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Available online at www.sciencedirect.com

ScienceDirect

journal homepage: www.intl.elsevierhealth.com/journals/dema

A comparative study on the wear behavior of a

polymer infiltrated ceramic network (PICN)
material and tooth enamel

Zhou Xu a,1 , Ping Yu a,1 , Dwayne D. Arola b,c , Jie Min a , Shanshan Gao a,∗
a State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of
Stomatology, Sichuan University, Chengdu 610041, China
b Department of Materials Science and Engineering, University of Washington Seattle, WA, USA
c Department of Restorative Dentistry, Dental School, University of Washington Seattle, WA, USA

a r t i c l e i n f o a b s t r a c t

Article history: Objective. To investigate the wear mechanisms of a polymer infiltrated ceramic network
Received 22 February 2017 (PICN) material, to compare its wear behavior with that of tooth enamel, and to provide
Received in revised form evidence relevant to its clinical use.
8 August 2017 Methods. The Vickers hardness (HV) and elastic modulus (E) of a commercial PICN material
Accepted 31 August 2017 (ENAMIC) and enamel were measured. Reciprocating wear tests were performed under a
Available online xxx ball-on-flat configuration. Three wear pairs were explored including ENAMIC and enamel
subjected to Si3 N4 ball antagonists and ENAMIC subjected to enamel cusp antagonists. The
Keywords: coefficients of Friction (CoFs) were monitored continuously to 5 × 104 cycles. The wear depth
Polymer infiltrated ceramic network of ENAMIC, enamel specimens and enamel cusps were quantified using white light inter-
material ferometry, and the wear morphologies were examined using scanning electron microscopy
Enamel (SEM) to distinguish the wear mechanisms.
Wear Results. The HV of ENAMIC is similar to tooth enamel but the E is much lower. For both mate-
Damaging mode rials, the CoFs increased sharply in the early stage and then reached plateaus in the later
phase. Throughout the cyclic loading history, ENAMIC exhibited larger wear depths than
enamel. However, the damage evolution in ENAMIC was similar to that of enamel as the
polymer phase was worn preferentially similar to inter-rod enamel, and then the ceramic
phase exfoliated from the wear surface akin to enamel rods. The SEM images showed evi-
dence of few cracks within wear tracks of ENAMIC, in comparison to numerous cracks in
tooth enamel.
Significance. ENAMIC has lower wear resistance than tooth enamel, but it exhibits a wear
damage mode similar to tooth enamel.
© 2017 Published by Elsevier Ltd on behalf of The Academy of Dental Materials.

∗
Corresponding author. Fax: +86 28 8550 3482.
E-mail address: christina12357@163.com (S. Gao).
1
These two authors contributed equally to this work.
http://dx.doi.org/10.1016/j.dental.2017.08.190
0109-5641/© 2017 Published by Elsevier Ltd on behalf of The Academy of Dental Materials.

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1. Introduction
Tooth wear refers to the loss of hard tissue caused by means
other than dental caries or dental trauma [1]. It is a normal
physiological process occurring throughout life. Accelerated
tooth wear can cause problems, such as dentine hyper-
sensitivity, pulp exposure and even periapical diseases [2].
Lambrechts et al. reported that the wear depth of natural tooth
enamel is 15–40 ␮m a year in normal circumstances, and that
this physiological wear is of great importance for the mainte-
nance of the stomatognathic system’s health [3]. In the early
stage, it can eliminate premature contact and establish a sta-
ble and wider occlusal contact; in the middle stage, it can
reduce the height of cusps, to decrease the lateral forces on
the periodontal tissues [4]; in the terminal stage it can coordi-
nate the proportion of tooth crown and root, and reduce the
burden of periodontal tissues [5].
In many cases tooth enamel is replaced by ceramics or
composites because of caries, fracture, or external trauma.
The overall tooth wear is then dependent on the behavior
of these restorative materials [6]. Previous research has indi-
cated that traditional ceramics may induce excessive wear
of the opposing teeth, leading to high loss of dental hard
tissues, destruction of anatomical morphologies, abnormal
occlusal curves and even temporomandibular joint disorders
[7]. In general, composites can not maintain long term sta-
bility because of their poor wear resistance, aging sensitivity
and microleakage problems [8,9]. This is especially true for
patients with bruxism. The clinicians’ primary goals in the
placement of a dental material are to avoid excessive wear of
natural teeth, and maximize the lifespan of the restoration. To
achieve this goal, it appears that a new restorative material is
needed.
Recently, a commercial polymer infiltrated ceramic net-
work (PICN) material named ENAMIC was developed to
simulate the mechanical behavior of natural tooth struc-
ture [10]. In contrast to InCeram Alumina, ENAMIC is
infiltrated with polymer instead of glass, and the most
common monomers are Triethylene glycol dimethacrylate
(TEGDMA) and Urethane dimethacrylate (UDMA) [11]. The
ceramic network constitutes a three-dimensional framework
of interconnected particles, in comparison to the scattered
distribution of isolated particles in traditional dental compos-
ite materials. Previous studies have shown that the ENAMIC
possesses higher elastic modulus and hardness more closely
matching natural tooth structure than current dental com-
posites [12], and comparable fracture toughness and better
damage tolerance than glass ceramics [13]. The mechani-
cal performance suggests that ENAMIC can serve as a better
restorative material than glass ceramics and resin compos-
ites. However, the ideal restorative material should not only
have excellent mechanical performance, but also show simi-
lar wear rates to that of tooth enamel [14]. There is presently
no literature comparing wear properties of ENAMIC and tooth
enamel, or a detailed evaluation of the wear mechanism and
damage evolution process of ENAMIC. Therefore, the primary
aim of this paper was to investigate the wear behavior and
damage modes of ENAMIC, and to compare them with those
of tooth enamel.
Please cite this article in press as: Xu Z, et al. A comparative study on the wear behavior of a polymer infiltrated ceramic network (PICN) material
and tooth enamel. Dent Mater (2017), http://dx.doi.org/10.1016/j.dental.2017.08.190
2. Materials and methods
2.1. Specimen preparation
The study was approved by the Research Ethics Committee of
Sichuan University, China, and all teeth were collected with
patients’ consent. Forty tooth specimens and twenty ENAMIC
specimens were prepared according to the following proce-
dures. Twenty unerupted third molars were collected (18–25
years old), and preserved for less than three months in dis-
tilled water prior to sample preparation. The crowns were
separated from the roots at the cemento-enamel junction
and then cut into sections along the mesial–distal axis with
a diamond-coated band saw under continuous water cooling
(Struers Minitom; Struers, Copenhagen, Denmark). A commer-
cially available PICN material (Vita ENAMIC, Vita Zahnfabrik,
Bad Sackingen, Germany) consisting of feldspathic porcelain
(86 wt%, 75 vol%) and polymer matrix (14 wt%, 25 vol%) was
also used in this study. The ENAMIC material was cut into
cuboid blocks approximately 4 × 4 × 2 mm3 . Next, the forty
tooth sections and twenty ENAMIC blocks were embedded in
self-curing epoxy resins (Struers, Copenhagen, Denmark) with
labial or lingual surfaces of the tooth facing outward. After
solidification, all specimens were ground with silicon carbide
abrasive papers (Struers, Copenhagen, Denmark) in a decreas-
ing order of abrasive size (#800, #1200, #2400, and #4000) under
continuous water irrigation. The forty tooth specimens were
ground down to a thickness of 80–110 ␮m from the labial or
lingual enamel surfaces [15]. Then, all of the specimens were
polished sequentially using DiaDuo-2 (Struers, Copenhagen,
Denmark) of 3 ␮m and OP-S NonDry (Struers, Copenhagen,
Denmark) of 0.04 ␮m on a polishing machine (Struers, Copen-
hagen, Denmark) until a mirror-like surface was achieved.
Finally, the specimens were ultrasonically cleaned for 10 min
in deionized water (KQ-50B, Shumei, Kunshan, China).
Twenty human molars (donors 18–25 years old) were used
to prepare enamel cusp antagonists. Firstly, the crowns were
separated from the roots at the cement–enamel junction and
cut into sections along the mesial–distal and buccal–lingual
axis to get mesio-buccal cusps, with a diamond-coated band
saw under continuous water cooling (StruersMinitom; Struers,
Copenhagen, Denmark). Then, the enamel cusps were stan-
dardized using a diamond hemispherical and hollow rotary
drill with diameter of 3 mm [16,17], resulting in a hemispheri-
cal area on the tip of the cusps. Finally, the cusps were polished
with an enamel polish bur (Shofu, Enamel adjustment CA Kit
dental polishing kit 0307, Japan), and mounted on a steel stylus
with acrylic resin.
2.2. Vickers hardness
Vickers Hardness (HV) of the ENAMIC and tooth enamel speci-
mens was measured using a Vickers hardness tester (MVK-H2,
Akashi, Japan) with a maximum load of 0.5 N for 15 s. Ten
indentations were made with an interval of 200 ␮m between
indentations on the central area of each specimen. Three spec-
imens were tested for both the ENAMIC and tooth enamel,
respectively.
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2.3. Elastic modulus

Elastic modulus (E) of tooth enamel and ENAMIC samples was

measured using a TriboIndenter (Hysitron Triboscope, Min-
nesota, USA) with a spherical indenter of 20 ␮m nominal tip
radius [18]. All tests were performed at room temperature in
the load-control mode and with a maximum load of 2 mN.
The loading was performed using a trapezoid function includ-
ing a 5 s linear loading period, a 30 s hold period at the peak
load, and a 5 s unloading period. Thirty indentations were
made with an interval of 50 ␮m between indentations on three
ENAMIC and tooth enamel specimens, respectively.

2.4. Wear testing

Tribological tests were conducted in a commercial wear

machine (Rtec instruments inc., MFT 5000, USA), using a ball-
flat contact mode. Forty Silicon nitride ceramic balls with a
diameter of 6.37 mm [19,20] and twenty standardized enamel
cusps were used as antagonists. A total of twenty enamel spec-
imens and forty ENAMIC specimens were made for the wear
test. Three groups (of n = 20 specimens each) were randomly
designed for the wear tests, including an ENAMIC specimen
– ceramic ball antagonist group (P-C), an enamel specimen –
ceramic ball antagonist group (E–C) and an ENAMIC specimen
– enamel cusp antagonist group (P–E). The experiments were
performed under artificial saliva lubrication at room tempera-
ture. The testing parameters included an imposed load of 20 N,
displacement amplitude of 0.5 mm, a rate of 2 mm/s and a
frequency of 2 Hz. A total of 5 × 104 translation cycles were per-
formed and the coefficient of friction (CoF) was continuously
calculated by the test system throughout test from the ratio
of the transverse load divided by the applied normal load. In
order to observe the evolution in wear response, five intervals
of analysis were employed over the 5 × 104 cycles, including
after 5 × 102 , 1 × 103 , 5 × 103 , 1 × 104 and 5 × 104 cycles, and
each interval was repeated four times.
The wear tracks and enamel antagonists before and after
test were scanned using a white light interferometer equipped
with the tribometer. Three-dimensional topographies of wear
tracks were reconstructed using the matched software (Gwyd-
dion 2.30, Department of Nanometrology, Czech Metrology
Institute). The vertical loss of antagonists was assessed
through the height difference of the same cusp before and
after test. The wear depths were used to calculate the apparent
wear rates over the total period of articulation [21].
Fig. 1 – Micrograph of the ENAMIC microstructure. C
represents the ceramic phase (light gray) and P represents
the polymer phase (dark gray).
2.6. SEM observations
In order to analyze features concerning the progression of
wear and the overall morphology of the two materials under
ceramic ball antagonists, a sequential analysis was performed
over the 5 × 104 cycles. Specifically, the samples were ultra-
sonically cleaned and examined using a scanning electron
microscope (SEM, INSPECTE, Czech, Republic) after 5 × 102 ,
1 × 103 , 5 × 103 , 1 × 104 and 5 × 104 test cycles.
3. Results
3.1. Microstructure of ENAMIC
A representative image of the ENAMIC microstructure is
shown in Fig. 1. The ceramic phase (C) and interstitial sec-
ondary polymer phase (P) appeared to be distributed uniformly
throughout the ENAMIC. They intercrossed with each other
closely and no cracks or separation were evident at the inter-
face. The ceramic particles varied in size and shape with
effective diameter ranging from approximately 3.5 ␮m–10 ␮m,
whereas the infiltrated polymer matrix islands varied in size
from 1 ␮m to 3 ␮m.

2.5. Data analysis 3.2. Mechanical properties

Student’s t-tests were performed to assess differences in HV
and E between human tooth enamel and ENAMIC. One-way
ANOVA was conducted to assess differences in the wear
depths of different intervals in the P–C group, E–C group, P–E
group ENAMIC specimen and P–E group enamel antagonist.
Statistical analysis was performed using SPSS 18.0. A p-value
of less than 0.05 was considered statistically significant.
Table 1 presents the results of HV and E of the ENAMIC and
tooth enamel specimens. The mean hardness of the ENAMIC
was comparable to that of tooth enamel. However, the mean
elastic modulus was substantially less than that of tooth
enamel. Results from the student’s t-test showed there were
statistical differences (p < 0.05) between ENAMIC and tooth
enamel for both HV and E.

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the CoF increased dramatically before 5 × 103 cycles and then

reached a plateau with values for the P–C group and P–E group
of approximately 0.5 and 0.75, respectively.

3.3. Wear behaviors

Fig. 2 – Progression of the coefficients of friction (CoF) with
accumulation of wear cycles for the P–C, E–C, and P–E
groups. The dotted lines define the division of stage I and
stage II wear.
The CoF history for the P–C, E–C and P–E groups are pre-
sented in Fig. 2 over the entire wear process. All three groups
exhibited similar trends in the CoF, which could be divided into
two stages. Stage I exhibited a sharp increase in CoF, whereas
Stage II transitioned into a plateau. The three groups showed
different segmentation times and plateau values in Stage II.
For instance, the CoF of the E–C group reached Stage II rapidly
with a plateau value of almost 0.45. For the P–C and P–E groups,
Table 1 – Vickers hardness (HV) and elastic modulus (E)
of the ENAMIC and tooth enamel.
ENAMIC Enamel
HV0.5N [GPa] 3.35 ± 0.30 3.70 ± 0.25
E [GPa] 23.54 ± 2.44 90.08 ± 4.15
Note: number of data for each group was 30.
Results for the wear depth of the ENAMIC and enamel are
shown in Fig. 3. All responses exhibited an increase in wear
depth with increasing number of cycles. When ceramic balls
were used as antagonists, the mean wear depth of the ENAMIC
(P–C group) was larger than that of tooth enamel (E–C group)
in all instants of the wear history. When tooth enamel cusps
were used as antagonists, the mean wear depth of the ENAMIC
specimens (P–E group) was also larger than that of tooth
enamel antagonists (P–E group). However, the mean wear
depth of the ENAMIC (P–C group) and tooth enamel (E–C group)
with ceramic ball antagonist was much lower than that of
the ENAMIC specimens and tooth enamel antagonists with
enamel cusp antagonists (P–E group).
The wear history of the specimens is shown in Fig. 3.
According to the experimental results for the wear depth,
the wear history could be divided into two stages, namely
a running-in stage and steady-state stage. These two stages
were differentiated by the dotted lines in Fig. 3A and B, except
the E–C group. Overall, the transition from the running-in
stage to the steady-state stage occurred at approximately
5 × 103 cycles. As evident in Fig. 3B, the mean wear rate at
5 × 103 cycles was significantly lower than that at 1 × 103
cycles, while no significant difference in wear rate was
observed between 5 × 103 and 1 × 104 cycles. Under the con-
ditions of the current study, the running-in stage of P–C group
and P–E group ranged from about 0 to 5 × 103 cycles. During
this period, the wear depth showed a rapid increase result-
ing from high wear rate. When the steady-state stage was
reached, the wear depth increased relatively slowly, the wear
rate decreased and got stable gradually. A distinct difference
in response was evident between the E–C group and the other
two groups. The wear rate for the five intervals of the E–C
group showed no statistical differences with each other, and
the wear depth increased only marginally.

Fig. 3 – Wear history resulting from articulation including (A) wear depth and (B) wear rate of the P–C group, E–C group,
ENAMIC specimens and enamel antagonists of the P–E group over the total period of evaluation. Dotted lines were added to
divide the running-in stage and the steady-state stage.

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Fig. 4 – A comparison of wear tracks for the P–C group and E–C group. Wear tracks on the specimens of the P–C group and
E–C group are shown at (A) 5 × 102 , (B) 5 × 103 , and (C) 5 × 104 cycles, respectively. Shown at each interval are the
reconstructed three-dimensional maps of the wear tracks (sides), as well as the depth profiles obtained near the center of
the wear track.

A comparison of the 3D topography and depth profiles of
the wear tracks in ENAMIC and tooth enamel caused by the
ceramic ball antagonists is presented in Fig. 4. Three differ-
ent instants of the wear tests are presented, including 5 × 102 ,
5 × 103 , and 5 × 104 cycles in Fig. 4A through C, respectively.
Profiles of the wear tracks were obtained from near the center
of the wear tracks and perpendicular to the long axes of the
wear scars. All the wear tracks were oval-shaped, shallow at
the edges and deep in the central region. The wear depths and
wear volumes increased with the increase of testing cycles, as
expected. As evident from these comparisons, the wear depths
in the ENAMIC were significantly higher than those in tooth
enamel over the entire period of testing.
Micrographs detailing the morphology of typical wear
tracks in ENAMIC are shown in Fig. 5 after different number
of wear cycles. The wear tracks exhibited exfoliation of parti-
cles and shallow plough marks at all increments of evaluation.
Fig. 5A presents the wear morphology at 5 × 102 cycles and
shows exfoliation (red dotted circle) occurred on the super-
ficial surface of ENAMIC. The polymer matrix (blue arrow)
peeled off from the wear surface, and the interconnected
ceramic network (red arrow) protruded from the worn sur-
face. Details of the wear scar after 5 × 103 cycles are shown
in Fig. 5B. Part of the superficial protuberant ceramic particles
fractured from the subjacent ceramic structure and exfoliated
from the wear surface. The ceramic structure (red arrow) was
evident discontinuously on the wear surface, and numerous
pores (yellow arrow) were apparent on the worn area. Sparse
islands of wear debris (red solid circle) were also occasionally
found covering the middle part and marginal area of the wear

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Fig. 5 – Representative SEM micrograph (columns from left at 5000×; 200×; 5000× magnification) of the worn surfaces of
ENAMIC after different periods of testing. A: 5 × 102 cycles; B: 5 × 103 cycles; C: 5 × 104 cycles. The white dotted square
outlines the marginal area of the wear scar and is shown in the left image; the white solid square outlines the middle area
of the wear scar and is shown in the right image. The red dotted circle indicates exfoliation; the red solid circle indicates
wear debris; the blue arrow indicates the peeled-off polymer phase; red arrows highlight the ceramic network; yellow
arrows indicate pores. (For interpretation of the references to colour in this figure legend, the reader is referred to the web
version of this article.)

track. The wear surface after 5 × 104 cycles in Fig. 5C shows
that the wear debris layer has disappeared and a clear wear
surface is exposed. In this figure the polymer matrix appeared
depleted and the ceramic structures (red arrow) were abun-
dant with smooth plane and partially interconnected. A larger
number of pores were observed (yellow arrow) than that after
5 × 103 cycles.
Micrographs detailing the morphology of typical wear
tracks in the enamel are shown in Fig. 6 after different periods
of wear. At all evaluation periods the wear tracks in enamel
displayed deep and dense ploughs marks parallel to the slid-
ing direction. In the wear morphology at 5 × 102 cycles (Fig. 6A),
delamination was not seen on the wear surface, but some
microcracks (yellow arrow) were noted at both ends of the
wear track. Fig. 6B shows the wear scar after 5 × 103 cycles,
microcracks and macrocracks (yellow arrow) developed in
the middle and marginal areas of the wear track. The inter-
rod enamel (blue arrow) was worn out preferentially and the
enamel rods (red arrow) were evident on the wear surface.
The wear surface after 5 × 104 cycles is shown in Fig. 6C, and
exhibits abundant irregular wear debris layers (red solid circle)
on both the marginal and middle areas of the wear track.

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Fig. 6 – Representative SEM micrograph (columns from left at 5000×; 200×; 5000× magnification) of the worn surfaces of
enamel after different periods of wear testing. A: 5 × 102 cycles; B: 5 × 103 cycles; C: 5 × 104 cycles. The white dotted square
outlines the marginal area of the wear scar and is shown in the left image, whereas the white solid square outlines the
middle area of the wear scar and is shown in the right image. The red solid circles indicate wear debris; blue arrows
indicate the worn-out interrod enamel; red arrows indicate enamel rods; yellow arrows indicate cracks. (For interpretation
of the references to colour in this figure legend, the reader is referred to the web version of this article.)

4.1. Mechanical properties

4. Discussion
Mechanical properties such as the hardness and elastic modu-
When choosing a restorative material that will experience
lus are very important to the performance of dental materials.
occlusal contact, the wear behavior should be considered
One criterion for assessing the appropriateness of a restora-
because wear is an irreversible and unavoidable process [22].
tive material is that the mechanical properties are compatible
The wear properties of the restoration should enable both the
to those of tooth enamel. For ENAMIC, while its hardness is
restoration and antagonist to achieve a long lifespan when
similar to tooth enamel, its elastic modulus is much lower
subjected to repetitive masticatory force. Studying the wear
than tooth enamel. Although HV and E of ENAMIC are not
behavior of a candidate material and analyzing the wear
in exact agreement with those of enamel, they are between
mechanism can generate the theoretical foundation and help
mechanical properties of glass ceramics and resin compos-
to improve its wear resistance.
ites. For instance, Elsaka reported that Vita Suprinity and IPS
e.max show indentation hardness value of 6.53 ± 0.46 and

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5.45 ± 0.28 GPa [23], respectively, which are nearly double that
of the polymer infiltrated material; the elastic modulus of Vita
Suprinity and IPS e.max are 70.44 ± 1.97 and 60.61 ± 1.64 GPa
[23], which is approximately three times higher than that of
ENAMIC. Another study comparing the mechanical properties
of resin composite and ENAMIC indicated that the hardness
and elastic modulus of ENAMIC are approximately double the
values of Paradigm MZ100 [24].
Considering the microstructure of ENAMIC, the infiltra-
tion of polymer in a pre-sintered glass–ceramics network is
expected to improve the mechanical properties. Adjusting the
proportion of ceramic and polymer is possible. Indeed, the
hardness and elastic modulus of ENAMIC can be changed
via the proportion of the ceramic structure and the polymer
phase; the hardness and elastic modulus increase with higher
content of the ceramic structure [25]. Thus, the elastic mod-
ulus of ENAMIC can be increased, to be more consistent with
that of enamel, by increasing the content of the ceramic struc-
ture. This may be most relevant to posterior restorations.
4.2. Wear behavior
In analyzing the COF and wear rate history for the P–C and
P–E groups (Fig. 3), it was found that the total wear process
over 5 × 104 testing cycles could be divided into two stages.
Based on the trends in data, the period between 0 to 5 × 103
cycles was defined as the running-in stage, and the subse-
quent cyclic responses were defined as the steady-state stage.
The mean wear rate in the first stage was high and decreased
sharply, and the CoF increased dramatically before 5 × 103
cycles. In contrast, in the second stage, the wear rate was low
and was relatively stable, and the CoF remained steady beyond
5 × 103 cycles. At the beginning of the wear test, the point con-
tact between the antagonist and specimen surface resulted in
a small contact area and a high contact stress. Under such
stress conditions, the volume of superficial ENAMIC material
in the contact zone experienced wear damage and material
loss. Correspondingly, the wear curve showed rapid growth
during the running-in period [26]. SEM images of the wear
facets during this stage revealed rough surfaces with plough
marks (Fig. 5B). The generation of this damage and the sur-
face characteristics were responsible for the sharp increase of
the CoF before 5 × 103 cycles. As wear progressed, the contact
area increased gradually, which in turn reduced the contact
stress [27]. Consequently, the wear rate decreased and then a
transition from the running-in stage to the steady-state stage
occurred. Perhaps the transition is related to the decrease in
contact stress below a threshold value, which changes the con-
tributing mechanisms. Thereafter, the wear process reached
the steady-state stage, in which the CoF and wear rate reached
plateaus. During this stage, the surface of the ceramic struc-
ture was comparatively smooth (Fig. 5C). The wear history
of the tooth enamel also contains two stages [28]. However,
the running-in stage for the tooth enamel (E–C group) is very
short and is a very small portion of the whole process to
5 × 104 cycles, as is evidenced by the sharp increase of CoF
before 100 cycle. That observation indicates that under con-
tact with a smooth and wear-resistant ceramic antagonist, the
microstructure of tooth enamel allows it to achieve a plateau
in wear rate, CoF and surface roughness very quickly. It would
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be valuable if the ENAMIC could be designed to mimic this
desirable response.
Throughout the cyclic loading history, the ENAMIC exhib-
ited larger wear depths than enamel, indicating its poorer
wear resistance. Despite this difference, it was interesting to
find that ENAMIC showed a similarity in the wear mechanism
to enamel. In the wear process of tooth enamel, the interrod
region is the weaker phase, which is more susceptible to wear
than enamel rods [28]. When the peripheral interrod enamel
was worn to an extent, the enamel rods fractured from the
below contact surface, and underwent exfoliation, as shown in
Fig. 6B. The ENAMIC exhibited a similar mode of wear damage
(Fig. 5). The polymer phase in ENAMIC plays a role similar to
the protein-rich interrod region of the enamel, which act as a
stress buffer for the brittle ceramic phase and enamel rods [29].
During the wear process, the polymer matrix was worn out
preferentially (Fig. 5A). With further cyclic motion, the protu-
berant ceramic particles fractured from the subjacent ceramic
structure, and then exfoliated from the wear surface.
ENAMIC is manufactured by infiltration of a ceramic net-
work with a polymer, which is substantially different from
other resin composite materials that are reinforced with a dis-
persion of fillers particles. The innovative microstructure of
ENAMIC results in a damage mode during wear that is very
different from other composite materials. Although the wear
mechanism of other composites were not evaluated in the
experiment, previous studies have detailed the wear mech-
anisms for resin composites [30]. The wear process involves
preferential wear of the polymer matrix, which exposes the
fillers and enables their protrusion from the matrix. With ade-
quate stress and articulation cycles the fillers detach from the
matrix without fracture. A schematic representation of the
damage process for ENAMIC and resin composites caused by
cyclic articulation is shown in Fig. 7A and B, respectively.
Despite the similarity, there are distinct differences in the
wear process between ENAMIC and tooth enamel. The biggest
difference is that cracks were apparent in the enamel wear
track in the early stage, while very few cracks were iden-
tified on the ENAMIC wear surface. It is well accepted that
friction and wear behavior depend strongly upon chemical
compositions, microstructure, and mechanical properties of
the material [31]. In regards to the chemical composition,
ENAMIC contains 75 vol% ceramic phase and 25 vol% poly-
mer matrix, while tooth enamel consists of approximately
95 vol% inorganics, with the remainder consisting of organic
proteins and water [15]. The higher polymer content of the
ENAMIC may lead to a stronger crack growth resistance.
Secondly, ENAMIC is composed of dual interpenetrating three-
dimensional intersecting networks. Cracks in the ENAMIC
propagate predominantly through the ceramic network and
are deflected by the polymer-ceramic interface [29]. That
mechanism of crack growth resistance helps to resist localized
mechanical degradation induced by compression and fracture
[32,33]. However, in tooth enamel, cracks primarily propa-
gate within the protein-rich rod boundaries [34]. In the inner
enamel, bridging by unbroken ligaments of the tissue and the
organic matrix and decussation of enamel rods can reduce the
local opening mode stress and promote crack closure [35]. In
the outer enamel with less potent toughening mechanisms,
the cracks initiate and propagate in tooth enamel more easily,
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Fig. 7 – Schematic representation of the wear and damage processes in (A) ENAMIC and (B) resin composite. In A: ENAMIC,
C — ceramic phase, P — the polymer matrix. In B: resin composites, F — fillers, M — matrix.

which was evident from the wear tests (Fig. 6A and B). Thirdly,
the infiltration of polymer increases the fracture toughness
of the ENAMIC, and the fracture toughness of ENAMIC is
reportedly higher than that of enamel [36], suggesting that the
microstructure of ENAMIC has better resistance to the growth
of cracks.
4.3. Correlation between mechanical properties and
wear results
As previously mentioned, ENAMIC consists of the interwoven
ceramic structure and the polymer phase. This combination
of material phases in ENAMIC is what contributes to the
moderate mechanical properties, and the intermediate wear
resistance between resin composites and glass ceramics [37].
In light of this material combination, it could be expected that
the factors affecting the wear resistance of ceramic structure
and polymer phase would contribute to the wear resistance of
ENAMIC simultaneously. The hardness and surface roughness
is claimed to have significant contribution to wear of the poly-
mer phase [38]. The polymer phase shows lower wear depths
with a higher hardness and a lower surface roughness. In addi-
tion, the greater abrasiveness of ceramics results in a higher
CoF [39]. Thus, the hardness, surface roughness, and the COF
are all expected to play important roles to the wear resis-
tance of ENAMIC, as well. The lower hardness (Table 1), higher
CoF (Fig. 1), and rough wear surface of the ENAMIC would
be expected to be responsible for its inferior wear resistance
when compared to tooth enamel. However, relative magni-
tude of these properties can only explain the rank in wear
results partially, because wear is a complex process of mate-
rial removal by physical separation, chemical dissolution, or
melting at the contact interface [40]. It can be affected by many
other factors, including the magnitude of contact loads, the
corresponding stresses, and duration of interaction [41,42], as
well as the lubrication environment [30]. These are relevant to
the wear process.
Overall, the wear depths in the ENAMIC and tooth enamel
under articulation with a ceramic ball antagonist were much
higher than those under contact with an enamel cusp antag-
onist. This is further evidence that the volumetric wear is
dependent on the testing conditions, but raises an impor-
tant issue with respect to laboratory evaluations. Wear testing
methods that use high strength ceramics as antagonists
instead of enamel would be expected to overestimate the
wear resistance of the material, since enamel antagonist are
expected to roughen more than ceramic antagonists [43].
4.4. Clinical implications
Previous research has shown that ENAMIC has a moderate
wear resistance, that is between resin composites and glass
ceramics [37]. It will not cause excessive wear of antagonists
like glass ceramics, and it will not quickly wear out as found

Please cite this article in press as: Xu Z, et al. A comparative study on the wear behavior of a polymer infiltrated ceramic network (PICN) material
and tooth enamel. Dent Mater (2017), http://dx.doi.org/10.1016/j.dental.2017.08.190
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with resin composites, which is promising in regards to its
clinic use. Although the wear resistance is not equivalent to
tooth enamel, ENAMIC has been proven to be an acceptable
choice for dental restorations. In addition, ENAMIC has a favor-
able fracture toughness [13], and the experimental results
showed few cracks that evolved in the wear process. As such,
ENAMIC may be a very suitable choice as a dental restora-
tions for bruxism patients, which have been shown to pose a
threat to ceramic veneer fracture [44]. Results from the present
study show that ENAMIC has a similar wear mechanism to
tooth enamel, which suggests that its special dual-phase
interconnected microstructure is an effective design. A
restorative material which has wear resistance matching that
of tooth enamel could promote lifelong health involving both
the restoration and tooth life. It is possible that ENAMIC may
be improved to have a wear resistance more consistent with
tooth enamel by adjusting the proportion of the ceramic struc-
ture and the polymer phase.
Although care was taken in the experiment to simulate
conditions of the oral environment, there are some differences
between the test conditions and the oral environment. The
oral environment is complicated and highly varied, includ-
ing temperature and level of acidity, which have influence on
the wear mechanisms and wear behavior of ENAMIC [45,46].
As such, follow-up experiments are currently underway that
consider the influence of acid and temperature on the wear
behavior of ENAMIC.
5. Conclusions
The wear mechanisms and damage mode of ENAMIC with
75 vol% feldspathic porcelain was analyzed, and the results
were compared with those for human enamel. Within the
limits of this study, the following conclusions were drawn:
1. The wear resistance of ENAMIC was significantly lower
than that of tooth enamel.
2. The wear damage mode of ENAMIC is similar to that of
tooth enamel. The polymer phase undergoes wear prefer-
entially, similar to the interrod region in enamel, and then
the ceramic phase exfoliates from wear surface, similar to
what occurs in the enamel rods.
Acknowledgement
The authors gratefully acknowledge the financial support
provided for this study by the National Natural Science Foun-
dation of China (81100777).
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