OBJECTIVES: This in vitro study evaluated the effects of simulated toothbrushing on surface roughness, gloss, and color stability of milled and printed resin-based and lithium disilicate materials for permanent dental restorations. MATERIALS AND METHODS: Five materials were tested, including CAD/CAM prepolymerized resin blocks, a ceramic material, a resin composite and a newly FDA-cleared 3D-printed resin for permanent crowns. Specimens underwent a controlled brushing protocol simulating 5 years of brushing (50,000 cycles). Surface roughness (R RESULTS: Ceramic materials exhibited superior resistance to surface roughness and gloss loss, maintaining high esthetic properties (p <
0.001). In contrast, 3D-printed resin materials showed notable increases in surface roughness and gloss reduction, reflecting a higher susceptibility to wear. Resin composites demonstrated variable performance, with direct-use composites performing worse than their CAD/CAM milled counterparts. Glossed ceramic materials exhibited clinically acceptable color changes, while all other groups exceeded thresholds, posing potential esthetic challenges. CONCLUSIONS: Milled materials, particularly ceramics, demonstrated superior durability and esthetic retention. Optimization is needed for 3D-printed resin materials to enhance their mechanical and esthetic properties for long-term use. These findings guide material selection for durable, esthetic dental restorations.