Depth of cure of radiation-activated materials--effect of mould material and cavity size

Impact of light-curing distance on the effectiveness of cure of bulk-fill resin-based composites

Objective

To investigate the effect of light-curing distance on the effectiveness of cure (EC) of bulk-fill resin-based composites (RBCs).

Materials and methods

Two bulk-fill RBCs (a Tetric N-Ceram Bulk Fill (TN) and a Filtek Bulk Fill (FK)) are evaluated. Specimens (4 mm high) are cured for 20 s at different distances (0 mm (D0), 2 mm (D2), 4 mm (D4), 6 mm (D6) and 8 mm (D8)) and stored for 24 h in 100% relative humidity at 37 °C. The top and bottom surface hardness (SH) (n = 12) are assessed using a Knoop microhardness tester and the EC is calculated. The EC is characterized by the hardness ratio (HR) (mean bottom: top SH). An HR of 0.8 is used as the benchmark for an effective/adequate cure. Data are analyzed using one-way analysis of variance and Tukey’s post hoc test (α = 0.05). Correlations between the top and bottom surfaces are examined using the Pearson correlation (α = 0.05).

Results

For the TN, the HR at D8 is significantly lower than all other light-curing distances, while for the FK, it is significantly lower than D0 only.

Conclusion

The effect of light-curing distance on the EC of bulk-fill RBCs is material dependent. Notwithstanding the light-curing distance, the EC of the FK and TN is below the threshold HR value of 0.8 when photopolymerized for 20 s in 4 mm increments in black opaque molds.

Influence of Light-curing Distances on Microflexural Strength of Two Resin-based Composites

Objective:

Our objective was to investigate the influence of different curing distances on microflexural strength and the microflexural modulus of two resin-based composites.

Methods:

Two nanohybrid composites were used; Filtek Z250 (Z250) and Tetric EvoCeram (TEC). Rectangular specimens were prepared (2-mm wide × 1-mm deep × 6-mm long) light cured according to the manufacturer's instructions at 0-mm, 2-mm, and 8-mm distances (n=10) and were stored wet at 37°C for 24 hours. A microflexural strength test was performed using a universal testing machine at a crosshead speed of 1 mm/min. The microflexural strength and microflexural modulus data were analyzed using a two-way analysis of variance followed by a Tukey multiple comparison post hoc test (α=0.05).

Results:

The TEC composite had a significantly higher microflexural strength at an 8-mm distance compared with the 0-mm distance. The Z250 composite expressed significantly higher microflexural strength, at 2-mm and 8-mm compared with the 0-mm distance. TEC showed a significantly higher microflexural modulus at an 8-mm distance compared with the 0-mm and 2-mm distances. Z250 also exhibited a significantly higher microflexural modulus at the 2-mm distance, compared with the 8-mm distance. In total, Z250 presented a significantly higher microflexural strength and modulus compared with TEC.

Conclusion:

Curing the explored composites at 2-mm or 8-mm distances from the specimen surface did not have a significant influence on microflexural strength but did significantly affect the microflexural modulus.

Effect of Curing Light and Exposure Time on the Polymerization of Bulk-Fill Resin-Based Composites in Molar Teeth

OBJECTIVES

This study examined the influence of different light-curing units (LCUs) and exposure times on the microhardness across bulk-fill resin-based composite (RBC) restorations in a molar tooth.

METHODS AND MATERIALS

Tip diameter, radiant power, radiant exitance, emission spectra, and light beam profile were measured on two single-emission-peak LCUs (Celalux 3 and DeepCure-S) and two multiple-peak LCUs (Bluephase 20i and Valo Grand). A mold was made using a human molar that had a 12-mm mesial-distal length, a 2.5-mm deep occlusal box, and two 4.5-mm deep proximal boxes. Two bulk-fill RBCs (Filtek Bulk Fill Posterior and Tetric EvoCeram Bulk Fill) were photoactivated for 10 seconds and for 20 seconds, with the light guide positioned at the center of the occlusal surface. Microhardness was then measured across the transverse surface of the restorations. The light that reached the bottom of the proximal boxes was examined. Data were statistically analyzed with the Student t-test, two-way analysis of variance, and the Tukey post hoc test (α=0.05).

RESULTS

The four LCUs were different regarding all the tested characteristics. Even when using LCUs with wide tips and a homogeneous beam profile, there were significant differences in the microhardness results obtained at the central and proximal regions of the RBCs (p<0.05). LCUs with wider tips used for 20 seconds produced higher microhardness values (p<0.05). The multiple-peak LCUs produced greater hardness values in Tetric EvoCeram Bulk Fill than did the single-emission-peak LCUs (Celalux 3 and DeepCure-S). Results for the light measured at the bottom of proximal boxes showed that little light reached these regions when the light tip was positioned at the center of restorations.

CONCLUSIONS

Curing lights with wide tips, homogeneous light beam profiles, and longer exposure times are preferred when light-curing large MOD restorations. Light curing from more than one position may be required for adequate photopolymerization.

Comparisons of ISO depth of cure for a resin composite in stainless-steel and natural-tooth molds

The purpose of this study was to compare the depth of cure (DOC) of a resin-based composite (RBC) using the ISO DOC protocol with stainless-steel and molar-tooth molds (4 mm cylindrical cavity). The tooth mold included testing with and without the occlusal surface being covered with black tape around the cavity opening. The RBC was cured with either halogen (HAL) or light-emitting diode (LED) light. The results showed that specimens made in the non-taped tooth mold had DOCs that were significantly greater (28%-35%) than those in the stainless-steel mold. The taped tooth mold also produced significantly greater DOCs, but only by 6%-8%. Knoop hardness (KNH) measurements along the central axis of the RBC specimens showed that depths for 80% of maximum hardness were substantially greater than those determined by the ISO DOC protocol but were limited to the center and quickly dropped below 80% in a lateral direction. The KHN mapping for each of the three molds found that the ISO DOCs could validate a KHN of ≥80% across the RBC to the periphery, only for the non-taped tooth mold. This was due to light incident on the tooth surrounding the RBC being scattered into the RBC.

Effects of Light Attenuation through Dental Tissues on Cure Depth of Composite Resins

Objective

Polymerization of light-cured resin-based materials is well documented; however, the intensity of the activating light can be reduced by passage through air, dental structure, or restoration compromising the physical properties of the restoration. The aim of this study was to evaluate the depth of cure of different light cured composite resins polymerized directly or transdental, through enamel and enamel/dentin tissues.

Material and methods

Five composite resins were selected for this experiment: SureFil SDR, Dentsply (SDR), Filtek Supreme Plus, 3M ESPE (FSP), Aelite LS, Bisco (ALS), Filtek LS, 3M ESPE (FLS), and TPH, Dentsply (TPH). Thirty specimens of each material were prepared with 2- or 4-mm thickness. The specimens were light-cured (Elipar 2500, 3M ESPE) for 40 sec using three different protocols: direct or transdental, through a disc of enamel with 1 mm of thickness, and a disc of enamel and dentin with 2 mm of thickness. Eight Vickers microhardness (VH) measurements were taken from each specimen, four on top and four on bottom surface (Micromet, Buehler, 100 g per 15 sec). Data was analyzed with ANOVA three-way, Tukey HSD post-hoc (α = .05).

Results

Bottom surfaces of specimens exhibited statistically significant lower Vickers microhardness than the top surfaces for all composite resin evaluated, regardless of the curing conditions, except for the SDR when direct light-cured. Transdental light curing through enamel/dentin layer, significantly decreased VH (P<0.05) on the bottom surface of all composite groups.

Conclusion

The results of this study showed that light-curing attenuation of dental structures negatively affect the micro-hardness of composite resins.

Effect of Mold Type and Diameter on the Depth of Cure of Three Resin-Based Composites

Objective:

To evaluate the effects of different mold materials, their diameters, and light-curing units on the mechanical properties of three resin-based composites (RBC).

Methods and Materials:

A conventional nano-filled resin composite (Filtek Supreme Ultra, 3M Oral Care, St Paul, MN, USA) and two bulk-fill composites materials, Tetric Evoceram Bulk fill (Ivoclar Vivadent, Schaan, Liechtenstein) and Aura Bulk Fill (SDI, Bayswater, VIC, Australia), were tested. A total of 240 specimens were fabricated using metal or white semitransparent Delrin molds that were 4 or 10 mm in diameter. The RBCs were light cured for 40 seconds on the high-power setting of either a monowave (DeepCure-S, 3M Oral Care) or polywave (Bluephase G2, Ivoclar Vivadent) light-emitting diode (LED) curing unit. The depth of cure was determined using a scraping test, according to the 2009 ISO 4049 test method. Data were analyzed using multivariate analysis of variance followed by Tukey multiple comparison test (p&lt;0.05).

Results:

In general, when used for 40 seconds, both LED curing lights achieved the same depth of cure (p=0.157). However, the mold material and its diameter had a significant effect on the depth of cure of all three RBCs (p&lt;0.0001).

Conclusion:

Curing with either the polywave or monowave LED curing light resulted in the same depth of cure in the composites. The greatest depth of cure was always achieved using the 10-mm-diameter Delrin mold. Of the three RBCs tested, both Tetric Bulk Fill and Aura achieved a 4-mm depth of cure when tested in the 10-mm-diameter metal mold. Tetric Bulk Fill was the most transparent and had the greatest depth of cure, and the conventional composite had the least depth of cure. Very little violet (&lt;420 nm) light penetrated through 6 mm of any of the RBCs.

Correlation between the beam profile from a curing light and the microhardness of four resins

OBJECTIVE

To demonstrate the effect of localized irradiance and spectral distribution inhomogeneities of one LED-based dental light-curing unit (LCU) on the corresponding microhardness values at the top, and bottom surfaces of four dental resin-based composites (RBCs), which contained either camphorquinone (CQ) alone or a combination of CQ and monoacylphosphine oxide (TPO) as photoinitiators.

METHODS

Localized irradiance beam profiles from a polywave LED-based LCU were recorded five times using a laser beam analyzer, without and with either a 400 nm or 460 nm narrow bandpass filter placed in front of the camera lens. Five specimens of each of the four RBCs (two containing CQ/TPO and two containing CQ-only) were exposed for 5-, 10-, or 30-s with the light guide directly on the top surface of the RBC. After 24 h, Knoop microhardness values were measured at 45 locations across the top and bottom surfaces of each specimen. Microhardness readings for each RBC surface and exposure time were correlated with localized patterns of the LCU beam profile, measured using the 400 nm and 460 nm bandpass filters. Spearman rank correlation was used to avoid relying on an assumption of a bivariate normal distribution for the KHN and irradiance.

RESULTS

The local irradiance and spectral emission values were not uniformly distributed across the light tip. There was a strong significant positive correlation with the irradiance beam profile values from the LCU taken through bandpass filters and the microhardness maps of the RBC surfaces exposed for 5 and 10 s. The strength of this correlation decreased with increasing exposure time for the RBCs containing CQ only, and increased for the RBCs containing both CQ and TPO.

CONCLUSIONS

Localized beam and spectral distributions across the tip end of the light guide strongly correlated with corresponding areas of microhardness in both the top and bottom surfaces among four RBCs with different photoinitiator contents. Significance: A light-curing unit with a highly inhomogeneous light output can adversely affect localized microhardness of resin-based composites and this may be a contributing factor for premature failure of a restoration.

Effects of Different Temperatures and Storage Time on the Degree of Conversion and Microhardness of Resin-based Composites

OBJECTIVE

Dental materials are often made at room temperature, whereas clinically they are made in the mouth. This study evaluated the effects of temperature on the degree of conversion (DC) and Knoop microhardness (KHN).

MATERIALS AND METHODS

Two types of resin-based composites (RBCs) were light-cured using a light-emitting diode (LED) light-curing unit. The resin specimens were centered on an Attenuated Total Reflectance Fourier transform infrared (FT-IR) plate heated to 23°C or 33°C. The DC of the resin was calculated after 120 seconds, the specimens were removed, and the KHN was tested at the bottom of the specimens both immediately, after 24 hours, and after 7 days storage in distilled water in complete darkness at 37°C. The effects of different temperatures on the DC and KHN with their storage time were compared by analysis of variance and Fisher's protected least significant difference post hoc multiple comparison tests (p < 0.05).

RESULTS

Increasing the temperature had a significant and positive effect on the DC and KHN for immediate values of the RBCs. Greater conversion and hardness occurred when the curing temperature was increased from 23°C to 33°C. The KHN increased significantly after 24 hours of storage. There was a linear relationship between DC and KHN (R(2) = 0.86) within the range of DC and KHN studied.

CONCLUSION

The physical properties of dental materials can be expected to be better when made in the mouth than when they are made in a laboratory at room temperature.

Effect of mold type, diameter, and uncured composite removal method on depth of cure

OBJECTIVE

This study compared the effects of mold material and diameter on the thickness of cured composite remnants and depth of cure (DOC) of resin-based composites (RBC).

MATERIAL AND METHODS

One Polywave® curing light was used to photo-cure two shades of the same "bulk-fill" RBC in 4, 6, or 10-mm internal diameter metal or white Delrin® molds. For 60 specimens, the uncured RBC was manually scraped away as described in the ISO 4049 depth of cure test. The remaining 60 specimens were immersed in tetrahydrofuran for 48 hours in the dark. Maximum lengths of remaining hard RBC and their DOC values were compared using analysis of variance (ANOVA) and Tukey-Kramer post hoc multiple comparison tests (α = 0.05).

RESULTS

Specimen thickness and DOC were always greater using the white Delrin® molds compared to metal molds (p < 0.001). Increase in mold diameter significantly increased specimen thickness and DOC when made in the metal molds and in the 6-mm diameter Delrin® molds (p < 0.01). Increasing the diameter of the Delrin® molds to 10-mm did not increase specimen thickness or DOC. Sectioning and staining of specimens revealed an internal, peripheral transition zone of porous RBC in the solvent-dissolved specimens only.

CONCLUSION

Mold material and internal diameter significantly influenced cured composite remnant thickness as well as depth of cure. The existence of an outer region of RBC that is hard, yet susceptible to solvent dissolution, requires further investigation.

CLINICAL RELEVANCE

The depth of cure results obtained from a 4-mm diameter metal mold may not represent the true potential for evaluating composite depth of cure. A universally acceptable mold material and diameter size need to be established if this type of testing is to be useful for evaluating the relative performance of a given type of LCU and RBC.

Properties evaluation of silorane, low-shrinkage, non-flowable and flowable resin-based composites in dentistry

Purpose. This study tested the null hypothesis that different classes of direct restorative dental materials: silorane-based resin, low-shrinkage and conventional (non-flowable and flowable) resin-based composite (RBC) do not differ from each other with regard to polymerization shrinkage, depth of cure or microhardness.

Methods. 140 RBC samples were fabricated and tested by one calibrated operator. Polymerization shrinkage was measured using a gas pycnometer both before and immediately after curing with 36 J/cm² light energy density. Depth of cure was determined, using a penetrometer and the Knoop microhardness was tested from the top surface to a depth of 5 mm.

Results. Considering polymerization shrinkage, the authors found significant differences (p < 0.05) between different materials: non-flowable RBCs showed lower values compared to flowable RBCs, with the silorane-based resin presenting the smallest shrinkage. The low shrinkage flowable composite performed similarly to non-flowable with significant statistical differences compared to the two other flowable RBCs. Regarding to depth of cure, low-shrinkage flowable RBC, were most effective compared to other groups. Microhardness was generally higher for the non-flowable vs. flowable RBCs (p < 0.05). However, the values for low-shrinkage flowable did not differ significantly from those of non-flowable, but were significantly higher than those of the other flowable RBCs.

Clinical Significance. RBCs have undergone many modifications as they have evolved and represent the most relevant restorative materials in today’s dental practice. This study of low-shrinkage RBCs, conventional RBCs (non-flowable and flowable) and silorane-based composite—by in vitro evaluation of volumetric shrinkage, depth of cure and microhardness—reveals that although filler content is an important determinant of polymerization shrinkage, it is not the only variable that affects properties of materials that were tested in this study.

Curing characteristics of a composite. part 2: the effect of curing configuration on depth and distribution of cure

OBJECTIVE

The objective of this study was to examine the effect different configurations of curing would have on the depth and distribution of the cure within each configuration, for a specific resin-based composite (RBC).

METHODS

RBC was cured in a variety of configurations, consisting of 6mm molds of three different colors; large molds that simulated the condition of no mold at all; and 3-6mm diameter molds to check the effect of size. All specimens were cured for 20s with a quartz-halogen lamp and were allowed to cure for 24h in the dark. Transmission measurements were made for these same configurations. Knoop hardness measurements were made across the central plane of some configurations to determine the distribution of curing.

RESULTS

Depths of cure and distribution of curing were significantly affected by changes in configuration. Under the configuration of no mold, the cure extended well beyond the periphery of the light guide due to scattering of the light. When a mold was used, a pronounced effect by the walls resulted in decreased hardness as the mold wall was approached, and the severity of this effect was dependent on the color of the mold. It is believed that this is due to absorption/reflection characteristics of light by the walls, with the white molds showing the least effect. Reducing the diameter of the molds resulted in significant decreases in depth of cure, which are attributed to light absorption by the walls that limits the penetration of light during the curing procedure.

SIGNIFICANCE

Configuration of curing has a significant effect on the depth of cure, but also significantly reduces the cure near the mold wall. This can have clinical ramifications for the cure along a stainless steel matrix band for Class II restorations, and for test procedures in general, where there is no standardization regarding configuration or where measurements are made on specimens.

Inconsistency in the strength testing of dental resin-based composites among researchers

The aims of this paper were to review the current strength testing methods of the dental resin-based composites (RBCs) and to explore the inconsistencies with regard to strength testing among researchers.

Data selection/extraction: An outline of the most relevant aspects of RBCs was created, and a subsequent literature search for articles published during last four decades (1970-2010) was conducted using the databases, namely PubMed, Science Direct and ISI Web of Knowledge.

Conclusion: The literature review highlighted a lack of consensus among researchers regarding the reliability of ISO recommended three-point flexure strength testing method. Several investigators have used Weibull statistics for the analysis of RBCs strength data, however their applicability might be questioned as many RBCs contain greater resin content and may exhibit sufficient viscous deformation prior to brittle failure. In addition, variability in the selection of cross-head speed and mould material for strength testing was evident which may lead to variation in the strength data and render the interpretation difficult among researchers.

The effect of specimen temperature on the polymerization of a resin-composite

OBJECTIVE

To use rapid scan FT-IR and Knoop microhardness to determine the effect of specimen temperature on the rate and extent of polymerization of a dental resin.

METHODS

Two-millimeter thick specimens of shade A2 Tetric EvoCeram were light cured for 20s at 22, 26, 30, and 35°C. The IR spectrum was obtained at the bottom of the specimens at a rate of 3 measurements per second for the first 5 min, and then again 2h later. The Knoop microhardness was measured at the bottom of the samples in the region where the IR spectrum was recorded at 5 min and 2h after light curing. Data were statistically analyzed using mixed model ANOVA (with Fisher's PLSD) to examine the effect of temperature, time and their interaction. The rate of conversion was determined using first differences and smoothed using a cubic spline procedure.

RESULTS

The bottom surfaces of the samples light cured at 22, 26, 30 and 35°C were all significantly different from each other (p<0.05). The higher temperature resulted in higher degree of conversion and Knoop microhardness values, and faster maximum rate of polymerization, which also occurred sooner. One second after the light was turned on, the rate of conversion was 106% faster at 35°C than at 22°C (p=0.003). Regression analysis showed a positive linear correlation between the degree of conversion and Knoop microhardness (r²=0.93).

SIGNIFICANCE

A relatively small difference in temperature can have a large and significant effect on the rate and extent of polymerization of dental resin. Consequently laboratory studies comparing the performance of resins should be conducted at clinically relevant temperatures.

Curing Efficiency of Three Different Curing Modes at Different Distances for Four Composites

Doubling the exposure time of a high-intensity light-emitting diode curing light with a turbo tip and autofocus capability does not predictably compensate for distance in deep cavities.

Knoop Microhardness Mapping Used to Compare the Efficacy of LED, QTH and PAC Curing Lights

The output of a curing light measured at a distance of 0 mm is a poor indicator of how much light energy will be delivered to a restoration in the mouth. When used for manufacturers' suggested curing times and at clinically relevant distances, some curing lights deliver much less energy than is recommended (&lt;10J/cm2) and produce softer composites.

Effect of Configuration Factor on Shear Bond Strengths of Self-etch Adhesive Systems to Ground Enamel and Dentin

Despite recent improvements in self-etch bonding systems, a two-step etch and rinse system gave consistently higher shear bond strengths to both ground enamel and dentin and would be the best system to use clinically.

Effect of Distance from Curing Light Tip to Restoration Surface on Depth of Cure of Composite Resin

Aims

While light-activating composite resins, the light tip may not always be close to the surface of the restoration. This may be intentional in an attempt to create a ramp cure. The aim of this study was to determine the effect of a range of separation distances between the light tip and the restoration surface on the depth of composite cure for different types of light-curing units with a broad range of outputs.

Methods

Three halogen light units, one plasma arc-curing (PAC) light unit and two light-emitting diode (LED) curing lights in clinical use were tested, and a total of 570 restorations cured in a two-part human tooth model at separations ranging from 0 to 15 mm. The tooth was disassembled and depth of cure determined using the scrape test ISO 4049. Light intensity was also measured at each separation distance for each light.

Results

The depth of cure was generally found to decrease as the separation distance increased for all lights at the various cure times. However, the effect of increasing the separation distance was less than anticipated. The depth of cure was also related to the light output.

Conclusions

Depth of composite cure was directly related to intensity and duration of light exposure and inversely related to distance of the light source from the surface for halogen and plasma lights. However, the effect of increasing the separation distance up to 15 mm was less than expected. Altering the separation distance in order to modify the polymerisation characteristics is unlikely to be effective.

Depth of cure and surface microhardness of experimental short fiber-reinforced composite

OBJECTIVES

The aim of this study was to analyze the depth of cure of a short fiber-reinforced composite (FRC) assessed by microhardness at different curing times and storage conditions.

MATERIAL AND METHODS

Experimental composite resin (FC) was prepared by high-speed mixing 22.5 wt% short E-glass fibers (3 mm in length) and 22.5 wt% resin matrix and gradually adding 55 wt% silane-treated silica filler. Half-split cylindrical test specimens were produced from both the FC and from the conventional particulate composite resin (control, Z250, 3M-ESPE). The test specimens (n=3/group) were polymerized at different exposure times (20, 40, 60 s) and then water-stored at 37 degrees C for 24 h and 30 days before testing. A universal testing machine was used for testing Vickers microhardness. All results were statistically analyzed with analysis of variance (ANOVA).

RESULTS

ANOVA revealed that curing time had a significant effect (p<0.05) on the microhardness of both composite resins. Depth of cure of conventional composite resin (control) was significantly greater than that of FC (p<0.05). Microhardness after water storage decreased as curing time increased.

CONCLUSIONS

The use of short fiber fillers in interpenetrating polymer network matrix (IPN) achieved the acceptable depth of cure and microhardness values recommended for clinical use, although lower than for commercial composite resin.

Cytotoxicity of resin composites as a function of interface area

OBJECTIVES

The standardization protocols for biomaterial cytotoxicity testing require fine tuning for oral biomaterials to obtain international comparability as the basis for risk assessment. The principal aims were specifically to evaluate the effect of (i) relative interface area (ratio of specimen surface to cell layer surface) and (ii) volume of cell culture medium on cytotoxicity as a potential modification of ISO 10993-5.

METHODS

ISO 10993-5 was followed with an interface area of 12.5%, as recommended, using primary human gingival fibroblasts and L-929 mouse fibroblasts. In another series of experiments (using L-929 cells) the interface area was varied between 12.5% and 0.71%. For each relative interface area, three conditions for affecting the cure of the resin composite were investigated by using three mould materials: white, transparent and black moulds. In addition, the volume of cell culture medium was varied. Composite specimens (Herculite XRV) were added to the cultures immediately after production or preincubation for 1, 2, 7 days or 6 weeks under cell culture conditions. Specimens were incubated with fibroblasts for 72 h and cell numbers determined by flow cytometry. Glass specimens resembling composite specimens in diameter and height were used as negative controls.

RESULTS

Cytotoxicity results with primary gingival fibroblasts were comparable to results with the cell line L-929. An effect from the color/material of the specimen moulds was found. Different ratios of specimen sizes to cell culture parameters (cell layer surface, volume of cell culture medium) produced different results. Three out of four differently designed specimens showed the same behavior in cell culture.

SIGNIFICANCE

Cytotoxicity tests should be further standardized in line with existing standards with regard to specimen production protocols to ensure results are internationally comparable to validate these tests as tools for risk assessment.

The effectiveness of different polymerization protocols for class II composite resin restorations

OBJECTIVES

To investigate the effect of reduced light exposure times on Vickers hardness (VH) of class II composite resin restorations.

METHODS

Class II restorations were made in vitro in three 2mm thick increments in a human molar. Two composite resins (Clearfil AP-X; Esthet-X) were polymerized with four light-curing units (Halogen; Astralis 10, LED; The Cure, L.E. Demetron I, Smartlite) following four curing protocols. Three protocols with exposure times of 10s, 20s or 40s (control) per layer. In the fourth protocol, 10s irradiation per layer was combined with additional lateral curing for 10s from buccal and palatal after removal of the metal matrix. VH of the axial surface was determined at top and bottom layers directly after light-curing and after 7 days storage. Linear regression analysis was performed to analyze the effect of protocol variables.

RESULTS

Directly after light-curing VH of both composite resins was significantly influenced by curing protocols. After 7 days, curing protocols had no significant effect on VH of Clearfil AP-X, except for the Smartlite. VH of Esthet-X was still influenced by curing protocol, but differences were smaller than directly after light-curing.

CONCLUSIONS

With high intensity light-curing units, exposure times of 10s/2mm increment can be sufficient to obtain under in vitro conditions a high degree of conversion, depending on materials and curing protocols. With additional lateral curing of a class II composite resin restoration a higher degree of cure can be obtained in less time.

Investigation of polymerisation shrinkage strain, associated cuspal movement and microleakage of MOD cavities restored incrementally with resin-based composite using an LED light curing unit

OBJECTIVES

To investigate the polymerisation shrinkage strain, associated cuspal movement, degree of conversion (DC) and cervical gingival microleakage of mesio-occlusal-distal (MOD) cavities restored with four resin-based composite (RBC) filling materials placed incrementally using a light emitting diode (LED) light curing unit (LCU).

METHODS

Standardised extensive MOD cavity preparations on extracted teeth were performed on 40 sound upper premolar teeth. Restoration of the teeth involved the placement of RBCs in eight increments with the appropriate bonding system before irradiation using an LED LCU. Buccal and palatal cusp deflections at each stage of polymerisation were recorded using a twin channel deflection measuring gauge. Following restoration, the teeth were thermocycled, immersed in a 0.2% basic fuchsin dye for 24 h, sagittally sectioned and examined for cervical microleakage. The DC was determined using a Fourier transform infra-red (FT-IR) spectrometer.

RESULTS

No significantly difference (P=0.677) in cuspal movement was recorded for Z100 (13.1+/-3.2 microm) compared with Filtek Z250 (8.4+/-3.5 microm), P60 (7.3+/-3.8 microm) and Admira (6.7+/-2.7 microm). The LED LCU deflections were compared with a halogen LCU used in a conventional (Fleming GJP, Hall D, Shorthall ACC, Burke FJT. Cuspal movement and microleakage in premolar teeth restored with posterior filling materials of varying reported volumetric shrinkage values. Journal of Dentistry, 2005;33:139-146) and soft-start mode (Fleming GJP, Cara RR, Palin WM, Burke FJT. Cuspal movement and microleakage in premolar teeth restored with posterior filling materials cured using 'soft-start' polymerization. Dental Materials, 2006, , in press) and a significant reduction in cuspal movement was identified for curing type and material type (P<0.001 and P=0.002, respectively). No significant differences were noted between the four RBC materials investigated when the DC or microleakage scores were examined for the LED LCU.

SIGNIFICANCE

It would appear that irradiation of RBCs using the LED LCU offered a significant reduction in associated cuspal movement in large MOD cavities. However, the microleakage scores following polymerisation were significantly increased with dye penetration into the pulp chamber from the axial wall evident in teeth restored with the LED LCU.

The influence of curing times and light curing methods on the polymerization shrinkage stress of a shrinkage-optimized composite with hybrid-type prepolymer fillers

OBJECTIVES

The aim of the study was to determine the influence of different light curing units (LCU) and regimes on the polymerization shrinkage stress (PSS) and the mechanical properties of a nano-hybrid composite.

MATERIAL AND METHODS

The polymerization shrinkage force (PSF) was measured continuously with compliance compensation for 300s after photo-initiating the composite, Tetric EvoCeram (Ivoclar Vivadent, Schaan, FL, Shade A3) in a Stress-Strain Analyser. Astralis 10, Bluephase and MiniL.E.D LCU with exposure times 10, 20 and 40s were used (C-factor=0.33, n=8 per group). Immediately after the PSF measurements, mechanical properties of the samples were measured at the top and the bottom using a Fischerscope H100C (Helmut Fischer GmbH, Sindelfingen, Germany). Statistical analyses were done using one-way ANOVA (p<0.05) and Tukey post hoc test.

RESULTS

Significant differences in the PSS for 10, 20 and 40s polymerization using Astralis 10 were found. The MiniL.E.D recorded low stress values. Modulus of elasticity is high after curing the composite with Astralis 10 at 10, 20 and 40s and for Bluephase 40s. Low moduli of elasticity were recorded for the MiniL.E.D and for the Bluephase 20 and 10s. The hardness values (HV) followed the same pattern as the modulus of elasticity. The Ramping mode of the MiniL.E.D had prolonged gel point.

CONCLUSIONS

High intensity LCU produce not just high HV but also high shrinkage, making it important to balance both the effects by choosing the appropriate curing time. Soft-start regimes have no paramount benefit in a LED regarding stresses in the clinical situation.

Relative curing degree of polyacid-modified and conventional resin composites determined by surface Knoop hardness

OBJECTIVES

The aim of the present study was to investigate the relative curing degree at a depth of 2 mm of several polyacid-modified composites (PAM-Cs) as a function of shade.

METHODS

The Knoop hardness of the irradiated top and non-irradiated bottom surfaces of 2 mm thick samples of the PAM-Cs Hytac, F2000, Glasiosite, Dyract, Dyract AP, and Compoglass F and of the resin composites Z100, Herculite Enamel XRV, and Durafill VS, were determined for shades A2 and A4.

RESULTS

The top and bottom hardness of F2000 and Glasiosite ranged between that of the two composites Herculite and Z100. Compoglass, Dyract and Dyract AP had a lower top and bottom hardness than the hybrid composites, but higher than that of the microfilled composite Durafill. The top hardness of Hytac compared with that of the first group, whereas the bottom hardness compared with the second group. The bottom-to-top KHN ratio reflecting the relative curing degree at a depth of 2 mm was less than 80% for the two shades of Hytac and Compoglass as well as for the A4 shade of Dyract AP and Herculite.

SIGNIFICANCE

A hard top surface of a PAM-C is not an indication of adequate in depth polymerization. Shade A2 results in significantly greater values for the curing degree compared to shade A4, the effect depending quantitatively on the formulation of the material. Some formulations of PAM-C do not reach an adequate curing degree at a depth of 2 mm so that it is recommended to apply the incremental technique even in box-only cavities with layers of maximum 2 mm.

How light source and product shade influence cure depth for a contemporary composite

Directly placed light activated resin based composite restorations are becoming increasingly popular for restoring cavities in posterior teeth. Marketing and patient as factors well as operator preference are behind this trend. Achieving adequate depth of cure is critical to the success of these restorations. Recently a number of second generation light emitting diode (LED) light activation units have been marketed and the manufacturer of one of these claims that it is capable of curing in half the time of its predecessor. This study tested that claim using a companion composite from the same manufacturer. The relationship between cure depth, shade changes on curing and opacity were also assessed. Under the limitations of the current investigation the results indicated that the second generation LED unit in question met the manufacturer's claim for halving cure time. Depths of cure approached those of a control halogen unit in half the 40 s radiation time of the latter. For the product tested depth of cure is strongly linked to material opacity.

Knoop hardness of ten resin composites irradiated with high-power LED and quartz-tungsten-halogen lights

This study compared a high-power light-emitting-diode (LED) curing light (FreeLight 2, 3M ESPE) with a quartz-tungsten-halogen (QTH) light (TriLight, 3M ESPE) to determine which was the better at photo-polymerising 10 resin composites. Class I preparations were prepared 4-mm deep into human teeth and filled with 10 different composites. The composites were irradiated for 50% or 100% of their recommended times using the LED light, and for 100% of their recommended times with the QTH light on either the high or medium power setting. Fifteen minutes later, the Knoop hardness of the composites was measured to a depth of 3.5 mm from the surface. When irradiated by the LED light for their recommended curing times, the Knoop hardness of all 10 composites stayed above 80% of the maximum hardness of the composite to a depth of at least 1.5 mm; three composites maintained a Knoop hardness that was more than 80% of their maximum hardness to a depth of 3.5 mm. Repeated measurements analysis of variance indicated that all the two-way and three-way interactions between the curing light, depth, and composite were significant (p < 0.01). To eliminate the choice of composite as a factor, an overall comparison of the lights was performed using the Kruskal-Wallis test and distribution free multiple comparisons of the ranked hardness values. The LED light, used for the composite manufacturer's recommended time, was ranked the best at curing the composites to a depth of 3mm (p < 0.01). The LED light used for 50% of the recommended time was not significantly different from the QTH light used for 100% of the recommended time on the high power setting.

Effect of power density of curing unit, exposure duration, and light guide distance on composite depth of cure

This in vitro study compared the depth of cure obtained with six quartz tungsten halogen and light-emitting diode curing units at different exposure times and light tip-resin composite distances. Resin composite specimens (Tetric Ceram, A3; diameter 4 mm, height 6 mm) were exposed from 0-, 3-, and 6-mm distance. The curing units (200-700 mW/cm2) were used for standard (20 and 40 s), pulse-delay mode (initial exposure of 3 s at 200 mW/cm2, followed by a resting period of 3 min and a final exposure of 10 or 30 s at 600 mW/cm2), or soft-start curing (40 s; exponential ramping). Curing depth was determined by measurement of Wallace hardness for each half millimeter starting at 0.5 mm from the top surface. For each specimen, a mean H(W) value was calculated from the H(W) values determined at the depths of 2.0 mm and less (0.5, 1.0, 1.5, and 2.0 mm, respectively). The depth of cure for each specimen was found by determining the greatest depth before an H(W) value exceeding the minimal H(W) value by 25% occurred. For all curing units, an increase in exposure time led to significantly higher depth of cure. Increasing the light tip-resin composite distance significantly reduced the depth of cure. With a light tip-resin composite distance of 6 mm, median values of depth of cure varied between 2.0 and 3.5 mm following a 20-s (or 3+10 s) exposure and between 3.0 and 4.5 mm following a 40-s (or 3+30 s) exposure. The composite situated above the depth of cure value cured equally well with all curing units. At both exposure times, Luxomax resulted in the significantly lowest depth of cure, and Astralis 7 yielded significantly higher depth. At both exposure times, a significant linear correlation was found between the determined power densities of the curing units and the pooled depth of cure values obtained. It seems that for the resin composite tested, the recommended exposure time of 40 s per 2-mm increment may be reduced to 20 s, or that increments may be increased from 2 to 3.5 mm. It may be that the absolute values of depth of cure found are material specific, but we believe that the relationships found between curing units, between exposure times, and between light guide distances are universal.

The effect of infection-control barriers on the light intensity of light-cure units and depth of cure of composite

AIM

Dental curing lights are vulnerable to contamination with oral fluids during routine intra-oral use. This controlled study aimed to evaluate whether or not disposable transparent barriers placed over the light-guide tip would affect light output intensity or the subsequent depth of cure of a composite restoration.

METHODS

The impact on light intensity emitted from high-, medium- and low-output light-cure units in the presence of two commercially available disposable infection-control barriers was evaluated against a no-barrier control. Power density measurements from the three intensity light-cure units were recorded with a radiometer, then converted to a digital image using an intra-oral camera and values determined using a commercial computer program. For each curing unit, the measurements were repeated on ten separate occasions with each barrier and the control. Depth of cure was evaluated using a scrape test in a natural tooth model.

RESULTS

At each level of light output, the two disposable barriers produced a significant reduction in the mean power density readings compared to the no-barrier control (P<0.005). The cure sleeve inhibited light output to a greater extent than either the cling film or the control (P<0.005). Only composite restorations light-activated by the high level unit demonstrated a small but significant decrease in the depth of cure compared to the control (P<0.05).

CONCLUSION

Placing disposable barriers over the light-guide tip reduced the light intensity from all three curing lights. There was no impact on depth of cure except for the high-output light, where a small decrease in cure depth was noted but this was not considered clinically significant. Disposable barriers can be recommended for use with light-cure lights.

Curing efficiency and heat generation of various resin composites cured with high-intensity halogen lights

The objective of this study was to assess the curing efficiency and heat generation of two high-intensity halogen lamps, the Astralis 10 HIP (1100 mW cm(-2)), and Optilux 501 Boost (1000 mW cm(-2)) in curing three resin composites (InTen-S, Tetric Ceram, and Filtek Z250). It was expected that the two lamps, having similar irradiance would give rise to the same curing efficiency and heat generation. The curing efficiency was evaluated by Vickers hardness and depth of cure measurements. Heat generation in the resin composites was studied in standardized restorations using a thermocouple. No significant differences were observed in curing efficiency between the two lamps for the three resin composites. The temperature rise in the composites during curing was between 11.2 degrees C and 16.2 degrees C. At subsequent irradiation, after the composites had been cured, the temperature rise was between 8.2 degrees C and 12.1 degrees C. The Optilux 501 generated, in all cases, less heat than the Astralis 10. This was not expected based on the irradiance, but could be accounted for by the differing spectra.

Second generation LEDs for the polymerization of oral biomaterials

OBJECTIVES

New blue, so called second generation light emitting diodes (LEDs) are now available with a high optical power output. These LEDs will potentially find widespread application in commercially available light curing units (LCUs). This study, therefore, investigated the curing performance of a prototype LCU containing one high power LED and a conventional halogen LCU (Polofil).

METHODS

The performances of the LCUs were evaluated by measuring the Knoop hardness and depth of cure of the composites. Three dental composites were selected (Z100, Admira and Revolcin Flow) in a light (A2) and a dark shade (A3.5 or A4), respectively, and were polymerized for 40 s each.

RESULTS

The LED prototype (irradiance=901 mW/cm2) achieved a statistically significantly greater (p<0.05) depth of cure than the halogen LCU (irradiance=860 mW/cm2) for all composites. Generally, there was no statistically significant difference in Knoop hardness on the top and bottom of a 2 mm thick disk for the composites Z100 and Admira if polymerized with the LED prototype or halogen LCU. The composite Revolcin Flow, however, showed in general a statistically significant lower Knoop hardness if polymerized with the LED LCU.

SIGNIFICANCE

The present study shows that second generation LEDs have the potential to replace halogen LCUs if the composites are selected carefully. Furthermore, this study confirmed that the depth of cure test does not discriminate between LCU's performance for composites containing co-initiators, but the Knoop hardness test does.

The reliability in flexural strength testing of a novel dental composite

OBJECTIVES

To investigate the reliability of bi-axial flexure and three-point flexure testing of an experimental, low-shrink oxirane-based dental composite, EXL596 compared with two conventional methacrylate based restoratives, Z250 and Z100.

METHODS

Specimens (n=20) of a novel oxirane-based composite and two commercially available methacrylate based composites were fabricated for flexural testing to evaluate mean bi-axial flexure strengths, three-point flexure strengths and the associated Weibull moduli (m) following 24 h immersion in a lightproof waterbath maintained at 37+/-1 degrees C.

RESULTS

Mean bi-axial flexure strengths and the associated m of EXL596, Z250 and Z100 were 168+/-11 MPa (m=16.2+/-4), 140+/-12 MPa (m=11.9+/-3) and 126+/-13 MPa (m=10.2+/-2), respectively. Three-point flexure strengths and the associated m of EXL596, Z250 and Z100 were 113+/-15 MPa (m=9.2+/-2), 92+/-10 MPa (m=8.5+/-2) and 79+/-16 MPa (m=6.3+/-1), respectively.

CONCLUSIONS

The present investigation suggests that bi-axial flexure strength testing of dental resin-based composites provides a more reliable testing method than three-point flexure. The increased reliability was considered in terms of the associated Weibull moduli following bi-axial flexure testing as a result of the elimination of the additional induced variability introduced during the curing regime of three-point flexure specimens.

Comparative efficiency of plasma and halogen light sources on composite micro-hardness in different curing conditions

OBJECTIVES

Recent developments have led to the introduction of high power curing lights, which are claimed to greatly reduce the total curing time. This study evaluated the effectiveness of a plasma-curing device (Apollo 95 E) and a halogen device (Heliolux DLX), in different curing conditions.

METHOD

Vicker's micro-hardness values were performed on 1 and 2 mm thick composite discs cured in a natural tooth mold by direct irradiation or indirect irradiation through composite material (2 or 4 mm) and dental tissues (1 mm enamel or 2 mm enamel-dentin). Measures were, respectively, performed after a 1, 3, 6 s (SC, step curing mode) or 18 s (3xSC) exposure to the plasma light, and a 5, 10, 20 or 40 s exposure to the halogen light.

RESULTS

With the PAC light used, a 3 s irradiation in the direct curing condition was necessary to reach hardness values similar to those obtained after a 40 s exposure to the halogen light. Using the indirect curing condition, hardness values reached after an 18 s exposure (3xSC mode) with the plasma light were either equivalent or inferior to those obtained with 40 s halogen irradiation.

SIGNIFICANCE

Direct polymerization with the plasma light used requires longer exposure times than those initially proposed by the manufacturer. The effectiveness of plasma generated light was lowered by composite or natural tissues, and therefore requires an important increase in the irradiation time when applied to indirect polymerization. The practical advantage of this polymerization method is less than expected, when compared to traditional halogen curing.

A comparative study of the properties of dental resin composites polymerized with plasma and halogen light

OBJECTIVES

Newly developed curing units utilizing plasma arc methodology have been advocated for rapid curing of dental composites. This study was conducted to investigate the effect of plasma light using a 3 s and a step cure regime on the properties of four dental restorative materials and compare it with properties resulting from halogen light curing of the same materials.

METHODS

Composites Quadrant, Filtek and two polyacid modified composites (compomers) Dyract AP and Compoglass F were cured, using a conventional halogen light, a plasma light for 3 s (Apollo95E) and a plasma step cure (Apollo 95E) method. The parameters studied for characterization of the restorative materials were polymerization exotherm, surface hardness and their interactions with saline.

RESULTS

Irradiation with plasma light for 3 s or step cure produced an order of hardness: Filtek>Compoglass F>Dyract AP>Quadrant (p<0.001), however, halogen cure yielded an order of hardness: Filtek>Quadrant>Dyract AP>Compoglass F. No significant differences in hardness were observed on the exposed and non-exposed surfaces of the materials cured by plasma step cure whereas a 3 s cure yielded a significant difference in the cases of Quadrant, Compoglass F and Dyract AP (p<0.001). Mass losses were also found to be greater in the specimens cured by plasma light for 3 s in comparison with plasma step cure and halogen cure.

SIGNIFICANCE

Plasma step and halogen curing were found to yield composites with superior properties in comparison to a 3 s plasma cure, suggesting, that a step cure regime is a preferred method, when a plasma light unit is used. A 3 s curing with a plasma light may lead to less than optimum properties of the composite cements.

The effect of curing with plasma light on the shrinkage of dental restorative materials

Commercially available light activated dental composites were used in this study to compare the shrinkage following curing with plasma light (Apollo95E, DMDS) and a convention halogen dental curing light (Prismetics Lite II, Dentsply). Polymerization shrinkage was determined by measuring the strain in one dimension by means of a contacting transducer. The percentage linear shrinkage were: Spectrum H = 1.84 + 0.31, P = 1.49 + 0.35*; Ana aesthetic H = 2.04 + 0.38, P = 1.85 + 0.27; Esthet.x H = 1.66 + 0.28, P = 1.69 + 0.25; Dyract AP H = 2.39 + 0.33, P = 2.18 + 0.35*; Apollo Restore H = 1.88 + 0.36, P = 1.42 + 0.33*; Surefil H = 0.88 + 0.28, P = 0.99 + 0.30 where * = significantly different, t-test at P < 0.05. The results suggested that there was less shrinkage when curing some, but not all, materials using the plasma light, although this could be attributed to a reduced level of polymerization.

Photoinitiator dependent composite depth of cure and Knoop hardness with halogen and LED light curing units

Light curing units (LCUs) are used for the polymerization of dental composites. Recent trends in light curing technology include replacing the halogen LCUs with LCUs using light emitting diodes (LEDs) reducing curing times and varying the LCUs light output within a curing cycle. This study investigated the time dependence of the Knoop hardness and depth of cure of dental composites polymerized with a halogen LCU (Trilight) and two LED LCUs (the commercial Freelight and custom-made LED LCU prototype). The halogen LCU was used in the soft-start (exponential increase of output power) and standard mode. Four dental composites (Z100, Spectrum, Definite, Solitaire2) were selected, two of them (Definite, Solitaire2) contain co-initiators in addition to the standard photoinitiator camphorquinone. The depth of cure obtained with the Trilight in the standard mode was statistically significantly greater (p < 0.05) than that obtained with the LED LCUs for all materials and curing times. The custom made LED LCU prototype (LED63) achieved a statistically significantly greater depth of cure than the commercial LED LCU Freelight for all materials and curing times. There was no statistical difference in Knoop hardness at the 95% confidence level at the surface of the 2 mm thick sample between the LED63 or Trilight (standard mode) for the composite Z100 for all times, and for Spectrum for 20s and 40s curing time. The composites containing co-initiators showed statistically significantly smaller hardness values at the top and bottom of the samples if LED LCUs were used instead of halogen LCUs. The experiment revealed that the depth of cure test does not and the Knoop hardness test does discriminate between LCUs, used for the polymerization of composites containing photoinitiators in addition to camphorquinone.

The effect of two configuration factors, time, and thermal cycling on resin to dentin bond strengths

Most in vitro testing of bonding systems is performed using specimens made in a mold with a low configuration (C) factor (ratio of bonded/unbonded surfaces) whereas clinically the C-factor is usually much greater. This study compared the effect of thermal cycling on the measured shear bond strength of 3M Single Bond dental adhesive bonded to dentin using molds with two different C-factors. The hypothesis was that neither C-factor nor thermal cycling would affect measured bond strengths. Resin composite was bonded to human dentin in cylindrical molds with an internal diameter of 3.2mm and either 1mm or 2.5mm deep. The 1mm deep molds had a C-factor of 2.2 and the 2.5mm deep molds had a C-factor of 4.1. Specimens were debonded either 10min after they had been bonded to dentin, or after they had been stored for 7 days in water at 37+/-1 degrees C, or after thermal cycling 5000 times for 7 days. Two-way ANOVA showed that overall both the C-factor and the storage condition had a significant effect on bond strength (p<0.001). There was a significant interaction (p<0.001) between the C-factor and how the specimens had been stored. The GLM/LSMEANS procedure with Sidak's adjustment for multiple comparisons showed that overall the specimens made in the mold with a high C-factor (4.1) had a lower bond strength than those that had been made in the mold with a lower (2.2) C-factor (p<0.001). Thermal cycling had a negative effect on the bond strength only for specimens made in molds with a C-factor of 4.1 (p<0.001).

Optical power outputs, spectra and dental composite depths of cure, obtained with blue light emitting diode (LED) and halogen light curing units (LCUs)

OBJECTIVE

To test the hypothesis that a prototype LED light curing unit, (LCU), a commercial LED LCU and a halogen LCU achieve similar cure depths, using two shades of a camphorquinone photoinitiated dental composite. To measure the LCUs' outputs and the frequency of the LED LCU's pulsed light, using a blue LED array as a photodetector.

DESIGN

Cure depth and light output characterisation to compare the LCUs.

SETTING

An in vitro laboratory study conducted in the UK.

MATERIALS AND METHODS

The LCUs cured A2 and A4 composite shades. A penetrometer measured the depth of cure. Analysis was by one-way ANOVA, two-way univariate ANOVA and Fisher's LSD test with a 95% confidence interval. A power meter and spectrograph characterised the LCUs' emissions. A blue LED array measured the pulsed light frequency from an LED LCU.

RESULTS

Statistically significant different LCU irradiances (119 mW/cm2 to 851 mW/cm2) and cure depths (3.90 mm SD +/- 0.08 to 6.68 mm SD +/- 0.07) were achieved. Composite shade affected cure depth. A blue LED array detected pulsed light at 12 Hz from the commercial LED LCU.

CONCLUSIONS

The prototype LED LCU achieved a greater or equal depth of cure when compared with the commercial LCUs. LEDs may have a potential in dentistry for light detection as well as emission.

Polymerization of dental composite resins using plasma light

Five visible light-cured composite resins used as restoration or adhesive materials in dentistry, were irradiated with high energy plasma light (1300 mW/cm2), and contraction, rate of contraction, irradiation-induced temperature were analysed. A comparison was carried out with the same materials irradiated with a conventional halogen light (400 mW/cm2). The exposure to the photoactivating lights was either continuously or sequentially in three or more intervals with 10 min between intervals. Comparing the lengths of exposure of both lights, which induced the same contraction in a given material, it was found that the exposure length to the plasma light was greatly reduced, when compared with the exposure length of the halogen light (1:10). Frequently, the final contraction of plasma-irradiated materials was lower, whereas the rate of contraction, as indicated by the linear dimensional variation curves obtained by laser beam scanning method, did not show significant differences between the two lights. The temperature increase induced by plasma light on the material did not exceed the temperature induced by conventional light.

Effect of exposure intensity and post-cure temperature storage on hardness of contemporary photo-activated composites

OBJECTIVES

The effect of variation in post-exposure storage temperature (18 vs. 37 degrees C) and light intensity (200 vs. 500mW/cm(2)) on micro-hardness of seven light-activated resin composite materials, cured with a Prismetics Mk II (Dentsply) light activation unit, were studied.

METHODS

Hardness values at the upper and lower surfaces of 2mm thick disc shaped specimens of seven light-cured resin composite materials (Herculite XRV and Prodigy/Kerr, Z100 and Silux Plus/3M, TPH/Dentsply, Pertac-Hybrid/Espe, and Charisma/Kulzer), which had been stored dry, were determined 24h after irradiation with a Prismetics Mk II (Dentsply) light activation unit.

RESULTS

Hardness values varied with product, surface, storage temperature, and curing light intensity. In no case did the hardness at the lower surface equal that of the upper surface, and the combination of 500mW/cm(2) intensity and 37 degrees C storage produced the best hardness results at the lower surface.

CONCLUSIONS

Material composition had a significant influence on surface hardness. Only one of the seven products (TPH) produced a mean hardness values at the lower surface >80% of the maximum mean upper surface hardness obtained for the corresponding product at 500mW/cm(2) intensity/37 degrees C storage temperature when subjected to all four test regimes. Despite optimum post-cure storage conditions, 200mW/cm(2) intensity curing for 40s will not produce acceptable hardness at the lower surface of 2mm increments of the majority of products tested.

The application of magnetic resonance microimaging to the visible light curing of dental resins. 3. Stray-field nuclear magnetic resonance imaging (STRAFI)

OBJECTIVE

To investigate the application of stray-field nuclear magnetic resonance imaging (STRAFI) to the visible light curing of dental restorative materials. STRAFI can overcome peak broadening associated with the conventional magnetic resonance microimaging (MRM) of glassy polymers, and has the potential to image dental restorative resins at both low and high degrees of conversion.

METHODS

Cylindrical composite specimens were light-cured from one end to produce some that were fully cured throughout their length and others that were fully cured at one end and uncured at the other. A one-dimensional probe was used to measure the magnetisation in 40 microm thick slices at 100 microm intervals along the length of the specimen. A quadrature pulse sequence was applied and the magnetisation decay recorded in a train of eight echoes.

RESULTS

A value for T(2) could be obtained only for the polymer (59+/-16 microms), therefore the echoes were summed to give an approximate indication of the degree of conversion. The echo sum for the monomer was significantly higher than that for the polymer. Differences in composite shade and cure time produced changes in the cure profiles.

SIGNIFICANCE

STRAFI produced measurements for both monomer and polymer in all stages of conversion that allowed cure profiles to be produced. Summing the decay echoes produced a qualitative measure of the condition of the material in the selected slice. The same data can be used to calculate T(2), a quantitative parameter. This first investigation has demonstrated that STRAFI is well suited to polymerisation studies.

The application of magnetic resonance microimaging to the visible light curing of dental resins. Part 2. Dynamic imaging by the FLASH-MOVIE pulse sequence

OBJECTIVES

To investigate the application of a rapid NMR imaging pulse sequence, FLASH-MOVIE, to the visible light curing of dental restorative materials.

METHODS

The light guide was applied at one end of a cylindrical specimen of visible light curing unfilled resin and the light directed along the cylinder. During polymerisation an NMR imaging pulse sequence, FLASH-MOVIE, was run at 15s intervals with a 50 ms repetition time. The image of a 1mm thick vertical slice was recorded with a (125 microm)2 pixel size.

RESULTS

Images with good contrast were obtained from all resin monomers. The image intensity from the polymer was indistinguishable from the background intensity. Thus, the progress of light activated polymerisation in the material could be followed in real time through a series of up to 16 images. Initially the image intensity increased in the material closest to the light guide, then decreased over time to zero. Concomitant with this fall, a "cure-front" moved through the specimen.

SIGNIFICANCE

The FLASH-MOVIE NMR pulse sequence applied to microimaging of dental diacrylate resins can be used to obtain a dynamic record of visible light curing. A more refined experimental protocol will be required to apply this unique data to models proposed for this polymerisation mechanism.

Investigations into the use of an ultrasonic chisel to cut bone. Part 2: Cutting ability

OBJECTIVES

Ultrasound may offer a possible alternative to rotary instruments for removing bone. This study was undertaken to analyse in vitro the various factors that influence the cutting of bone by an ultrasonic chisel.

STUDY DESIGN

A block of bovine femur was moved in a longitudinal direction under a stationary ultrasonic chisel. The force and depth of the cut was recorded for cutting rates of 28-112 mm/min and with increasing rake angles of 0 to +20 degrees. The pressure exerted by the chisel was recorded for different cutting rates.

RESULTS

When the cutting rate increases there is a corresponding increase in the downward force which is followed by a decrease in the force at rates greater than 56 mm/min. The depth of the cut increases up to a rate of 56 mm/min after which it decreases. Both the longitudinal and downward forces do not change when the rake angle changes from 0 to +10 degrees. The downward force decreases when the rake angle increases from +10 to +20 degrees.

CONCLUSIONS

The bone is cut slowly with the ultrasonic chisel, but this would assist in precision. Where such an instrument is used for cutting bone the clinicians should be aware that both low forces and cutting rates are required, and the instrument should be held at a low rake angle.

Investigations into the use of an ultrasonic chisel to cut bone. Part 1: Forces applied by clinicians

OBJECTIVES

To measure in vitro the direction and force of applied loads applied by clinicians when using both a conventional slow surgical handpiece (CH) and an ultrasonic chisel (USC) for cutting bone.

STUDY DESIGN

Five clinicians were asked to cut bovine bone using either an USC or a CH. The bone was placed on a force measurement system that could measure both longitudinal and downward loads. The rate of cut was calculated over a fixed time-period and the depth of cut measured using a penetratometer.

RESULTS

The magnitude of the longitudinal forces generated varied between 1.48 and 3.22 N (USC) and 0.04 and 4.56 N (CH). The CH had a pulling force directed towards the operator. Both instruments produced a similar range of downward forces although there was intra- and inter-operator variability. The rate of cut varied in a similar manner, however, the CH produced a significantly greater depth of cut (p < 0.05).

CONCLUSIONS

The force measurement system demonstrated differences in the way clinicians used the USC and CH instruments to cut bone. Of the two cutting methods investigated, the rotary bur is more efficient than the ultrasonic chisel. An ultrasonic chisel does cut bone in a different manner from a conventional bur and clinicians may require training before using it clinically.

Depth of cure and compressive strength of dental composites cured with blue light emitting diodes (LEDs)

OBJECTIVE

The primary objective of this pilot study was to test the hypotheses that (i) depth of cure and (ii) compressive strength of dental composites cured with either a light emitting diode (LED) based light curing unit (LCU) or a conventional halogen LCU do not differ significantly. The second objective of this study was to characterise irradiance and the emitted light spectra for both LCUs to allow comparisons between the units.

METHODS

Dental composite (Spectrum TPH, shades A2 and A4) was cured for 40 s with either a commercial halogen LCU or a LED LCU, respectively. The LED LCU uses 27 blue LEDs as the light source. The composites' depth of cure was measured for 10 samples of 4 mm diameter and 8 mm depth for each shade with a penetrometer. The results were compared using a Student's t-test. Compressive strengths were determined after 6 and 72 h, for six samples of 4 mm diameter and 6 mm depth for each shade after being polymerised for 40 s from each end of the mould. Groups were compared using a three way ANOVA.

RESULTS

The conventional halogen LCU cured composites significantly (p < 0.05) deeper (6.40 mm A2, 5.19 mm A4) than did the LED LCU (5.33 mm A2, 4.27 mm A4). Both units cured the composite deeper than required by both ISO 4049 and the manufacturer. A three way ANOVA showed that there were no significant differences in the compressive strengths of samples produced with either the LED LCU or the halogen LCU (p = 0.460). Significant differences in compressive strength of samples stored for 6 and 72 h (p = 0.0006) and of samples of different shades (p = 0.035) were found as confirmed by the three way ANOVA. The light spectra of both units differed strongly. While the halogen LCU showed a broad distribution of wavelengths with a power peak at 497 nm, the LED LCU emitted most of the generated light at 465 nm. The LED LCU produced a total irradiance of 350 mW cm-2 whereas the halogen LCU produced a total irradiance of 755 mW cm-2.

SIGNIFICANCE

The results showed that both units provided sufficient output to exceed minimum requirements in terms of composites' depth of cure according to ISO 4049 and the depth of cure and the composites' compressive strength stated by the manufacturer. Compressive strengths of dental composites cured under laboratory conditions with a LED LCU were statistically equivalent to those cured with a conventional halogen LCU. With its inherent advantages, such as a constant power output over the lifetime of the diodes, LED LCUs have great potential to achieve a clinically consistent quality of composite cure.

Cure behaviour of visible light-activated pattern materials

AIM

This study tested the hypothesis that the cure behaviour (depth of cure and polymerization contraction) of light-activated pattern materials was no worse than that of light-activated composite resins, allowing them to be handled in a similar fashion.

METHODOLOGY

Depth of cure was measured by a penetrometer method.

RESULTS

Cure depths were comparable to those of composite resins, ranging from 3.52 mm (Lumin-X paste) to 6.76 mm (Visioform) after visible light activation for 30 s. There were significant differences in the depth of cure of the three materials tested (P < 0.001). Polymerization contraction was assessed by a minimal load transducer method. Values ranged from 0.45% (Lumin-X paste) to 1.89% (Visioform), lower than that of composite resins. There were significant differences in the polymerization contraction values for each of the three materials (P < 0.001).

CONCLUSIONS

It was concluded that light-activated pattern materials cure in a manner comparable to composite resins, and may be built up incrementally in a similar fashion.