Dental curing lights--maintenance of visible light curing units.

Successful curing depends directly on many factors of which the most important is the correct functioning of the curing unit to emit light of sufficient intensity and quality. If the contribution of any of these factors is at a less than adequate level, the light-sensitive materials will not polymerise completely, which in the long term may be responsible for secondary caries and decreased longevity of the restoration. Factors which may reduce the light output include ageing of the bulb and filter, damage of the light guide or fibre optics, deposits on the light tip due to composite build-up or autoclave scale, erosion of light tip surface due to immersion sterilisation, and line voltage fluctuations. Recent studies carried out to investigate the effectiveness of curing lights in clinical use show that most practitioners are unaware of the importance of routine monitoring, care and maintenance of curing lights. This paper reviews some of the available literature on the monitoring, care and maintenance of curing lights, including information on the influence that some of these may have on the intensity emitted by the curing light.     

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光固化复合树脂通过光聚合进行固化,已有多种光固化灯用于口腔材料的光固化。随着发光二极管（LED）技术的迅速发展,LED光固化灯已逐渐成为多数临床应用的标准设备。本文就LED光固化灯的物理学特性、口腔临床应用发展、导光管及其消毒作一综述,分析未来发展趋势,为其在口腔临床应用提供参考依据。     

Biological effects of blue light from dental curing units.

OBJECTIVES: This study assessed the effects of three common dental photo-curing light sources (quartz-tungsten-halogen (QTH), plasma-arc (PAC), and laser) on the cellular function of fibroblasts in vitro. METHODS: Mouse fibroblasts were exposed to light from dental photo-curing units for clinically relevant durations, with total energy exposures ranging from 1.3 to 60 J/cm(2). The temperature rise of the cell-culture medium was measured to assess any possible effect from temperature increases, and cellular function was assessed by succinic dehydrogenase (SDH) activity of mitochondria. To directly compare the three light sources, additional experiments were done using equivalent total energy exposures from each source by adjusting the exposure durations for each unit. RESULTS: In experiments that used clinically relevant exposure durations for each light, exposures ranging from 5 J/cm(2) (laser) to 15 J/cm(2) (PAC, QTH) irreversibly suppressed SDH activity nearly 100% when compared to no-light controls up to 72 h post-exposure. For the PAC and QTH sources, exposures as low as 3.5 J/cm(2) also irreversibly suppressed SDH activity. When equivalent energies were used from each light source, exposures of 1 J/cm(2) did not suppress SDH activity for the QTH and laser sources, but significantly (50%) suppressed SDH for the PAC source, indicating a difference in the biological effects of the outputs of the different curing units. Equivalent energy exposure experiments also indicated a definite dependence of SDH activity on the total light energy of exposure. Temperature rises ranged from 2 to 9 degrees C, and elevated temperatures lasted for 60-300 s above the base temperature of 37 degrees C, but peak temperature and the duration of temperature elevation were not always related and depended on the light source used. SIGNIFICANCE: Results from the current study indicate that these photo-curing sources pose some risk of disrupting cellular function in vivo. Further study is necessary in other cell types and under more clinically relevant conditions to estimate the in vivo risk of photo-curing to oral tissues.     

Localised irradiance distribution found in dental light curing units

Objective

To measure the localised irradiance and wavelength distributions from dental light curing units (LCUs) and establish a method to characterise their output.

Methods

Using a laboratory grade integrating sphere spectrometer system (Labsphere and Ocean Optics) the power, irradiance, and spectral emission were measured at the light tips of four LCUs: one plasma-arc (PAC) unit, one single peak blue light-emitting diode (blue-LED) unit, and two polywave LED (poly-LED) units. A beam profiler camera (Ophir Spiricon) was used to record the localised irradiance across the face of the light tips. The irradiance-calibrated beam profile images were then divided into 45 squares, each 1 mm². Each square contained the irradiance information received from approximately 3200 pixels. The mean irradiance value within each square was calculated, and the distribution of irradiance values among these 45 squares across the tip-ends was examined. Additionally, the spectral emission was recorded at various regions across each light tip using the integrating sphere with a 4-mm diameter entrance aperture.

Results

The localised irradiance distribution was inhomogeneous in all four lights. The irradiance distribution was most uniformly distributed across the PAC tip. Both the irradiance and spectral emission from the poly-LED units were very unevenly distributed.

Conclusions

Reporting a single irradiance value or a single spectral range to describe the output from a curing light is both imprecise and inappropriate. Instead, an image of both the irradiance distribution and the distribution of the spectral emission across the light tip should be provided.

Clinical significance

The localised beam irradiance profile at the tip of dental LCUs is not uniform. Poly-LED units may deliver spectrally inhomogeneous irradiance profiles. Depending on the photoinitiator used in the RBC and the orientation of the LCU over the tooth, this non-uniformity may cause inadequate and inhomogeneous resin polymerisation, leading to poor physical properties, and premature failure of the restoration.     

Performance of two blue light-emitting-diode dental light curing units with distance and irradiation-time.

OBJECTIVES: To assess the performance of two blue light-emitting-diode (LED) curing units, in terms of their spectral output and irradiance and the depth of cure (dcure) produced in standard hybrid and modified composites, compared with a conventional quartz tungsten halogen (QTH) light curing unit. METHODS: The following light curing units (LCUs) were studied: Elipar-Freelight-1 LED (LED-1) 3 M-ESPE, Ultralume-2 LED (LED-2) Optident, and the Optilux-500 QTH (QTH-1) Sybron-Kerr. For each LCU, using a UV-visible spectrophotometer, the output spectrum was measured and the irradiance of emitted light as a function of source-detector distance. Three composites were studied of similar formulation but differing in their initiator concentrations and/or opacity. These were: Tetric Ceram (A3), Tetric Ceram HB containing an additional photoinitiator responding to approximately 435 nm (A3) and Tetric Ceram Bleach (L). dcure was measured using a calibrated digital needle-penetrometer, as a function of source-specimen distance and for irradiance periods of 10, 20 and 40 s. RESULTS: Each unit delivered a single peak in the blue region of the visible spectrum. The wavelength maxima for LED-1, LED-2 and QTH-1 were 486.4, 458.2 and 495.2 nm, respectively. Cure-depth (dcure) values varied significantly (p<0.001) with irradiance times and source-specimen distance for both LED and QTH sources. The percentage reduction in dcure values resulting from LED versus QTH irradiance increased with source-specimen distance. SIGNIFICANCE: The LED-LCUs had an energy-efficient spectral output for conventional composite curing but had a lower irradiance compared with the QTH-LCU, leading to reduced performance in depths of cure. Design improvements to provide greater irradiance from the LED-1 and to a lesser extent LED-2, should result in increased performance.     

Comparison of light transmittance in different thicknesses of zirconia under various light curing units

PURPOSE

The objective of this study was to compare the light transmittance of zirconia in different thicknesses using various light curing units.

MATERIALS AND METHODS

A total of 21 disc-shaped zirconia specimens (5 mm in diameter) in different thicknesses (0.3, 0.5 and 0.8 mm) were prepared. The light transmittance of the specimens under three different light-curing units (quartz tungsten halogen, light-emitting diodes and plasma arc) was compared by using a hand-held radiometer. Statistical significance was determined using two-way ANOVA (α=.05).

RESULTS

ANOVA revealed that thickness of zirconia and light curing unit had significant effects on light transmittance (P<.001).

CONCLUSION

Greater thickness of zirconia results in lower light transmittance. Light-emitting diodes light-curing units might be considered as effective as Plasma arc light-curing units or more effective than Quartz-tungsten-halogen light-curing units for polymerization of the resin-based materials.     

2种光固化灯固化对3种不同复合树脂聚合收缩的影响

目的:比较2种光固化灯对3种复合树脂聚合收缩的影响。方法:相移投影栅形貌测量仪测量Z100、Z250、AP-X等3种复合树脂在卤素灯和发光二极管固化灯开始固化后50s及开始固化后400s的树脂聚合收缩量。使用SPSS12.0软件包对QTH及LED固化组聚合收缩量进行单因素方差分析。结果:在开始固化后50s和400s,QTH固化灯和LED固化灯固化Z100、Z250树脂产生的聚合收缩量有显著差异,QTH固化灯固化Z100、Z250树脂产生的聚合收缩量显著大于LED固化灯(P<0.05),QTH和LED固化灯固化AP-X树脂产生的聚合收缩量则无统计学差异(P>0.05)。结论:LED及QTH固化灯固化Z100、Z250树脂产生的聚合收缩影响有显著差异(P<0.05),LED及QTH固化灯固化AP-X产生的聚合收缩无显著差异(P>0.05)。     

2种薄膜对LED光固化灯光照强度的影响

目的 通过检测2种光固化灯分别在裸机、套保鲜膜和套一次性薄膜套情况下,不同距离的光照射强度和衰减程度,比较2种薄膜对光固化灯光照强度的影响.方法 选择3M ESPE EliparTM S10和赛特力牙椅配套miniLed 2种光固化灯,使用光强检测仪器在垂直照射0 mm、3 mm、6 mm的情况下,分别检测裸机、套保鲜...     

Oral care in intensive care units: A literature review

Patients in an intensive care unit (ICU) may have significant oral health needs. This article offers a review of the available literature regarding oral care for patients in the ICU. Based on this review, the author describes signs and symptoms reported as common among patients in the ICU and makes recommendations concerning their oral care. The implications of these findings are also discussed.     

Influence of different light curing units on the cytotoxicity of various dental composites.

OBJECTIVES: To evaluate the dependence of the toxicity of various dental composites on the use of high- and low-power light curing units (LCUs). METHODS: The composites Filtek Z 250, Durafill VS, Solitaire 2 and Grandio were polymerized using different light densities from three LCUs, namely Heliolux II, Swiss Master Light (SML) and a prototype LED. The toxicity of polymerized samples was tested by exposing them to the cell culture medium up to 28 days. The extracts of the composites were collected daily and used for incubation in human gingival fibroblasts cultures. RESULTS: Slow, low-intensity curing using the LED or the Heliolux II showed similar characteristics for all four composites, regarding the cell viability rate of human gingival fibroblasts. After 1 day of storage suboptimal results could be observed for the SML/Durafill and optimal results for SML/Grandio combination (approximately 100% cell viability). In addition, the composite Solitaire the SML yielded significantly better results than the other LCUs (cell viability, p < or = 0.001: SML 60.5%, Heliolux 44.5%, LED 44.2%). Furthermore, the combination of the SML with Z 250 composite showed, after the first day and up to day 28, statistically significantly higher cell viability rates than the combination with the LED or Heliolux II. SIGNIFICANCE: This study shows that the combination of a high power LCU with some composites positively influences the HGF cell viability effected by the investigated composite extracts. Moreover, there is further indication that a reduction of composite toxicity is possible if the curing mode is adapted to the used composite.     

Post-gel shrinkage with different modes of LED and halogen light curing units

This study compared the post-gel shrinkage of two LED (light-emitting diodes) lights (Elipar FreeLight [FL], 3M ESPE; GC e-Light [EL], GC), a high intensity (Elipar TriLight [TL], 3M ESPE) and a very high intensity (Astralis 10 [AS], Ivoclar Vivadent) halogen light to a conventional (Max [MX] (control), Dentsply-Caulk) halogen light. Ten light curing regimens were investigated. These included continuous (FL1, EL2, MX, TL1 and AS1), soft-start (FL2, EL4, TL2), pulse activation (EL1) and turbo (EL3) modes. A strain-monitoring device and test configuration was used to measure the linear polymerization shrinkage of a composite restorative (Z100, [3M ESPE]) during and post-light polymerization up to 60 minutes when cured with the different modes. Five specimens were made for each cure mode. Results were analyzed using ANOVA/Scheffe's post-hoc test and independent sample t-tests at significance level 0.05. Shrinkage associated with the various modes of EL was significantly lower than MX immediately after light polymerization and at one-minute post-light polymerization. No significant difference between MX and the various lights/cure modes was observed at 10, 30 and 60-minutes post-light polymerization. At all time intervals, post-gel shrinkage associated with continuous light curing mode was significantly higher than the soft-start light curing mode for FL and TL.     

Temperature rise induced by some light emitting diode and quartz-tungsten-halogen curing units

Because of the risk of thermal damage to the pulp, the temperature rise induced by light-curing units should not be too high. LED (light emitting diode) curing units have the main part of their irradiation in the blue range and have been reported to generate less heat than QTH (quartz-tungsten-halogen) curing units. This study had two aims: first, to measure the temperature rise induced by ten LED and three QTH curing units; and, second, to relate the measured temperature rise to the power density of the curing units. The light-induced temperature rise was measured by means of a thermocouple embedded in a small cylinder of resin composite. The power density was measured by using a dental radiometer. For LED units, the temperature rise increased with increasing power density, in a statistically significant manner. Two of the three QTH curing units investigated resulted in a higher temperature rise than LED curing units of the same power density. Previous findings, that LED curing units induce less temperature rise than QTH units, does not hold true in general.