Protection hypothesis for composite wear.

Significant occlusal wear occurs on posterior composite restorations in areas without direct contact with opponent teeth (contact-free wear) in addition to wear at the contacts. Recent research has indicated that all occlusal posterior composite surfaces wear, and those surfaces show decreasing wear rates over time. This provides more evidence for an earlier theory proposed by Jørgensen et al. (1979) that composite contact-free wear is a function of access and attrition caused by small particles in the food bolus. This hypothesis is now called the "protection theory" or "protection hypothesis" for wear. Macroscopic protection or "sheltering" from wear is provided by cavity preparation walls. Microscopic protection against resin matrix wear is provided by filler particles that are close together. Clinical evidence supporting the protection hypothesis comes from recently confirmed low wear rates for microfill and hybrid composites. The objective of this work was to calculate the minimum inter-particle spacing required for microscopic protection (wear resistance) for composites based on assumptions of packing fractions (0.68) with small particles (0.02 microns radius) for dispersed versus agglomerated conditions. An inter-particle spacing (IPS) of < 0.10 microns was assumed to afford wear protection. The results are that only 1.5-6.0 volume percentage microfiller is theoretically required to generate an IPS of 0.1 micron for composite microscopic protection. However, microfiller particles are suspected to agglomerate into clusters. Modified calculations for that effect indicate that at least 35% filler is required to provide microscopic protection. This effect explains much of the 3 to 5 year clinical research results for microfills and hybrids.(ABSTRACT TRUNCATED AT 250 WORDS)