry, is oriented
towards tribology even if often in an incomplete way. Indeed, the wear phenomenon
is investigated singularly and not in a mutual relationship with friction and lubrication
concepts. Preliminary research using the keywords “dentistry” and “tribology” retrieved
only 60 results on Pubmed (4 October 2022) suggesting that the terms are poor applied in
dentistry field.
The aim of this scoping review was to offer an overview on tribology application
in dental composites research in order to identify knowledge gaps and address future
research needs.

2. Materials and Methods

This scoping review followed as closely as possible the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews [23] and
focused on the following research question: “What is the application of tribology concept
in dental resin composites research?”

2.1. Inclusion Criteria

In vitro animal and human studies that evaluated the application of tribology in dental
composites materials were included. Review articles, conference reports, short communica-
tions, and editorials were excluded. No language or date restrictions were applied.

2.2. Search Strategy

The literature search was performed on 23 September 2022. The search was carried
out by two independent reviewers on PubMed and Scopus databases. The strategy was
adopted on database, applying the MESH terms and the keyword identified in the most
relevant studies: (tribology OR biotribology OR (“dental wear” AND “dental friction”
AND lubrication)) AND (“dental material*” OR “dental composite*” OR “dental resin*”
OR “conservative dentistry”). Included articles and reviews were further screened for other
potentially relevant articles. All of the review process was conducted using the EndNote
program (EndNote X9; Thomson Reuters, New York, NY, USA). Articles were screened in
titles and abstracts by two independent reviewers to ensure inclusion criteria were satisfied.
All duplicates were removed.
J. Funct. Biomater. 2022, 13, 287 3 of 20

2.3. Study Selection

Studies with insufficient information were temporarily included and successively
screened independently in the full text by the two same reviewers. Any disagreement about
the inclusion was solved by discussion. No intervention of a third examiner was necessary.
Articles satisfying the inclusion criteria were considered for the qualitative synthesis.

2.4. Data Extraction and Synthesis

The relevant data were extracted by using a standardized form developed for this
purpose. The following items were recorded and tabulated: author and year, journal,
sample size (n), study design, objective, methodology, and main findings. The qualita-
tive synthesis focused on the principal tribology applications in dental composites, with
particular reference on the tested materials and properties investigated.

3. Results
Study Selection
The flow chart for study selection according to PRISMA 2020 is reported in Figure 1.
The search identified 163 potentially relevant studies (PubMed: n = 34; Scopus: n = 129).
After
J. Funct. Biomater. 2022, 13, x FOR PEER removal of duplicates (n = 11) and articles not fulfilling the inclusion criteria (n 4= of135),
REVIEW 21
17 laboratory studies met the eligibility criteria for qualitative synthesis. No animal or
human studies were identified. The included studies are listed in the Table 1 [22,24–39].

Flowchart
Figure1.1.Flow
Figure chartof
ofreview
reviewprocess.
process.
J. Funct. Biomater. 2022, 13, 287 4 of 20

Table 1. Main characteristics of the included studies.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
To assess the tribological Tribological behavior was
behavior: influenced by the concentration
and morphology of
- wear resistance (wear
EDS; added particles.
Journal of Materials rate mm3 /Nm);
Akhtar et al. pin-on-disk tribometer The fabricated composite with
Science: Materials NR Laboratory study - COF;
(2021) [24] (lubricant used); 0.4 Wt% concentration of the
in Medicine - Vickers hardness (HV)
microhardness tester. cubic-shaped filler particles
of mono-dispersed HA particles exhibited maximum hardness
and HA-reinforced acrylic resin and reduced wear and
(AR)-based composites. COF values.
To determine:
- wear volume loss (mm3 )
and wear mechanism
of universal microhybrid Filtek All composites showed abrasive
Silorane (3M ESPE); two wear in variable degree.
universal nanofilled composites, Modified pin-on-plate The mean total wear volume of
Filtek Supreme (3M ESPE) wear test apparatus; Filtek Supreme was significantly
Altaie et al. and Clearfil
Journal of Dentistry 10 Laboratory study white light profilometer; higher compared with the other
(2017) [22] Majesty Posterior (Kuraray); SEM; resin composites.
and three nanohybrids, Kalore EDS. Filtek Supreme and Kalore
(GC America), Venus Diamond reported signs of adhesive
(Heraeus Kulzer), and Tetric wear mechanism.
Ceram HB (Ivoclar-Vivadent)
resin composites
during short-term in vitro
wear testing.
J. Funct. Biomater. 2022, 13, 287 5 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
The 22-month period and the
To determine how different
pH 9 were the most impactful
values of pH (3,7, and 9) and
conditions on wear pattern of
aging time (3, 6, and 22 months)
the tested composites.
influenced tribological behavior
The wear resistance of Surefil,
in a reciprocating contact (wear
Ceramx, Prodigy, and Quixfil
Antunes volume, mm3 and COF)
Reciprocating tribometer; increased after storage in buffer
& Ramalho Wear NR Laboratory study of Filtek P60 (3M ESPE), Prodigy
SEM. solution with pH 3. Conversely,
(2009) [25] Condensable Surefil (Kerr
Filtek, Alert, and Synergy
Dentsply), Synergy Compact
showed an increase in the wear
(Coltène), Quixfil (Dentsply),
volume in the same conditions.
CeramX (DeTrey Dentsply
Independently of pH values,
GmbH), and Alert
aging damaged the interface
(Jeneric-Pentron).
matrix/reinforcement particles.
To evaluate
the effects of temperature
change and immersion in two
common beverages (tea and soft
drinks) on the mechanical: Thermocycling Overall, the tribological
- hardness (GPa); apparatus; indicators of nano- and
2 for thermocycling - elastic modulus (GPa); triboscope nanohybrid composites were
Ayatollahi et al. Materials Science and
procedure; Laboratory study - plasticity index; nanoindentation less susceptible to temperature
(2015) [26] Engineering C
5 for other tests - tribological properties: test system; changes and immersion in
- wear resistance (penetra- AFM; beverages compared
tion depth, u˛m3 ) nano-scratch test. with universal.
of universal Filtek Z250 (3M
ESPE), nanohybrid Filtek Z250
XT, and nano Filtek Z350 XT
dental resin composites.
J. Funct. Biomater. 2022, 13, 287 6 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings

To determine the effect of Both acids increased the surface

exposure to weak (lactic acid) roughness, mainly in samples in
and strong (hydrochloric acid) contact with hydrochloric acid
acids on: for 1 day. Similar trend was
Microindentation tests; recorded for the COF.
- roughness (nm);
Branco et al. 32 (n = 4 for ball-on-plate The microhardness decreased
Tribology Letters Laboratory study - hardness (HV);
(2019) [27] each group) nanotribological tests; after contact with both acids.
- friction and wear behavior
AFM. The hydrochloric acid solution
(COF and wear rate)
had a significantly negative
of a micro-hybrid impact on wear resistance of
methacrylate-based composite resin composite tested.
(Filtek Z250) after 1 and 7 days.

To assess the effect of aging by

thermocycling on the
mechanical and Overall, composite A exhibited
tribological properties: better mechanical properties
Surface profilometry;
than B. The thermocycling had
- surface roughness; impulse excitation of
Journal of the Brazilian no significant effect on hardness
- dynamic and static elastic vibration and four-point
Carreira et al. Society of Mechanical 120 (n = 20 for of both composites; conversely,
Laboratory study modulus (GPa); bending test;
(2017) [28] Sciences each group) it decreased the elastic modulus
- flexural strength (MPa) Vickers micro-
and Engineering and COF of composite B.
and WOF (Jm2 ); indentation;
In general, composite B was
- micro-hardness (MPa) and scratch test.
more affected by thermocycling
COF
than A.
of nanohybrid (A) and
microfilled (B) composites.
J. Funct. Biomater. 2022, 13, 287 7 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
To assess the influence of
different beverages (distilled
water, orange juice, and
Coca-Cola) on the surface Acid beverages negatively
mechanical properties: impacted the mechanical and
- nanohardness (GPa); tribological behavior of
Nanoindentation test;
- elastic modulus (GPa); microhybrid and
reciprocating
Fan et al. Journal of 60 (n = 15 for - wear behavior (penetra- microfilled composites.
Laboratory study nanoscratch test;
(2014) [29] Nanomaterials each group) tion depth, nm) The nanofilled resin composites
SEM;
of nanofilled Filtek Z350 (3M revealed the highest
SPM.
ESPE), nanohybrid TPH nanohardness/elastic modulus
(Dentsply Caulk)3 , microfilled values and the
Durafill (VS Heraeus Kulzer) least degradation.
and microhybrid Superlux
(DMG Germany)
resin composites.
To investigate the effect of
organic fillers (PE, PTFE) and The organic filler composites
inorganic friction modifier showed the lowest COF
Mystkowska
(Si3N4, BN) on the Pin-on-disk tribotester and wear.
& Dabrowski
˛ Solid State Phenomena NR Laboratory study
tribological properties: (lubricant used) Increase in loading negatively
(2009) [30]
- wear (volume loss, g) and COF impacted COF and wear of
of micro-filled tested composites.
dental composites.
Silica nanoparticles presented
lower values of roughness in
comparison with silica and
Roughness: To investigate the influence of
silica–zirconia nanoclusters
4 cylinders nanoparticles and nanoclusters AFM;
Rodríguez & while no significant differences
Journal of for sample of silica and silica–zirconia on: nanoindentation;
Casanova Laboratory study emerged for hardness.
Nanotechnology Nanohardness: - roughness (nm); SEM;
(2018) [31] Overall, roughness seemed to be
2 cylinders - nanohardness (GPa) TEM.
affected by particle size while
for sample of dental resin composites.
nanohardness by the
concentration of the
reinforcement materials.
J. Funct. Biomater. 2022, 13, 287 8 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
Wear resistance, correlated with
To compare the dissipated frictional energy,
wear resistance was significantly higher for
48 samples from (volume loss) Customized tribometer tooth enamel compared with
Sajewicz Journal of human teeth of (Arkona), Filtek (3M), Ful-Fil (lubricant used); composites. In addition,
Laboratory study
(2010) [32] Engineering Tribology 48 (n = 12 for (Dentsply), and Ecusit (DMG) EDS; topographical analysis revealed
each composite) with that of human tooth SEM. that wear pattern was mainly
enamel by an energy due to physical changes in
approach (J/mm3 ) enamel, but chemical changes in
the composites.
To examine the abrasive and Universal testing
The resin with the highest
reciprocating sliding wear machine (Instron 8874);
inorganic filler content
resistance (wear volume, mm3 , TE-66 micro-scale
(ClearfilTM ) showed the lowest
wear rate, and COF) and abrasion equipment
COF and wear rate.
compressive strength (MPa) (stainless steel
Souza et al. Abrasion tests showed fine
Tribology International 10 for each group Laboratory study of four dental resin composites: rotating ball);
(2016) [33] micro-scale abrasion as
GrandioR So (Voco, Germany); alumina ball and
principal wear pattern while the
Ceram-XTM (Dentsply, tribometer
reciprocating sliding tests
Germany); ClearfilTM (Kuraray, (lubricant used);
revealed surface fatigue
Japan); and Natural Elegances R optical microscope;
and abrasion.
(Henry Schein, USA). SEM.
Wear depth intensity was
To determine the effect of
negatively affected by
smokeless tobacco on the
Proceedings of the immersion in tobacco solution.
tribological properties (wear
Institution of Pin- on-disk tribometer Under different loading
Suryawanshi depth, u˛m3 )
Mechanical Engineers (lubricant used); conditions, Z350 Dentin showed
& Behera 2 for each material Laboratory study of two dental resin composites:
H: Journal of SEM. significantly less wear (and
(2020) [34] Tetric N-Ceram (Ivoclar) and
Engineering COF) compared with the Tetric
Z350 Dentin shade (3M ESPE)
in Medicine N-Ceram in the presence of
after 2, 3.5, 6, 15 days and
synthetic saliva, independently
1 month.
from tobacco immersion.
J. Funct. Biomater. 2022, 13, 287 9 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
To determine the effect of LED
or a QTH light curing unit on
mechanical behavior:
- microhardness (VHN)
The type of light unit influenced
- surface roughness (Ra)
the microhardness of resin
- wear resistance as wear
composites tested, with higher
loss (mg)
Journal of Biomedical Vickers hardness values for QTH. The nanofilled
Materials Research of nanofilled ((Filtek Supreme measuring instrument; composite Clearfil MajestyTM
Topcu et al. 10 for each (3M ESPE), Clearfil Majesty
Part B (Journal of Laboratory study profilometer; Posterior showed higher
(2010) [39] composite Posterior (Kuraray)),
Biomedical pin-on-disc tribometer; microhardness, less surface
Materials Research) nanohybrid ((Ceram X SEM. roughness, and higher wear
(Dentsply deTrey GmbH), resistance in comparison with
Premise (Kerr)), microhybrid the other composites, regardless
((Clearfil AP-X (Kuraray), the light-curing unit.
Herculite XRV (Kerr)), minifilled
hybrid ((Filtek Z250 (3M ESPE)),
and hybrid (Quixfil (Dentsply
deTrey GmbH)) composites.
To assess the mechanical SEM;
(Young’s modulus, MPa) and dynamic light scattering;
tribological behavior (abrasion FTIR;
The tested materials presented
(mg/s)−1 and wear resistance as X-ray diffraction;
relatively high
Vargas et al. Materials Research 7 for each penetration depth, u˛m3 ) induced coupled plasma
Laboratory test Young’s modulus;
(2013) [35] Innovations preparation of different dental materials optical emission
the alumina hardness improved
filled with spectroscopy;
the abrasion resistance.
HA and reinforced with two densitometry;
different types of ceramic micro-scratch tester;
particles, alumina, and silica. tribometer.
J. Funct. Biomater. 2022, 13, 287 10 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
pH 1 and 13 induced greater
damage on composites’ surface
To evaluate the effect of pH than neutral pH.
media (1,7,13) on mechanical Prolonged aging had a
and tribological properties: detrimental effect on mechanical
Vickers diamond
- Vickers microhardness (HV) and wear properties
indenter;
- wear behavior as COF and of composites.
Wu et al. Particulate Science 10 for each optical microscopy;
Laboratory study wear rate Under aging environment,
(2017) [36] and Technology composite block-on-ring wear tester
of AP-X (Kuraray), Z350 (3M nano-filled composites with low
(lubricant used);
ESPE), Filtek P60 (3M ESPE), filler (VITA ZETA and VITA LC)
SEM.
Vita Zeta (Vita), Vita LC (Vita) exhibited worse mechanical and
dental resin composites after 1, wear indices than the hybrid
13, and 20 days. composites with high filler
loading and distribution (AP-X,
Z350 and Filtek P60).
The composite with 0 wt% nHA
at a normal load of 40 N and
profile velocity of 140 RPM and
To determine the influence of a 28 min exhibited the lowest
low amount (0, 2, 4, 6, and wear rate for
8 wt%) of nHA and aluminium Pin-on- disc friction & Al2O3-nHAmaterials.
Yadav & Meena or titanium oxidum on the wear test rig; The composites with 8 wt%
Ceramics International NR Laboratory study
(2021) [37] tribological (two-body sliding SEM; nHA at a normal load of 70 N,
wear) behavior: EDS. profile velocity of 110 RPM and
wear rate 23 min reported the lowest
of dental resin composites. wear rate.
Overall, load, time, and filler
significantly impacted the wear
rate of tested composites.
J. Funct. Biomater. 2022, 13, 287 11 of 20

Table 1. Cont.

Author & Year Journal Sample Size (n) Study Design Objective Methodology Main Findings
The tested composites with
To assess the tribological
8 wt% nHa at a load of 40 N,
behavior (two body The pin-on-disc friction
sliding speed 120 RPM 23 min
Yadav et al. sliding wear): & wear test rig;
Polymer Composites NR Laboratory study showed a minimum wear rate.
(2022) [38] wear rate SEM;
In general, load and filler
of Ha-zinc oxide filled (from 0% EDS.
significantly impacted the wear
to 8%) dental resin composites.
rate of tested composites.
AFM: atomic force microscopy; AR: acrylic resin; HA: hydroxyapatite; COF: coefficient of friction; EDS: energy-dispersive X-ray spectroscopy; FTIR: Fourier transform infrared
spectroscopy; LED: light-emitting diode; NR: not reported; PE: polyethylene; PTFE: polytetrafluoroethylene; QTH: quartz–tungsten–halogen; SEM: scanning electron microscopy; SPM:
scanning probe microscopy; TEM: transmission electron microscopy; WOF: work of fracture.3.2. Findings Summary.
J. Funct. Biomater. 2022, 13, 287 12 of 20

J. Funct. Biomater. 2022, 13, x FOR PEER REVIEW 13 of 20

The number of publications increased through the years and 13 of 17 articles were
published after 2010. In addition, 13 studies were published in journals that covered
research into mechanical engineering or technology of nanosized and nanostructured
In addition,
materials, includingnanoadvanced
and nanohybrid
ceramiccomposite
materialssamples also demonstrated
and reinforced plastics and suitable
polymer
properties when
composites the samplesthree
[25–33,35–38]; were studies
thermocycled and immersed
were published in tea andthat
in journals softfocused
drinks [26] on the
or exposed to
application of acid environment
biomaterials [27,29].engineering
and tissue Antunes & in Ramalho [25] showed
the medical sciencesthat the 22- and
[24,34,39]
month
only period
one and pH 9 were
was published in a the most impactful
dentistry conditions on wear pattern of the tested
journal [22].
composites. Similarly, Wu et al. [36] outlined
Eight studies investigated the effect of the size, that the most extreme pHand
concentration, values (i.e.,of1 powder-
nature and
13) and prolonged aging had a detrimental effect on mechanical and wear
filling particles on the tribological behavior of resin composites [22,24,30,31,33,35,37,38]. properties of
tested composites. Moreover, the hybrid composites with high filler loading
Two articles assessed the influence of exposure to different acid solutions [27,29] and two and distribu-
tion exhibited
assessed betterofmechanical
the effect different pH andand wearaging
indices than[25,36].
times nano-filled
Other composites with low the
studies evaluated
filler. According to Carreira et al. [28], thermocycling had no influence
effect of temperature and immersion in beverages [26], thermocycling [28], smokeless on hardness of
nanohybrid and microfilled resin-based composites while decreased the
tobacco at different aging times [34], and different light curing units [39] on mechanical elastic modulus
and COF of those microfilled.
behavior of dental resins. Finally, one article compared the tribological behavior of human
Topcu et al. [39] assessed the effect of different light curing units (i.e., light-emitting
enamel with that of some resin composites [32].
diode, LED, and quartz-tungsten-halogen, QTH) on the mechanical behavior of some
The tribological behavior was investigated for volume loss/penetration
resin composites. The findings revealed that the type of light unit influenced the micro-
depth [22,25,26,29,30,32–35,39], roughness [27,28,31,39], plasticity index [26], coefficient of
hardness of resin composites tested, with higher values for QTH light units. In addition,
friction [24,25,27,28,30,33,36], wear rate [24,27,33,36–38], Vickers hardness [24,26–29,31,36,39],
the nano-filled composite (i.e., Clearfil MajestyTM Posterior, Kuraray) exhibited higher mi-
elastic modulus [28,29,35], abrasion resistance [35], flexural [28], and compressive [33] strength.
crohardness, less surface roughness, and higher wear resistance when compared with the
Several macroscopic and microscopic techniques were employed to investigate tribo-
other tested composites, regardless the light curing unit.
logical and mechanical
Suryawanshi properties
& Behera of tested
[34] explored materials.
the effect Thirteen
of smokeless studies
tobacco onused tribological
the tribolog-
testing [22,24,25,27,30,32–39]
ical properties of two dental resin andcomposites.
ten quantitative
Interestingly,assessment
the wear depth methods
intensitysuch was as
profilometer [22,39] or surface hardness or
negatively affected by immersion in tobacco solution. nanoindentation techniques [24,26–29,31,35,36,39].
Qualitative
Sajewiczevaluation
[32] wasincluded
the only scanning
researcher electron microscopy
who compared the(SEM)
wear [22,25,29,31–39],
resistance of tooth atomic-
force microscopy (AFM) [26,27,31], energy-dispersive X-ray spectroscopy
enamel with commercial resin-based composites, by means of energy approach. Wear re- (EDS) [22,24,32,37,38],
scanning probe microscopy
sistance, correlated with the(SPM) [29], optical
dissipated microscopy
frictional energy, was[33,36], and induced
significantly coupled
higher for toothplasma
optical emission spectroscopy [35]. The main
enamel compared with the investigated composites [32]. wear mechanisms are illustrated in Figure 2.

Figure 2.
Figure 2. The
Themain
mainwear
wearmechanisms
mechanismsidentified in in
identified thethe
included studies.
included studies.

Overall, tribological behavior of dental-resin-based composites was affected by the

morphology, particle uniformity, and concentration of inorganic fillers [22,24–39]. More
J. Funct. Biomater. 2022, 13, 287 13 of 20

explicitly, Akhtar et al. tested how the addition of hydroxyapatite (HA) particles modified
the tribological behavior of resin-based composites. The authors stated that the fabri-
cated composite with 0.4 Wt% concentration of the cubic-shaped filler particles exhibited
maximum hardness and reduced wear and COF values [24]. In addition to HA particles,
Vargas et al. [35] also tested the influence of polymeric matric reinforcement with two
different types of ceramic particles, alumina and silica; they found that the alumina hard-
ness improved the abrasion resistance. Moreover, in the studies of Yadav et al. [37,38],
the influence of a low amount (i.e., 0, 2, 4, 6, and 8 wt%) of nHA and aluminum or ti-
tanium oxidum [37] and Ha-zinc oxide filling (from 0% to 8%) [38] on the tribological
behavior of dental resin composites was tested. The authors concluded that load, time,
and filler significantly impacted the wear rate of tested composites [37,38]. According to
Mystkowska & Dabrowski˛ [30], the organic fillers composites exhibited the lowest COF
and wear. On the other hand, Souza et al. [33] found that resin with the highest inor-
ganic filler content reported the lowest COF and wear rate. Furthermore, as reported by
Rodríguez & Casanova [31], roughness of dental composite was affected by particle size
while the nanohardness was affected by the concentration of the reinforcement materials.
In particular, the authors showed that silica nanoparticles presented lower values of rough-
ness compared with silica and silica–zirconia nanoclusters while no significant differences
emerged for hardness.
Altaie et al. [22] determined the wear behavior of differently filled resin-based com-
posites. Although all composites showed abrasive wear to a variable degree, the universal
nano-filled composite Filtek Supreme (3M ESPE) exhibited the major wear volumetric loss
compared with the other composites.
In addition, nano and nanohybrid composite samples also demonstrated suitable
properties when the samples were thermocycled and immersed in tea and soft drinks [26]
or exposed to acid environment [27,29]. Antunes & Ramalho [25] showed that the 22-month
period and pH 9 were the most impactful conditions on wear pattern of the tested com-
posites. Similarly, Wu et al. [36] outlined that the most extreme pH values (i.e., 1 and 13)
and prolonged aging had a detrimental effect on mechanical and wear properties of tested
composites. Moreover, the hybrid composites with high filler loading and distribution
exhibited better mechanical and wear indices than nano-filled composites with low filler.
According to Carreira et al. [28], thermocycling had no influence on hardness of nanohybrid
and microfilled resin-based composites while decreased the elastic modulus and COF of
those microfilled.
Topcu et al. [39] assessed the effect of different light curing units (i.e., light-emitting
diode, LED, and quartz-tungsten-halogen, QTH) on the mechanical behavior of some resin
composites. The findings revealed that the type of light unit influenced the microhardness of
resin composites tested, with higher values for QTH light units. In addition, the nano-filled
composite (i.e., Clearfil MajestyTM Posterior, Kuraray) exhibited higher microhardness,
less surface roughness, and higher wear resistance when compared with the other tested
composites, regardless the light curing unit.
Suryawanshi & Behera [34] explored the effect of smokeless tobacco on the tribological
properties of two dental resin composites. Interestingly, the wear depth intensity was
negatively affected by immersion in tobacco solution.
Sajewicz [32] was the only researcher who compared the wear resistance of tooth
enamel with commercial resin-based composites, by means of energy approach. Wear
resistance, correlated with the dissipated frictional energy, was significantly higher for
tooth enamel compared with the investigated composites [32].

4. Discussion
Despite the advantages of dental composites [40–42], wear of resin composites rep-
resents one of the main issues associated with their clinical use [43,44]. The shape, size,
and distribution of the filler particles as well as the weight and volume percentage of the
inorganic filler are only some of the factors that affect the wear of resin materials [40,45,46].
J. Funct. Biomater. 2022, 13, 287 14 of 20

Temperature and environmental conditions such as pH and lubrication level are other
conditions able to significantly impact the clinical performance and durability of compos-
ites [47–50].
For all these reasons, manufacturers have introduced materials with enhanced physical
and mechanical properties [9]. An extensive knowledge of the mechanical behavior of
composites is required to know which are property-enhancing without damaging other
properties. Within this context, the application of the “tribology” concept to research
on composite dental materials can be extremely useful for a better understanding of the
mechanical behavior of composites [51,52]. The application of tribology in the dental field
is justified by the fact that the oral cavity is comparable to a tribological system. The relative
motion between teeth and restorative materials in the presence of saliva and external
components such as food and drink results in contact and subsequent wear of teeth and
restorative materials [6,51]. Understanding the tribological mechanisms underlying tooth
wear is important to minimize dental resin damage and promote efficient development of
new biomaterials.
A scoping review is a flexible approach for reviewing the existing literature on a
topic in order to identify gaps in knowledge and conceptual boundaries and direct future
research [53,54]. Thus, this methodological strategy is particularly indicated when a re-
search topic has not been extensively investigated [55]. The primary aim of our review was
exploratory in order to assess whether the tribology concept has been currently applied in
the research field of dental composites. Despite a huge number of studies on wear phenom-
ena of dental composites having been published, few of them have applied a tribological
methodological approach. Only one of seventeen studies identified was published in a
dental journal, confirming the trend observed in the exploratory search which showed that
the keywords “tribology” and “biotribology” are poorly applied in dentistry, and even
then, mainly in the conservative field.
Although the most reliable way to determine the clinical performance of dental com-
posites would be to conduct in vivo testing, some methodological limitations make them
inadequate for providing standardized and replicable results [51]. Consequently, in vitro
testing is much more used in research and results are more informative because of the
precise control of variables involved [51]. More specifically, the experimental parameters,
such as the normal load (e.g., 1–100 N and up to 1000 N in bruxism), number of cycles
(e.g., 5000–120,000 cycles), test frequency (e.g., 1.2–1.7 Hz), and lubrication medium are
adapted to the type of abrasion mechanism to be simulated [56]. Despite the rigorous
control of above variables, in vitro tests cannot reproduce the complexity of the oral envi-
ronment. Therefore, they are useful for obtaining insights into wear patterns but cannot be
directly translated to the clinics [57]. Table 1 provides a summary of the main testing used
in the included studies. In most of the studies, the contact was simulated by a two-body
wear test in pin-on-flat or ball-on-flat models [22,24,25,27,30,32–39]; thus, the geometries
required for conducting the tests were a flat sample and a cylindrical pin or sphere [6]. The
reciprocating tribometer is one of the most widely used models. It consists of a cylindrical
pin or sphere, in contact with a flat sample, subjected to a contact pressure generated by
a vertical load. The apparatus moves along a linear trajectory alternately forward and
backward, at imposed frequency parameters [6]. The tribometer provides the coefficient of
kinetic friction which can be considered an index of material wear [58,59]. The limitation
is that the reciprocating tribometer allows only alternating sliding and not impact to be
simulated [6]. The advantages include the standardized conditions and ability to conduct
the test under lubricated conditions [6].
Simulating lubrication represents a fundamental aspect in tribological investigation.
Six of the 17 included studies mentioned that the test was conducted under lubricated
conditions [24,30,32–34,36]. Lubrication is reproduced either by immersion in a bath or by
pumps that continuously lubricate the contact area during the test [6]. In vitro lubrication
can only be simulated by artificial saliva since natural saliva cannot ensure standardized
pH conditions [60]. Studies performed under dry conditions should be interpreted with
J. Funct. Biomater. 2022, 13, 287 15 of 20

caution because the composite material loss may be less in the wet environment due to the
lubricating action of artificial saliva or similar lubricant [24].
Dental wear is studied both quantitatively (i.e., depth and volume of wear) and
qualitatively (i.e., microscopic and macroscopic techniques of surface topography) [61].
Therefore, several macroscopic and microscopic methods and techniques have been used to
investigate the tribological behavior of composite materials [22,24–39]. Detailed analysis of
the different techniques is beyond the scope of this review. What is important to emphasize
here is that the best and most desirable approach for future studies is to integrate both
quantitative and qualitative techniques for obtaining more useful information on the wear
mechanism and the tribology of the system [22].
The dimensions and content of inorganic filler particles as well as the nature of organic
matrix polymers significantly impact the wear of dental composites [33,40,62]. Specifically,
the immersion of harder inorganic micro- and nano-particles in a matrix of lower hardness
allowed the material’s resistance to abrasion to be improved. In addition, increase in
inorganic filler volume/weight percentage enhanced the mechanical properties of dental
resin [24,26,33,36,37]. Furthermore, the increase in inorganic content implies a reduction
in the volume of the organic component. This mechanism decreases the polymerization
contraction and thermal expansion coefficient of the resin [33,41]. Of note, the addition
of the filler itself, regardless of the other properties, improves the tribological properties
of the polymer matrix. This mechanism can be explained by the presence of grooves
at the sliding contact. The addition of particles up to a certain optimal value fills the
grooves making the contact surface flat and providing extra protection against wear [24,63].
Similarly, microhardness is enhanced with increasing filler up to a certain limit, beyond
which microhardness is decreased. The composite has an optimal level of interfacial stress
due to the added particles that provide a block to both extensional and shear deforma-
tion [24]. However, further increase in filling can induce voids to form and particles to
agglomerate due to Van der Waal forces, resulting in reduced mechanical strength [64].
On the other hand, composites with organic friction modifiers (i.e., polyethylene, PE, and
polytetrafluoroethylene, PTFE) exhibited the lowest friction coefficients when compared
with composites with inorganic fillers [30]. This benefit could be linked to a better adhesion
of organic fillers to the organic matrix which depended on filler grain forms and bonding
forces [30]. The results are not directly comparable with the other studies due to differences
in filler type and the value of loading applied on the sample.
Interestingly, roughness of dental composite was influenced by particle size while
nanohardness was influenced by the concentration of the reinforcement materials [31].
This behavior justifies the application of nanoparticles to produce materials with lower
roughness because the lower particle size, the smaller loss material [65].
As reported by Vargas et al. [35], the adding of different-sized particles of alumina and
silica had a positive effect on Young’s modulus and wear resistance of resin-based dental
composites. In addition, Yadav et al. [37,38] showed that nHA and aluminum or titanium
oxidum [37] and Ha-zinc oxide filling (from 0% to 8%) [38] significantly improved the wear
rate of tested composites [37,38]. The incorporating of ceramic particles in a polymeric
matrix is a well-known mechanism to enhance the mechanical properties of the composites,
depending on the hardness and size of particles [66–68]. Yet, the methodologies differ
from others publications in several aspects such as in procedures for specimen prepara-
tion, nature/weight of particles added, and testing apparatus. Thus, the generalizability
of results is limited and the applicability in clinical practice requires caution. Indeed,
many other factors, including saliva, temperature, food particles, and muscle activity act
simultaneously in real-life conditions [33,37]. Consequently, the wear rates could vary in
different situations.
The environmental conditions have a notable impact on the in vivo degradation of
dental resin composites. Expositions to liquids may determine the chemical degradation
and wear of composites by two main mechanisms [69]. The first is linked to the diffusion of
water molecules into the polymer network which resulted in plasticization and swelling of
J. Funct. Biomater. 2022, 13, 287 16 of 20

the polymer matrix [70]. The second is a hydrolysis reaction which degrades the siloxane
bonds inducing the filler debonding [70].
These mechanisms are responsible for degradation or softening of resin-based com-
posites which may impact their mechanical behavior including hardness, strength, and
modulus of elasticity [69].
The magnitude of wear depth of resin-based composites was also negatively affected
by prolonged immersion in a tobacco solution [34]. Even pH modifications affect me-
chanical behavior of resins with extreme pH values reported to negatively impact the
wear resistance [25,36]. Indeed, an acid environment seems to induce hydrolysis of the
resin matrix [71] while an alkaline environment promotes resin-to-filler debonding and
fillers’ dissolution [72]. In addition, the tribological properties of resin materials such as
dental composites are frequently influenced by temperature variations [26,28]. Overall,
the sensitivity of dental composites to chemical and thermic degradation seems to be de-
pendent on the type and volume of filler, the nature of monomers, and the degree of resin
matrix cross-linking [25–27,29,36]. In addition, the mechanical behavior of resin composites,
particularly surface microhardness, is influenced by the type and polymerization degree.
Indeed, monomers not polymerized tend to decrease the hardness of inorganic filler and
consequently composite hardness [39]. Moreover, the intensity, band width, and curing
time of light units have been described as important parameters [73,74].
Of note, it is important to emphasize that human enamel possesses unique and not
replicable tribological properties, mainly good wear resistance, which are determined by
peculiar wear mechanisms not replicable in dental materials [32]. More specifically, as
reported by Sajewicz [32], wear resistance, correlated with the dissipated frictional energy,
was significantly higher for tooth enamel compared to the investigated composites [32].
Furthermore, the wear mechanism of the resin composites tested was characterized mainly
by chemical modifications, while enamel was characterized by physical transformations.
Sajewicz noted that energy approach is poorly applied in tribological investigations and
this could explain why similar methodologies generate different findings [32].
When investigated, the preponderant wear mechanism was abrasive, determined by
the contact between composite surface and antagonist, resulting in plastic deformation
and material loss [22,25,27–30,33–35,37–39]. The abrasive pattern was also confirmed by
the SEM analysis of wear facets with characteristic pitting, cracking, and material loss in
variable degrees depending upon the particle size distribution, filler volume, and density.
Furthermore, the presence of an adhesive mechanism [22,27] and delamination [28,29,36]
were described. The former determined the material transferal from composite to the
antagonist by cold welding through friction [75,76] and when combined with abrasive
mechanisms, could be responsible for the increased wear-volume values reported for
some resin-based composites [22]. The latter refers to the desquamation of reinforcement
particles in sheets or flakes promoted by subsurface crack propagation along the sliding
direction [77]. An exfoliation mechanism was also reported [24,36]. In this pattern, under
the action of shear force, two adjacent layers were easily exfoliated with a consequent
sliding movement of the layers, resulting in frictional and wear value reduction [64].
Of note, the type of wear process is strongly associated with testing apparatus [78]. In
more detail, the two-body wear test replicates the attrition between opposite structures,
while the three-body wear test mimics abrasion by food particles with multiple wear
phenomena occuring simultaneously [79]. All included studies were conducted under
two-body wear conditions.
Under the limitations of laboratory-based studies, some helpful strategies have been
suggested to improve wear phenomena of resin-based composites. Nanofilled composites
exhibited improved mechanical properties such as higher wear resistance [26,33,39] and
lower roughness [31,39]. Hence, their application could be more beneficial than conven-
tional composites mainly for long-lasting clinical restorations [26] and in acid environments
such as those generated by exposition to acid beverages [29]. Yet, beneficial effects derived
from variation in filler content and reinforcement are by no means automatic [35]. Indeed,
J. Funct. Biomater. 2022, 13, 287 17 of 20

the abrasive wear resistance of resin-based composites is material-dependent and cannot

be deduced from their category, filler loading, or composite matrix [80]. In addition, the
use of microcomposite resins requires extreme caution in patients with gastroesophageal
reflux disease (GERD) disease which increases the hydrochloric (HCl) acid concentration in
the oral environment [27].
Some limitations have to be considered. First, the review process. Secondary search
and the quality assessment of the studies have not been conducted. Scoping reviews
aim to provide an overview of available studies on a broad topic regardless of their bias
assessment. Thus, a qualitative assessment of the methodological frame is not mandatory.
In addition, the purpose of this scoping review was to explore the application of tribology
and biotribology concepts in field of dental composites. Thus, the search strategy by
keywords “tribology” and “biotribology” could have limited the findings retrieved. Yet,
a comprehensive research on studies that assessed the wear phenomena of resin-based
composites was beyond the aim of this review. Of note, the current review considered
only the application of the tribology concept in the composites field. Many other fields
of dentistry could be of interest for tribological applications. In particular, implantology
possesses suitable characteristics to be treated under a tribological approach for improving
the durability of prosthetic restorations and the implant survival rate in patients with
systemic diseases [81,82].
A second limitation refers to the studies included. The studies differ in several method-
ological aspects including type of composite, properties investigated, testing apparatus,
lubricant application, temperature, and pH values. Hence, the studies were not directly
comparable. In addition, due to the complex nature of the oral environment, no methodolog-
ical standard currently exists to investigate and measure mechanical and microstructural
behavior of dental resin composites. Most of the current studies focus on comparison
of wear characteristics of different composite materials; yet, studies for understanding
the underlying mechanisms are poor and sparse [51]. In addition, wear behavior is often
addressed from an engineering perspective without referring to clinical applications.
Based on the previous findings, future research should address three principal points:
1. A universal methodological standard applying the tribology concept is needed to
standardize the studies conducted. More specifically, the wear behavior of composite
materials should be investigated taking into account the reciprocal contact with dental
tissues under dry and wet conditions.
2. Several aspects including the frictional force, mechanical energy dissipation, thermal
micro- and nano-structural alterations have to be considered to fully understand the
wear mechanism of dental composites.
3. An integrated approach, i.e., engineering and clinical, is needed to provide useful
information for producers and translate the relevant finding to clinics. Understanding
wear mechanism could assist the clinicians in selecting suitable materials mainly for
patients with an increased wear risk.

5. Conclusions
This scoping review aimed to explore the application of the tribology concept in the
research field of resin dental composites. The majority of studies on dental tribology were
published in the area of research in mechanical engineering or nanotechnology and differ
in terms of materials, testing apparatus, and environmental conditions. The preponderant
engineering perspective and the lack of a standardized methodological approach make
the laboratory findings poorly informative for clinicians. Further studies should focus
on tribology behavior of dental materials composites, exploiting an integrated approach,
i.e., engineering and clinical, for improving development and advancement in this field
of research.
J. Funct. Biomater. 2022, 13, 287 18 of 20

Author Contributions: Conceptualization, G.R.M.L.R.; methodology, G.R.M.L.R. and E.P.; soft-

ware, L.G. and G.B.; validation, C.B., H.F.O. and P.N.; formal analysis, E.P. and L.G.; investigation,
G.R.M.L.R.; resources, E.P.; data curation, C.B., H.F.O. and G.B.; writing—original draft preparation,
G.R.M.L.R.; writing—review and editing, E.P. and P.N.; visualization, P.N. and L.G.; supervision,
E.P.; project administration, G.R.M.L.R. All authors have read and agreed to the published version of
the manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement: Not applicable.
Informed Consent Statement: Not applicable.
Data Availability Statement: Data sharing not applicable–no new data generated.
Conflicts of Interest: The authors declare no conflict of interest.

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