Nanofilled Resin Composite Properties and Clinical Performance - A Review

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Operative Dentistry, 2018, 43-4, E173-E190
Nanofilled Resin Composite

Properties and Clinical
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Performance: A Review
H Alzraikat ! MF Burrow ! GA Maghaireh ! NA Taha
Clinical Relevance
Nanocomposites have been found to exhibit properties and clinical performance
comparable to those of several hybrid composites but better than microfilled composites.
However, there is no long-term evidence yet to show a superior performance that justifies
their use in stress-bearing areas.
SUMMARY tion, color match, and surface roughness. A

The aim of this review was to compile recent search of English peer-reviewed dental litera-
ture (2003-2017) from PubMed and MEDLINE
evidence related to nanofilled resin composite
databases was conducted using the terms
materials regarding the properties and clinical
‘‘nanocomposites’’ or ‘‘nanofilled resin compos-
performance. Special attention was given to
ite’’ and ‘‘clinical evaluation.’’ The list was
mechanical properties, such as strength, hard- screened, and 82 papers that were relevant to
ness, abrasive wear, water sorption, and solu- the objectives of this work were included in
bility. The clinical performance of nanocom- the review. Mechanical properties of nano-
posite materials compared with hybrid resin composites are generally comparable to those
composites was also addressed in terms of of hybrid composites but higher than micro-
retention and success rates, marginal adapta- filled composites. Nanocomposites presented
lower abrasive wear than hybrids but higher
*Hanan Alzraikat, PhD, Department of Conservative Dentist-
ry, Jordan University of Science and Technology, Irbid, sorption values. Their clinical performance
Jordan was comparable to that of hybrid composites.
Michael F Burrow, EBM, BDS, MDS, PhD, MEd, MRACD-
S(Pros), FRACDS, Faculty of Dentistry, University of Hong INTRODUCTION
Kong, Prince Philip Dental Hospital, Hong Kong
Resin composite materials are increasingly used in
Ghada A Maghaireh, BDS, MS, ABOD, Department of modern dentistry due to several desirable qualities,
Conservative Dentistry, Jordan University of Science and
such as esthetic appearance and good physical and
Technology, Irbid, Jordan
mechanical properties.1 The availability of numer-
Nessrin A Taha, DCD Endo, Department of Conservative
ous commercial products makes resin composite
Dentistry, Jordan University of Science and Technology,
Irbid, Jordan suitable for use in several clinical applications,
including as restorative materials, cavity liners, core
*Corresponding author: PO Box 3030, Irbid 22110, Jordan;
e-mail: [email protected]
buildups, and luting cements, to name a few.2-4
Previous research has addressed several shortcom-
DOI: 10.2341/17-208-T
ings of composites, such as polymerization shrink-
E174 Operative Dentistry
age, strength, and wear resistance.5-9 A wide range esthetics and polishability in addition to excellent
of resin composites is available for anterior and wear resistance and strength.21,22
posterior restorations. This implies a wide range of In his review of resin composites, Ferracane2
organic and inorganic constituents that will influ- described the chronological development of resin
ence their clinical handling and performance.1 The composites outlining their classification according to
main composition of resin composites consists of an the filler particle size as follows: macrofill (10 to 50
organic polymeric matrix, inorganic fillers, and a lm), microfill (40 to 50 nm), and hybrid (10 to 50
silane coupling agent that links the first two lm þ40 nm). Hybrid composites were further distin-
components together.10 Mechanical properties and guished as ‘‘midifill resin composites’’ with an
esthetic appearance of resin composites have been average particle size slightly greater than 1 lm
shown to be influenced by their composition and and a portion of the 40 nm fillers. Further refine-
microstructure.11,12 Despite the improvements in ment of the filler particles resulted in what is known
various properties over recent years, major changes as microhybrids (0.6 to 1 lm and 40 nm). Finally,
to their composition have involved mainly the fillers nanofilled resin composites (1 to 100 nm) and
rather than the monomer systems, which were nanohybrid that is a combination of microhybrid
originally developed by Bowen13 in 1962. and nanofilled-size particles were introduced.
The original resin matrix monomer system was The growing interest in nanotechnology and its
based on the formula presented by Foster and use in resin composites was based on the desire to
Walker14 consisting mainly of (Bis-GMA: 2,2-bis[4- utilize the ability of nanosized particles to alter the
(2-hydroxy-3-methacryloxypropoxy) phenyl] pro- structure of the composite. This in turn may improve
pane) and later urethane dimethacrylate. Several mechanical, chemical, and optical properties and
approaches were suggested to modify the monomer develop a resin composite that can perform optimally
component to create resin composites with no or in all parts of the mouth.22,23 Consequently, Mitra
minimal shrinkage on polymerization and improved and others22 introduced novel nanofillers and then
wear resistance. One of the modifications in the utilized various methacrylate resins and curing
monomer system was the use of ring opening technologies to develop nanocomposites. This nano-
monomers. These monomers resulted in the devel- composite was subsequently marketed as the Filtek
opment of resin composites with decreased polymer- range of restorative materials (3M ESPE, St Paul,
ization shrinkage (ie, silorane-based resin compos- MN, USA).
ites).15 Organically modified ceramics (ormocers)
Two classes of resin composites that include
were introduced to overcome problems of polymeri-
nanoscale filler particles in their composition have
zation shrinkage associated with conventional meth-
been introduced, namely, nanofilled and nanohybrid
acrylate-based resin composites. Ormocers contain
resin composites. While nanofilled composites use
inorganic-organic copolymers in addition to inorgan-
nanosized particles throughout the resin matrix,22
ic filler particles.16 Ormocers have shown lower wear
nanohybrids include a mixture of nanosized and
rates compared to other composites17 and similar
conventional filler particles.24 It has been previously
shrinkage to hybrid composites despite their lower
suggested that the size of the fillers observed for the
filler content.18
nanohybrid composites could be a reason to not refer
It is well documented that mechanical properties to them as nanostructured materials. This sugges-
of resin composites are significantly influenced by tion was based on the fact that microhybrid
the filler particle morphology (shape), size range, composites may contain a mixture of similar nano-
and volume content.11,19,20 The increasing demand sized particles in combination with larger filler
for esthetic dentistry has led to the development of particles.1 Nanosized fillers can be categorized as
resin composites used for direct restorations. These either isolated discrete particles, with dimensions of
composites have demonstrated improved clinical around 5 to 100 nm, or fused aggregates of primary
performance both physically and esthetically.21 nanoparticles, where the cluster size may exceed 100
Traditional composites have been classified based nm.25 It has been proposed that finer particles when
on filler size. The classification divided the compos- incorporated into resin composite will lead to less
ites into macrofilled, microfilled, hybrid, and micro- interparticle space, which will provide more protec-
hybrid materials. The introduction of nanometer- tion to the more vulnerable, softer resin matrix. This
sized particles has been one of the latest develop- in turn will result in reduced ‘‘plucking’’ of filler
ments in the field and is thought to offer superior particles from the material surface.26,27
Alzraikat & Others: Nanofilled Resin Composites E175
Previous research has focused on testing various rial and significantly higher than the microfilled
properties of resin composites to evaluate their composite (Table 2). Similarly, Pontes and others29
performance in both laboratory and clinical studies. reported significantly higher FS of a nanocomposite
A large number of these studies aimed at comparing compared with a hybrid. On the other hand, several
nanocomposites with hybrid and microfilled resin investigators reported FS values of several nano-
composites.28 Therefore, the objective of the present composites comparable to or significantly lower than
work was to review laboratory studies that were a number of hybrid materials but significantly
higher than microfilled composites.11,31,36,40-42
undertaken on the so-called nanocomposites to
examine strength, fracture toughness, surface hard- A number of studies examined the influence of
ness, abrasive wear, water sorption, and solubility. several factors, such as light polymerization mode,
In addition, a review of the clinical performance of filler content (weight), and degree of conversion
dental nanocomposites was undertaken. Three ma- (DC) (defined as the percentage of reacted aliphatic
jor categories of resin composites, namely, nano- C=C bonds from the dimethacrylate monomers
composites, hybrid, and microfilled composites, were present in their polymeric matrices),43 on the FS
compared for the sake of offering a clear distinction of nanocomposites. Da Silva and others41 examined
between their performance and properties. A search the influence of using three different polymeriza-
of English peer-reviewed literature (2003-2017) from tion modes on the FS of a hybrid and a nano-
PubMed and MEDLINE databases was conducted composite (Table 2). The results showed that the FS
using the terms ‘‘nanocomposites’’ or ‘‘nanofilled of the tested composites was not influenced by
resin composite’’ and ‘‘clinical evaluation.’’ The list varying the light polymerization mode. Further-
was screened, and 82 papers that were relevant to more, FS of the hybrid composite was significantly
the objectives of this work were included. higher than the nanocomposite tested. Similar
conclusions were drawn by Pontes and others,29
STRENGTH who reported no significant effect on FS of a
The main aim of incorporating nanofillers into resin nanocomposite when varying polymerization
composites (ie, nanocomposites) is to create materi- modes. Similarly, Beun and others31 and Rodrigues
als that can be used to restore both anterior and and others42 reported no significant influence of
posterior teeth with a high initial polish and gloss. In varying polymerization modes on FS of nanocompo-
addition, they should exhibit mechanical strength sites and hybrid composites tested. Degree of
suitable for use in high-stress-bearing areas.22 Table conversion has been shown to influence mechanical
1 summarizes the main resin composites mentioned properties of resin composites.44 Beun and others31
in this literature with their reported classification showed a lower DC when using an LED curing unit
according to average filler size and the manufactur- for a 10 seconds of curing time compared with a
er. QTH curing unit at a 2-mm depth. The 2-mm
thickness is traditionally used and recommended by
Flexural Strength the ISO standard (4049) for dental resins.45 How-
One of the most commonly tested mechanical ever, in their study, Beun and others31 reported
properties of dental restorative materials is flexural that FS was not a discriminating factor used to
strength (FS), which is considered important for differentiate the tested composites since the nano-
characterizing brittle materials. This type of test composites showed comparable FS values to the
generates complex stresses that combine tensile, universal hybrids. Similar conclusions were drawn
compressive, and shear stresses when specimens are by Rodrigues and others42 regarding the effect of
loaded.29 Several studies examined FS of a number DC on FS. They reported comparable FS values of
of commercial nanocomposites comparing hybrid and composites tested that were attributed to the high
microfilled composites.11,13,22,28-36 Direct comparison filler loading of both composites (Table 2).
showed that the FS of nanocomposites was equiva- The influence of filler content on FS of nano-
lent to or even higher than other composites composites has also been examined comprehensive-
tested11,13,22,29,31,37 with values ranging from 103 to ly.11,29,31,40,46,47 Rodrigues Junior and others11
192 MPa.38-40 Mitra and others,22 who developed showed that there was a positive correlation
nanocomposite materials in 2003, reported FS values between the filler weight (FW) and FS of a nano-
ranging from 153 to 177 MPa. These values were composite (FW 84%). The nanocomposite showed
significantly higher than a number of tested hybrid intermediate strength values compared to other
composites, comparable to that of one hybrid mate- hybrid composites (FW 74% to 80%) and microfilled
Table 1: Summary of Resin Composites Reviewed, Category, and Manufacturer Information

Resin Composite Classification Manufacturer
Filtek Supreme Nanocomposite 3M ESPE, St Paul, MN, USA
Filtek supreme Z350 Nanocomposite 3M ESPE
Filtek Ultimate Nanocomposite 3M ESPE
Filtek Supreme Plus Nanocomposite 3M ESPE
Grandio Nanocomposite Voco, Cuxhaven, Germany
Grandio Flow Nanocomposite Voco
Esthet X improved Nanocomposite Dentsply Caulk, Milford, DE, USA
Premise Nanocomposite Kerr, Orange, CA, USA
TPH3 Nanocomposite Dentsply Caulk
Concept Advance Nanocomposite Vigodent, Rio de Janeiro, Brazil
Ceram X Nanocomposite Dentsply Caulk
Tetric EvoCeram Nanocomposite Ivoclar Vivadent, Amherst, NY, USA
Venus Diamond Nanocomposite Heraeus Kulzer, GmbH, Hanau, Germany
Charisma Diamond Nanocomposite Heraeus Kulzer
Ceram X mono Nanocomposite Dentsply Caulk
Ceram X Due Nanocomposite Dentsply Caulk
Clearfil Majesty Nanocomposite Kuraray America Inc, Houston, TX, USA
Ice Nanocomposite SDI, Bayswater, Australia
Filtek Z250 Hybrid 3M ESPE
Filtek P60 Hybrid 3M ESPE
Esthet X Hybrid Dentsply Caulk
Point 4 Hybrid Kerr
Charisma Hybrid Heraeus Kulzer
Clearfil AP-X Hybrid Kuraray America
Amaris Hybrid Voco, Cuxhaven
TPH Spectrum Hybrid Dentsply Caulk
Venus Hybrid Heraeus Kulzer
Filtek Z100 Hybrid 3M ESPE
Tetric Ceram Hybrid Ivoclar Vivadent
Prime-Dent Hybrid Prime Dental Manufacturing, Chicago, USA
Heliomolar Microfilled Ivoclar Vivadent
Helio Fill Microfilled Vigodent
Filtek A110 Microfilled 3M ESPE
Durafil Microfilled Heraeus Kulzer
Surefil Packable/hybrid Dentsply Caulk
Filtek Silorane Silorane resin 3M ESPE Dental Products, St. Paul, MN, USA
composite (FW 64%). However, it has been reported highest values of FS were observed at a filler
that the fracture behavior and the structural volume of 60%. Lin and others38 also suggested
reliability seem to not be affected in highly filled higher FS values being associated with higher filler
composites compared with composites with lower content when testing FS of several nanocomposites;
filler content, such as microfilled resin composites.42 however, in their study, spherical filler particles
This is because the volume percent content of the were not associated with higher strength values.
fillers may not be markedly different. A number of Contrary to the results reported by Lin and others,38
investigators indicated that filler content and Pontes and others29 reported no positive correlation
material category had a significant influence on between filler content and FS, which could be
mechanical properties of resin composites, including related to the fact that different products where
nanocomposites.28,39,47-49 Higher strength was asso- examined in the two previously mentioned studies.
ciated with spherical filler particles,47 and the Lawson and Burgess46 attempted to evaluate the
influence of nanofiller weight percent on mechanical by de Moraes and others,1 Pontes and others,29 and
properties of experimental resin composites. Three Lien and Vandewalle.36 This was attributed to the
experimental nanocomposites were formulated with presence of large individual filler particles in all of
different weight percent filler loads (25%, 50%, and them (Table 3).1
65%). There was an increase in the FS of all The CS and DTS of a number of nanocomposites
experimental composites up to 50% weight content were evaluated compared with hybrid, microfilled,
of the fillers. flowable, and ormocer-based composites.28 Large
Ilie and Hickel28 reported that large variations variations were observed in the strength values
exist between resin composites within the same (CS: 103 to 267 MPa; DTS: 32 to 45 MPa). Nano-
category. Flexural strength values ranging from 82 composites displayed the highest DTS values and
to 125 MPa were reported among 72 commercial comparable CS values to hybrid composites. It was
composites tested (nanocomposites, hybrid, pack- previously reported that the strongest influence was
able, microfilled, and flowable composites). Compa- for the filler volume on the DTS and that the
rable mechanical properties were found among a influence of material category was low and influ-
number of hybrid and nanocomposites that were enced mainly the CS.29,52,53 Generally, DTS of
expectantly higher than the flowable composites that nanocomposites is at least as good as that of several
have a lesser amount of fillers.28 hybrid composites and higher than a number of
hybrid and packable composites. However, Ilie and
In conclusion, it would be difficult to predict the
Hickel28 reported that having a lower modulus of
performance of a single material based on its type. It
elasticity makes nanocomposites experience more
is reasonable to conclude that the reported FS of
elastic deformation under functional stresses. There-
nanocomposites was not superior to that of most
fore, their clinical success is questionable when used
hybrid composites but was significantly higher than
in stress-bearing areas.
microfilled composites. Furthermore, it should be
noted here that the previously mentioned studies
Fracture Toughness
used filler weight percent rather than filler volume
percent when comparing different composites. It has Fracture toughness (FT) has been occasionally
been mentioned previously that percent filler con- assessed for nanocomposites in addition to the
tent is perhaps best expressed in terms of volume previously mentioned properties.22,33,36,54,55 FT is
because the mechanical properties of resin compos- used for assessing brittle materials in order to
ites are dictated mainly by their filler volume identify a material’s resistance to fracture. It is also
fraction.16 used to assess the amount of energy that is needed to
cause the propagation of a crack from a well-defined
Compressive and Diametral Tensile Strength preexisting crack or notch placed in the tested
material.54 However, due to the sensitivity of the
Compressive strength (CS) and diametral tensile
test to the dimensions of the prepared notch or flaw,
strength (DTS) have been positively correlated in the
the results can vary among studies.54 Mitra and
literature when routinely testing mechanical prop-
others22 developed nanocomposites and compared
erties of restorative materials. In both tests, the
the seven-day FT with hybrid and microfilled
samples are subjected to a compressive load along
composites. The reported values of the two nano-
different planes. Subsequently, fractures occur due
composites (standard and translucent) were 1.3 and
to a combination of tensile and shear stresses.50,51
1.2 MPa=m, respectively, comparable to the hybrid
Mitra and others22 reported CS and DTS values of (1.2 MPa=m) and significantly higher than the
nanocomposites to be comparable to or higher than microfilled (0.9 MPa=m). However, FT of the
the tested hybrid and microfilled composites. The CS translucent nanocomposite was significantly lower
and DTS of nanocomposites have also been studied than other hybrids tested (1.4 MPa=m) (Table 4).
by several investigators who reported variability Similarly Ilie and others54 reported that FT of a
among nanocomposites when compared with other nanocomposite (1.46 MPa=m) was significantly
composites.1,13,21,22,29,33,40 Several investigators at- higher than microfilled and flowable composites
tributed variability and differences in part to the but lower than most hybrid composites. A number
nanofiller content (wt%).21,40 of researchers reported that FT of a nanocomposite
The study by Lu and others13 showed comparable was comparable to that of several hybrid compos-
values of CS and DTS of a number of nanocomposites ites.30,33,55 Improved mechanical properties of nano-
and hybrid composites. Similar trends were observed composites have been previously attributed to the
Table 2: Flexural Strength (FS, MPa) of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)
Study Material Category FS (MPa)a Test Conditions
22
Mitra and others Filtek A110 M 94 E
TPH spectrum H 136 D Three-point bending test

Point 4 H 136 D
Esthet X H 140 C
Filtek Supreme standard N 153 BC
Filtek Z250 H 161 AB
Filtek Supreme translucent N 177 A
Pontes and others29b Charisma H 112, 126, 113 B Three-point bending test
Filtek Z350 N 138, 142, 149 A Curing modes:
Conventional QTH (400 mW/cm2
for 40 s)
Conventional LED (900 mW/cm2
for 20 s_
Ramped LED (5-s exposure,
then exposure to 900 mW/cm2
for 15 s_
Lu and others13 Esthet X H 125 B Three-point bending test
Tetric Ceram H 134 AB
Filtek Supreme N 140 A
Rosa and others40 Grandio N 103 B Three-point bending test

Esthet X H 106 AB
Filtek Z350 N 123 A
Lien and others36c Esthet X H 95 C Three-point bending test

Filtek Supreme N 115 AB
Filtek Silorane H 125 AB
Filtek Z250 H 137 A
Rodrigues Junior and others11 Helio Fill M 86 D Three-point bending test

Filtek Supreme N 119 C
7-d water storage
Charisma H 127 C
Esthet X H 145 B
Filtek Z250 H 168 A
Rodrigues Junior and others42 Filtek Supreme N 135 A Three-point bending test
Filtek Z250 H 140 A
Beun and others31c Durafill VS M 50 B Three-point bending test

Filtek A110 M 70 AB
Curing modes:
Conventional QTH (650 mW/
Venus H 80 AB
cm2)
Grandio flow N 85 AB LED (450 mW/cm2 for 10 s)
Tetric Ceram H 90 A
Grandio N 110 A
Point 4 H 110 A
Filtek Supreme N 115 A
Filtek Z100 H 120 A
da Silva and others41b Filtek Supreme N 173C, 185 BC, 190 BC Three-point bending test
Filtek P60 H 225 A, 209 AB, 221 A
Curing modes:
Standard (650 mW/cm2 output
intensity (30 s)
High intensity (1000 mW/cm2
(20 s)
Ramped (100 to 1000 mW/cm2
for 10 s þ 1000 mW/cm2 for 10)
a
Means with the same letters within each study are not statistically different. For studies with multiple values, one letter was used to indicate significant difference
between different materials.
b
Multiple values for each material property indicate the reported values under each test condition in the study.
c
Approximate values are used since data were reported using a chart presentation.
Table 3: Compressive Strength (CS) and Diametral Tensile Strength (DTS, MPa) of Resin Composites (N, Nanocomposite; H,
Hybrid; M, Microfilled)
Study Material Category CS (MPa)a DTS (MPa) Test Conditions
22
Mitra and others Filtek A110 M 376 B 52 D NA
TPH Spectrum H 378 B 80 B
Esthet X H 422 AB 66 C
Filtek Supreme standard N 426 80
A B
Point 4 H 433 A 76 B
Filtek Z250 H 454 A 96 A
Filtek Supreme Translucent N 458 A 87 A
Lien and others36b Filtek Silorane H 250 C 48 A NA

Esthet X H 320 B 52 A
Filtek Supreme N 360 AB 54 A
Rosa and others40 Esthet X H 173 A 41 B NA

Grandio N 181 A 42 AB
Filtek Z350 N 184 A 50 A
Lu and others13 Filtek Supreme N 262 A 54 A NA

Esthet X H 263 A 46 B
Tetric Ceram H 263 A 49 AB
de Moraes and others1 Concept Advance N 38 B NA

Premise N 40 B
TPH N 53 AB
Filtek Z250 H 53 AB
Grandio N 54 AB
Filtek Supreme XT N 58 A
Pontes and others29c Charisma H 50, 50, 50 B Curing modes:

Filtek Z350 N 54, 55, 56 A
Conventional QTH (400
mW/cm2 for 40 s)
Conventional LED (900
mW/cm2 for 20 s)
Ramped LED (exposure
for 5 s, followed by
exposure to 900 mW/
cm2 for 15 s)
Abbreviation: NA, not applicable.
a
Means with the same letters within each study for each property are not statistically different.
b
c
Multiple values for each material property indicate the reported value under each test condition in the study.
incorporation of nanofillers into the resin matrix. HARDNESS

This in turn leads to a reduction in interparticle The hardness of commercial resin composites is a
space and therefore protection of the organic matrix. property that is closely related to wear resistance
Furthermore, nanofillers can act as points that may and long-term stability of these materials in the oral
slow the initiation of or even stop crack propaga- environment.56 Surface hardness has also been used
tion.54 However, the variations in test protocols and as an indicator for the degree of monomer conversion
sample preparation among studies may lead to by using the hardness ratio of the bottom and top
different reported values, making direct comparisons surfaces of tested samples.57 Previous literature
difficult. Generally, the previously mentioned stud- suggests that a composite is ‘‘properly’’ polymerized
ies indicate that FT of nanocomposites was not when the maximum hardness of the bottom surface
superior to that of hybrids but higher than micro- is #80% of the hardness value of the top surface.13,21
filled composites. Further studies using comparable The hardness of composites has been positively
methodology are required to facilitate comparison correlated with filler volume %58 and with filler
between materials. weight %.21,29,31,46
Table 4: Fracture Toughness (FT, MPa=m) of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)
Study Material Category FT (MPa=m)a Test Conditions
22
Mitra and others Filtek A110 M 0.9 C Chevron-shaped notched short
Filtek Supreme Translucent N 1.2 B
rod method,
7-d storage
Esthet X H 1.2 B
Point 4 H 1.2 B
Filtek Supreme standard N 1.3 AB
Filtek Z250 H 1.4 A
TPH Spectrum H 1.4 A
Lien and others36b Esthet X H 0.58 A Single-edge notched beam

Filtek Supreme N 0.59 A
method,
24-h storage
Filtek Z250 H 0.67 A
Filtek Silorane H 0.68 A
Rodrigues Junior and others42 Filtek Supreme N 1.3 B Notched bar method,
Filtek Z250 H 1.5 A
24-h storage
Hamouda and Abd Elkader30 Prime Dent H 6.28 A Sharp notch bar method,
Filtek Supreme N 6.54 A
24-h storage
Thomaidis and others55 Filtek Ultimate N 1.20 A Single-edge notched beam
Filtek Z250 H 1.43 A
method
a
Means with the same letters within each study are not statistically different.
b
Approximate values are used since data were reported using a bar chart.
Various trends have been reported when micro- 5).36,42,58,62-64 Cao and others65 reported significantly
hardness of nanocomposites was compared to other lower Vickers hardness (VH) values of the nano-
types of resin composites (Table 5). Mota and composite compared with all tested hybrid compos-
others21 reported a wide range of Knoop microhard- ites in their study. Each composite showed a distinct
ness values of nanocomposites that were attributed performance in terms of hardness and wear that was
mainly to differences in the filler content (55 to 123 attributed to the formulation of each material.
KHN). Beun and others31 reported significantly Comparable microhardness values were reported
higher hardness values of the nanocomposites by da Silva and others41 for a nanocomposite and a
compared to most of the hybrid and microfilled hybrid. However, using high-intensity light yielded
composites tested in their study. Several researchers the highest microhardness values. A positive corre-
reported higher hardness values for a number of lation between curing method, depth of cure, curing
nanocomposites compared to hybrid composites. This time, and the hardness of nanocomposites were also
was attributed to higher filler content, large and reported by others.66-68 Similarly, Marchan and
densely packed filler particles, and resin content of others69 reported better microhardness values of
the nanocomposite tested (Table 5).1,12,29,59 Similarly tested nanocomposites when light cured for 20
Lombardini and others57, and Poggio and others60 seconds using QTH and LED units compared to 10
reported greater surface microhardness of nano- seconds. The majority of the nanocomposites pro-
composites tested compared with the hybrid com- duced better VH when cured by LED compared with
posites, a finding that was statistically significant QTH, the reason for which was unclear. One nano-
(Table 5). The hardness values were not influenced composite showed higher VH compared to the other
by varying polymerization mode or time or sample nanocomposites due to its higher filler content (Table
thickness, something that was also reported by other 5).
researchers.29,61 The different values of microhardness reported
On the other hand, the microhardness of a nano- indicate the influence of the specific formulation of
composite was found to be inferior to that of a hybrid each material, ultimately affecting its hardness
by several researchers who attributed this to the behavior.40,65 Moreover, different study protocols
complex nature of the nanocomposites’ filler content, and testing methods may account for this variability
larger filler volume, and greater amount of pigment. in reported values. Consequently, it would be
These proposed factors may lead to light attenuation difficult to accurately compare results. Therefore,
yielding a decreased degree of polymerization (Table further investigations using comparable methodolo-
Table 5: Hardness Values of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)

Study Material Category Hardnessa Test Conditions
1
De Moraes and others Concept Advance N 44 E Knoop hardness
TPH N 54 D
Premise N 62 C
Filtek Z250 H 69 B
Filtek Supreme XT N 72 B
Grandio N 111 A
Pontes and others29 Charisma H 40 B Vickers hardness

Filtek Z350 N 64 A
Curing modes:
Conventional QTH (400 mW/
cm2 for 40 s)
Conventional LED (900 mW/
cm2 for 20 s)
Ramped LED (exposure for 5
s, followed by exposure to 900
mW/cm2 for 15 s)
Top Bottom
Poggio and others60b Amaris H 41, 46, 45 36,39,39 D Vickers hardness
Filtek Silorane H 51, 50, 51 45,45,47 C
Curing times and modes:
Standard: 1000 mW/cm2 for
Esthet X H 52, 59, 60 45,55,56 C
20 s
Ceram X Mono N 55, 62, 61 44,58,58 C Standard: 1000 mW/cm2 for
Filtek Supreme XT N 82, 82, 84 79,79,81 B 40 s
Soft start: 0 to 1000 mW/cm2
Grandio N 104, 105, 103 101,100,100 A
for 5 s þ1000 mW/cm2 for 35
s
Lombardini and others57b Amaris H 44, 44 39,36 D Vickers hardness
Filtek Silorane H 51, 51 45,44 C
Depth of cure and curing time:
2 mm and 3 mm for 40 s
Esthet X N 55, 52 44,42 C
Ceram X Mono H 57, 57 55,46 C
Filtek Supreme XT N 83, 82 79,75 B
Grandio N 104, 104 101,91 A
Lien and others36c Esthet X H 41 C Knoop hardness

Filtek Silorane H 44 C
Filtek Supreme N 57 B
Filtek Z250 H 63 A
Rodrigues Junior and others42 Filtek Supreme N 57 43 B Knoop hardness

Filtek Z250 H 62 55 A
Beun and others31c Durafill VS M 19 F Vickers hardness

Filtek A110 M 38 E
Tetric Ceram H 40 E
Venus H 45 E
Point 4 H 50 D
Filtek Supreme N 60 C
Grandio flow N 60 C
Grandio N 98 B
Filtek Z100 H 105 A
da Silva and others41b Filtek Supreme N 99, A 135, B 94 A Knoop hardness

Filtek P60 H 103, A 141, B 94 A
Curing modes:
Standard: 650 mW/cm2 output
intensity (30 s)
High intensity: 1000 mW/cm2
(20 s)
Ramped: 100 to 1000 mW/
cm2 (10 s) þ 1000 mW/cm2
(10 s)
Table 5: Continued.
Study Material Category Hardnessa Test Conditions
59
Kaminedi and others Filtek Z250 H 61 B Vickers hardness
Filtek Z350 N 67 A
Cao and others65 Charisma Diamond N 54 C Vickers hardness following

Filtek Z250 H 79 B
abrasive challenge
Surefil H 79 B
Filtek P 60 H 82 B
Clearfil AP-X H 87 A
Rastelli and others58 TPH3 N 53 B 46 C Vickers hardness

Filtek Supreme N 72 A 56 B
Thome and others62b Filtek Supreme N Top surface Hardness Vickers hardness
A3.5: 76, 74, 61 Shade: A1, A3.5 Curing
A1: 83, 79, 67 B distance: 0, 6, 12 mm
Filtek Z250 H A3.5: 90, 76, 71
A1: 98, 81, 68 A
Suzuki and others12c Tetric Evo Ceram N 35 D Knoop hardness
Venus Diamond N 45 C
Grandio N 80 A
Marchan and others69b Clearfil Majesty N 33, 27, 28 26, 26, 26 D Vickers hardness
Tetric Evo Ceram N 34, 33, 30 28, 33, 30 D
Curing mode and time:
QTH: 495 mW/cm2 for 20 s
Ice N 51, 51, 47 43, 45, 43 C
LED: 890 mW/cm2 for 20 s
Filtek Z350 N 65, 61, 64 64, 59, 54 B LED: 890 mW/cm2 for 10 s
Grandio N 73, 75, 72 70, 70, 66 A
a
Means with the same s letters within each study are not statistically different. For studies with multiple values, letter was used to indicate significant difference
between different materials.
b
c
Approximate values are used since data were reported using a bar chart.
gy should be done in order to be able to directly Mitra and others22 examined the wear rate of
compare results. nanocomposites (standard and translucent) com-
pared with hybrid and microfilled composites using
ABRASIVE WEAR a three-body wear test. The wear rate of the
standard nanocomposite was equivalent to a hybrid
Wear has been defined as the gradual removal of but significantly lower than the other hybrid and
material as a result of the interaction between two microfilled composites. The translucent nanocompo-
surfaces moving against each other.70 Wear of resin site demonstrated equivalent wear values to the
composite has been reported to be dependent on filler microfilled composite but was significantly lower
loading and size in addition to the formulation of its than the other hybrid materials. Comparable results
resin matrix and the adhesion of fillers to the were shown by Cao and others,65 who reported
matrix.27 significantly lower volume loss of the tested nano-
composite compared with hybrid materials. Similar-
Several studies investigated abrasive wear of
ly, Yesil and others72 reported comparable wear rate
nanocomposites compared with hybrid and micro- of a nanocomposite to that of a microfilled and a
filled composites by measuring specimen thickness hybrid composite. Hamouda and Abd Elkader30
using calipers,71 assessing surface roughness,12 and reported that the nanocomposite tested in their
measuring weight loss of tested samples following study demonstrated a significantly lower wear value
abrasion.30 Table 6 shows abrasive wear values compared to the hybrid composite that was attribut-
reported by the studies included in the current ed to the higher filler loading and smaller particle
literature review. size associated with the nanocomposites. Suzuki and
Table 6: Abrasive Wear of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)

Study Material Category Abrasive Weara Test Conditions
22b
Mitra and others Filtek Supreme standard N 2.1 C Three-body wear test
Filtek Z250 H 2.4 C
Wear determined every 39,000
cycles (lm/39,000)
Filtek A110 M 3.0 B
Filtek Supreme Translucent N 3.1 B
Point 4 H 3.4 A
Esthet X H 3.5 A
TPH Spectrum H 3.6 A
Hamouda and Abd Elkader30 Filtek Supreme N 25 B Two-body abrasion, then

Prime Dent H 74 A
measuring weight loss (mg)
Cao and others65 Charisma Diamond N 6 C Wear volume loss (mm3)
Filtek Z250 H 8 B
Filtek P60 H 8 B
Clearfil AP-X H 8 B
Surefil H 10 A
Yesil and others72 Point 4 H 7 B Simulated masticatory wear

Heliomolar RO M 12 AB
mechanism using human enamel
as opposing cusp (lm)
Filtek Supreme N 14 AB
Premise N 19 A
Suzuki and others12b Grandio N 10 C Tooth brushing abrasion test

Venus Diamond N 80 B
(lm)
Tetric Evo Ceram N 600 A

a
Means with the same letters within each study are not statistically different.
b
others12 submitted several commercial nanocompo- SORPTION AND SOLUBILITY

sites to an abrasion challenge. It was suggested by
Longevity of a restorative material in the oral
the authors that the nanocomposite, which displayed
environment is directly related to its resistance to
the lowest wear rate, behaves more like a hybrid
degradation.76 Therefore, the assessment of solubil-
composite, and its low wear was attributed to its
ity and salivary sorption is essential to predict
densely packed fillers.73
material behavior and clinical performance.32,77
On the other hand, Mayworm and others 74 The influence of polymerization mode, curing times,
investigated abrasive wear of a nanocomposite and storage media, and filler content on sorption and
a hybrid before and after storage in saliva for 62 solubility have also been investigated.1,32,77-79 Table
days. Greater abrasive wear of the nanocomposite 7 shows reported results from different studies and
compared with a hybrid was reported. This was special testing conditions.
attributed to the larger interparticle space of the Da Silva and others77 reported significantly higher
former leading to larger wear rates. sorption and solubility of a nanocomposite compared
Several researchers have suggested that wear with a hybrid composite tested in their study when
resistance behavior of composites is material depen- using two polymerization modes (conventional and
dent and cannot be predicted from only a material’s ramped) (Table 7). The ramped polymerization mode
filler loading or organic matrix composition.75 How- was associated with a lower DC in both composites.
ever, the reported results suggest that several Higher sorption and solubility of the nanocomposite
commercial nanocomposites have shown wear values was explained by the greater surface area of the
that are lower than several hybrid composites. Also, nanofillers. This makes them more prone to ion
a number of researchers reported comparable wear leaching and hydrolysis of the silane coupling agent,
values between nanocomposites and microfilled leading to the filler particles becoming detached and
composites that have been reported to display the lost. Higher values of salivary sorption of the
lowest abrasive wear among resin composites. nanocomposite were attributed to water accumula-
Table 7: Sorption and Solubility Values (lg/mm3) of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)
Study Material Category Sorption (lg/mm3)a Solubility (lg/mm3) Test Conditions
77b
da Silvaand others Filtek P60 H 6.7, D 7.04 C 0.38, C 0.43 B Curing modes:
Filtek Supreme N 7.35, B 8.74 A 0.41, B 0.49 A
Conventional: 850 mW/
cm2 (10 s)
Ramped: 100 to 1000
mW/cm2 (10 s and 1000
for 20 s)
Kumar and Sangi32b Filtek Z250 H 17.3, 23.5 B 1.5, 1.1 B Storage period:
Filtek Supreme N 18.7, 24.9 B 1.1, 1.0 B
1 wk
translucent 13 wk
Filtek Supreme N 23.6, 27.4 A 2.3, 3.6 A
body
Shin and others82b Grandio N 11.4, 11.3 F 3.1, 0.8 E Curing modes:
Ceram X N 15.3, 15.4 E 4.6, 0.9 D
DPSS laser: 400 mW/cm2
Conventional: 800 mW/
Tetric Ceram H 16.6, 15.7 D 5.2, 1.2 C
cm2
Filtek P60 H 17.4, 18.1 C 2.4, $1.4 F
Premise N 20.7, 21.0 B 6.6, 1.6 A
Filtek Z350 N 24.1, 22.8 A 6.3, 1.0 B
De Moraes and others1 Grandio N 15.1 B 3.1 A 7-d storage in water

Concept Advanced N 17.3 B 3.1 A
Premise N 18.1 AB 5.1 A
TPH3 N 26.4 A 2.9 A
Filtek Supreme XT N 29.1 A 2.9 A
Filtek Z 250 H 30.7 A 1.9 A
Almeida and others78b Filtek P60 H 2.8, 8.9, 7.3, 4.0 B 2.4, 6.4, 3.4, 2.4 A Storage media:
Filtek Z350 N 14.1, 20.4, 11.9, 14.8 A 3.1, 6.2, 4.4, 3.0 A
Artificial saliva
Listerine
Plax fresh mint
Plax
a
Means with the same letters within each study for each property are not statistically different. For studies with multiple values, one letter was used to indicate
significant difference between different materials.
b
tion at the filler–matrix interface and inside the no effect on sorption values of the tested composites
aggregates of the nanocomposite. Similarly, Kumar when varying polymerization mode. One nanocom-
and Sangi32 reported significantly higher water posite displayed the lowest sorption and second-
sorption and solubility for one nanocomposite com- lowest solubility compared to a hybrid composite.
pared with the other nanocomposite and a hybrid This was attributed to its high and dense filler
following 13 weeks of water storage. Furthermore, content. Similarly, de Moraes and others1 reported
lower strength values were reported for the nano- significantly lower sorption of a nanocomposite
composite that showed the highest sorption and compared to a hybrid and other nanocomposites
solubility values. The lower strength values of the tested, while all tested composites displayed compa-
nanocomposite were attributed to the poor silane rable solubility values. The authors suggest that
penetration of the porous nanoclusters. This made results of water sorption and solubility are probably
the nanocomposite susceptible to degradation when related to the nature of the organic matrix chemical
stored in water. Lower sorption by the hybrid was rather than to the filler content of the material
attributed to the better coupling between filler
(Table 7).
content and matrix.80 On the other hand, Lopes
and others81 demonstrated no influence of varying The effect of using different storage media on
polymerization mode on sorption and solubility of a sorption and solubility of resin composites was
nanocomposite. This was attributed to the formation assessed by several researchers.78,81,83 Almeida and
of a densely cross-linked polymer network due to the others78 and Lopes and others81 demonstrated an
use of an adequate energy density in all the curing influence of storage media on the sorption of resin
methods used. Similarly, Shin and others82 reported composites tested. Negative values of solubility were
reported by researchers for a number of nano- Several clinical studies extending from one to four
composites indicating weight gain masking the real years reported comparable performance between
solubility. Almeida and others78 reported significant- nanocomposites and hybrid composites in posterior
ly higher sorption of a nanocomposite compared with teeth and noncarious cervical cavities.88-102 There
a hybrid in Listerine (Warner Lambert Health Care, was no detection of restoration failure, good surface
Eastleigh, UK), Plax fresh (Colgate-Palmolive, Guil- characteristics, good color match, and no postopera-
ford, UK), Plax (Colgate-Palmolive), and artificial tive sensitivity.103-106 Better polishability and sur-
saliva. The solubility of the nanocomposite and face gloss retention in favor of the nanocomposites
hybrid composites was comparable, with significant- were reported and attributed to the reduced filler
ly higher values obtained when placed in Listerine plucking and less wear of the nanofillers.107-109
and Plax fresh. Similar results regarding water However, a number of studies reported a certain
sorption were shown by Curtis and others,84 who degree of deterioration in marginal quality over time
investigated these properties after different storage with minor defects creating surface roughness in all
periods of a nanocomposite and hybrid composite. It composites tested.93,109,110 Türkün and others111
was suggested that the higher water sorption was reported a high retention rate of the nanocomposite
related to the larger ratio of surface area to volume but a better color match of the polyacid-modified
of the silica nanofillers and the hydrophilic nature of composite tested after two years. In a two-year
the polymeric matrix.85 evaluation, it was reported that beyond one year, a
Goncalves and others79 assessed sorption and negative step occurred due to wear, in addition to
solubility of a nanocomposite and a hybrid and DC staining of the composites tested.94 Similarly, Dukic
in simulated deep proximal cavities. This was done and others102 reported deterioration of all composites
to investigate composite behavior in a situation tested after three years with regard to anatomic
similar to a clinical setting. Sorption and solubility form, marginal integrity, and marginal discolor-
were assessed for every 1-mm increment of the 5- ation, but these composites were still regarded as
mm-deep restoration in three immersion media: being clinically acceptable.
distilled water, artificial saliva, and lactic acid. The Several long-term clinical performance studies of
nanocomposite displayed a lower DC and signifi- nanocomposites ranging from five to 10 years have
cantly higher sorption and solubility values than the been published. Palaniappane and others112,113
hybrid. Regardless of media type, the immersion of evaluated the five-year clinical performance of
both resin composites presented an increase in nanocomposite materials compared to hybrid com-
solubility and sorption as a function of depth. posites in occlusal and posterior approximal cavi-
The previously mentioned data generally indicate ties. There was no significant difference in the
higher sorption and solubility of nanocomposites. vertical and volumetric wear between one nano-
The number of studies investigating sorption and composite and a hybrid composite as reported by
solubility of nanocomposites compared to hybrid and Palaniappane and others,112 while another nano-
microfilled composites is still limited. Further inves- composite material showed lower volume loss com-
tigations using test conditions that simulate a pared to the hybrid composites tested by Palaniap-
clinical setting and compare a wide range of pane and others113 after five years. This was
materials are recommended to ascertain the perfor- explained by the densely packed nanofillers in the
mance of nanocomposites. nanocomposite that offered protection to the softer
resin matrix from the abrasive action of food
CLINICAL STUDIES particles.
The clinical performance of nanocomposites has been Cetin and others115 reported excellent five-year
investigated in numerous studies and was found to clinical performance of two nanocomposites when
be comparable to that of other resin composites. The compared to two indirect composite materials. No
majority of these clinical trials used the modified restorations were rated unacceptable in any aspect
USPHS criteria first described by Cvar and Ryge86 of the evaluation. A nanocomposite was also com-
and the US Public Health Service’s modified Ryge pared to a hybrid material after six, eight, and 10
criteria.87 These criteria include retention, color years.116,117 The overall success rates of the nano-
match, marginal discoloration, anatomic form, re- composite were 88.1%, 98%, and 80%, respectively,
current caries, surface roughness, marginal adapta- with a comparable performance between the inves-
tion, postoperative sensitivity, gross fracture, tooth tigated composites.116-118 The higher success rate at
integrity, gingival health, and proximal contact. eight years compared with six years may be due to
the use of different nanocomposite material in each 2. Ferracane JL (2011) Resin composite—State of the art
study. Furthermore, the inclusion criteria for re- Dental Materials 27(1) 29-38.
cruited subjects differed in that high-caries-risk 3. Curtis AR, Palin WM, Fleming GJ, Shortall AC, &
patients were not excluded from the six-year evalu- Marquis PM (2009) The mechanical properties of nano-
filled resin-based composites: The impact of dry and wet
ation period study.116 On the other hand, Frank-
cyclic pre-loading on bi-axial flexure strength Dental
enberger and others118 included subjects with a high Materials 25(2) 188-197.
level of oral hygiene, which may have contributed to
4. Lu H, Roeder LB, Lei L, & Powers JM (2005) Effect of
the reported higher success rate after eight years surface roughness on stain resistance of dental resin
compared with six years. The authors reported no composites Journal of Esthetic and Restorative Dentistry
significant difference in the clinical behavior be- 17(2) 102-108; discussion 109.
tween the tested composite restorations. Further- 5. Drummond JL (2008) Degradation, fatigue, and failure
more, significant changes over time were found for of resin dental composite materials Journal of Dental
all criteria evaluated. Research 87(8) 710-719.
On the basis of the results of the previous studies, 6. Ferracane JL, & Mitchem JC (1994) Properties of
posterior composite: Results of round robin testing for
it seems reasonable to conclude that there is no a specification Dental Materials 10(2) 92-99.
evidence yet that the nanocomposites perform
7. Lu H, Stansbury JW, & Bowman CN (2005) Impact of
clinically better than hybrid composites.
curing protocol on conversion and shrinkage stress
Journal of Dental Research 84(9) 822-826.
CONCLUSION
8. Tyas MJ (1990) Correlation between fracture properties
The current review of the published literature has and clinical performance of composite resins in Class IV
shown that commercially available nanocomposite cavities Australian Dental Journal 35(1) 46-49.
materials do not hold any significant advantage over 9. Watts DC, Marouf AS, & Al-Hindi AM (2003) Photo-
hybrid composites in terms of strength and hard- polymerization shrinkage-stress kinetics in resin-com-
posites: Methods development Dental Materials 19(1)
ness. Furthermore, higher sorption and solubility
1-11.
values were found for nanocomposites compared
10. Rawls HR, & Esquivel-Upshaw JF (2003) Restorative
with hybrid composites, and these might influence
resins In: Anusavice KJ (ed) Phillips’ Science of Dental
their clinical performance. On the other hand, the Materials Elsevier Science, St Louis, MO 399-437.
incorporation of nanofillers into resin composite
11. Rodrigues Junior SA, Zanchi CH, Carvalho RV, &
materials was associated with lower abrasive wear Demarco FF (2007) Flexural strength and modulus of
of nanocomposites. However, attention should be elasticity of different types of resin-based composites
focused on the resin matrix composition and not only Brazilian Oral Research 21(1) 16-21.
the filler system to be able to assess abrasive wear 12. Suzuki T, Kyoizumi H, Finger WJ, Kanehira M, Endo T,
behavior. In the current review, nanocomposites Utterodt A, Hisamitsu H, & Komatsu M (2009) Resis-
demonstrated acceptable clinical performance com- tance of nanofill and nanohybrid resin composites to
pared with hybrid resin composites for review toothbrush abrasion with calcium carbonate slurry
Dental Materials Journal 28(6) 708-716.
periods ranging from one to 10 years. However,
there was no definitive report of the superior 13. Lu H, Lee YK, Oguri M, & Powers JM (2006) Properties
of a dental resin composite with a spherical inorganic
performance of nanocomposites in the majority of filler Operative Dentistry 31(6) 734-740.
evaluation criteria used.
14. Foster J, & Walker R (1674) US Patent No. 3825518.
15. Maghaireh GA, Taha NA, & Alzraikat H (2017) The
Conflict of Interest
silorane-based resin composites: A review Operative
The authors of this article certify that they have no Dentistry 42(1) E24-E34.
proprietary, financial, or other personal interest of any nature
or kind in any product, service, and/or company that is 16. Ilie N, & Hickel R (2011) Resin composite restorative
presented in this article. materials Australian Dental Journal 56(Supplement
1) 59-66.
(Accepted 8 December 2017) 17. Tagtekin DA, Yanikoglu FC, Bozkurt FO, Kologlu B, &
Sur H (2004) Selected characteristics of an ormocer and
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Nanofilled Resin Composite Properties and Clinical Performance - A Review

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Operative Dentistry, 2018, 43-4, E173-E190

Nanofilled Resin Composite

SUMMARY tion, color match, and surface roughness. A

Table 1: Summary of Resin Composites Reviewed, Category, and Manufacturer Information

TPH spectrum H 136 D Three-point bending test

Filtek Z250 H 161 AB

Filtek Supreme translucent N 177 A

Filtek Supreme N 140 A

Rosa and others40 Grandio N 103 B Three-point bending test

Filtek Z350 N 123 A

Lien and others36c Esthet X H 95 C Three-point bending test

Filtek Silorane H 125 AB

Filtek Z250 H 137 A

Rodrigues Junior and others11 Helio Fill M 86 D Three-point bending test

Filtek Z250 H 168 A

Beun and others31c Durafill VS M 50 B Three-point bending test

Filtek Supreme N 115 A

Filtek Z100 H 120 A

Filtek Supreme standard N 426 80

Filtek Z250 H 454 A 96 A

Filtek Supreme Translucent N 458 A 87 A

Lien and others36b Filtek Silorane H 250 C 48 A NA

Filtek Supreme N 360 AB 54 A

Filtek Z250 H 390 A 58 A

Rosa and others40 Esthet X H 173 A 41 B NA

Filtek Z350 N 184 A 50 A

Lu and others13 Filtek Supreme N 262 A 54 A NA

Tetric Ceram H 263 A 49 AB

de Moraes and others1 Concept Advance N 38 B NA

Pontes and others29c Charisma H 50, 50, 50 B Curing modes:

incorporation of nanofillers into the resin matrix. HARDNESS

Filtek Z250 H 1.4 A

TPH Spectrum H 1.4 A

Lien and others36b Esthet X H 0.58 A Single-edge notched beam

Filtek Silorane H 0.68 A

Table 5: Hardness Values of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)

Pontes and others29 Charisma H 40 B Vickers hardness

Ceram X Mono H 57, 57 55,46 C

Filtek Supreme XT N 83, 82 79,75 B

Grandio N 104, 104 101,91 A

Lien and others36c Esthet X H 41 C Knoop hardness

Rodrigues Junior and others42 Filtek Supreme N 57 43 B Knoop hardness

Beun and others31c Durafill VS M 19 F Vickers hardness

Filtek Z100 H 105 A

da Silva and others41b Filtek Supreme N 99, A 135, B 94 A Knoop hardness

Cao and others65 Charisma Diamond N 54 C Vickers hardness following

Rastelli and others58 TPH3 N 53 B 46 C Vickers hardness

Table 6: Abrasive Wear of Resin Composites (N, Nanocomposite; H, Hybrid; M, Microfilled)

Filtek Supreme Translucent N 3.1 B

TPH Spectrum H 3.6 A

Hamouda and Abd Elkader30 Filtek Supreme N 25 B Two-body abrasion, then

Yesil and others72 Point 4 H 7 B Simulated masticatory wear

Suzuki and others12b Grandio N 10 C Tooth brushing abrasion test

Tetric Evo Ceram N 600 A

others12 submitted several commercial nanocompo- SORPTION AND SOLUBILITY

Premise N 20.7, 21.0 B 6.6, 1.6 A

Filtek Z350 N 24.1, 22.8 A 6.3, 1.0 B

De Moraes and others1 Grandio N 15.1 B 3.1 A 7-d storage in water