The effectiveness of cure of LED and halogen curing lights at varying cavity depths

This study compared the effectiveness of cure of two LED (light-emitting diodes) lights (Elipar FreeLight [FL], 3M-ESPE and GC e-Light [EL], GC) to conventional (Max [MX] (control), Dentsply-Caulk), high intensity (Elipar TriLight [TL], 3M-ESPE) and very high intensity (Astralis 10 [AS], Ivoclar Vivadent) halogen lights at varying cavity depths. Ten light curing regimens were investigated. They include: FL1-400 mW/cm2 [40 seconds], FL2-0-400 mW/cm2 [12 seconds] --> 400 mW/cm2 [28 seconds], EL1-750 mW/cm2 [10 pulses x 2 seconds], EL2-350 mW/cm2 [40 seconds], EL3-600 mW/cm2 [20 seconds], EL4-0-600 mW/cm2 [20 seconds] --> 600 mW/cm2 [20 seconds], TL1-800 mW/cm2 [40 seconds], TL2-100-800 mW/cm2 [15 seconds] --> 800 mW/cm2 [25 seconds], AS1-1200 mW/cm2 [10 seconds], MX-400 mW/cm2 [40 seconds]. The effectiveness of cure of the different modes was determined by measuring the top and bottom surface hardness (KHN) of 2-mm, 3-mm and 4-mm thick composite (Z100, [3M-ESPE]) specimens using a digital microhardness tester (n = 5, load = 500 g; dwell time = 15 seconds). Results were analyzed using ANOVA/Scheffe's post-hoc test and Independent Samples t-Test (p < 0.05). For all lights, effectiveness of cure was found to decrease with increased cavity depths. The mean hardness ratio for all curing lights at a depth of 2 mm was found to be greater than 0.80 (the accepted minimum standard). At 3 mm, all halogen lights produced a hardness ratio greater than 0.80 but some LED light regimens did not; and at a depth of 4 mm, the mean hardness ratio observed with all curing lights was less than 0.80. Significant differences in top and bottom KHN values were observed among different curing regimens for the same light and between LED and halogen lights. While curing with most modes of EL resulted in significantly lower top and bottom KHN values than the control (MX) at all depths, the standard mode of FL resulted in significantly higher top and bottom KHN at a depth of 3 mm and 4 mm. The depth of composite cure with LED LCUs was, therefore, product and mode dependent.     

Comparative depths of cure among various curing light types and methods

This study evaluated the depth of cure associated with commercial LEDs (light-emitting diodes) (Elipar FreeLight [FL], 3M-ESPE; GC e-Light [EL], GC), high intensity (Elipar TriLight [TL], 3M-ESPE) and very high intensity (Astralis 10 [AS], Ivoclar Vivadent) Quartz Tungsten Halogen (QTH) curing lights. Depth of cure of the various lights/curing modes were compared to a conventional QTH light (Max [Mx], Dentsply-Caulk). Ten exposure regimens were investigated: FL1 - 400 mW/cm2 [40 seconds]; FL2 - 0-400 mW/cm2 [12 seconds] --> 400 mW/cm2 [28 seconds]; EL1 - 750 mW/cm2 [10 pulses x 2 seconds], EL2 - 350 mW/cm2 [40 seconds]; EL3 - 600 mW/cm2 [20 seconds]; EL4 - 0 - 600 mW/cm2 [20 seconds] --> 600 mW/cm2 [20 seconds]; TL1 - 800 mW/cm2 [40 seconds]; TL2 - 100- 800 mW/cm2 [15 seconds] --> 800 mW/cm2 [25 seconds]; AS1 - 1200 mW/cm2 [10 seconds]; MX - 400 mW/cm2 [40 seconds]. Depth of cure was determined by penetration, scraping and microhardness techniques. The results were analyzed using one-way ANOVA/Scheffe's post-hoc test and Pearson's correlation at significance level 0.05 and 0.01, respectively. All light curing regimens met the ISO depth of cure requirement of 1.5 mm with the exception of EL1-EL3 with the microhardness technique. Curing with most modes of EL resulted in significantly lower depths of cure than the control [MX]. No significant difference in depth of cure was observed among the control and the two modes of FL. Curing with TL1 resulted in significantly greater depth of cure compared to MX with all testing techniques. No significant difference in depth of cure was observed between the control and AS1 for all testing techniques except for the penetration technique. The depth of composite cure is light unit and exposure mode dependent. Scraping and penetration techniques were found to correlate well but tend to overestimate depth of cure compared to microhardness.     

Analysis of the degree of conversion of LED and halogen lights using micro-Raman spectroscopy

This study determined the degree of conversion of two LED (light-emitting diodes) (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. The degree of conversion of these lights was compared to a conventional halogen light (Max [MX] (control), Dentsply-Caulk). Ten different light curing regimens, including pulse (EL1), continuous (FL1, EL2, TL1), turbo (EL3, AS1) and soft-start (FL2, EL4, TL2) modes of various lights were also investigated. Composite specimens of dimensions 3 x 3 x 2 mm were cured with the 10 different light curing regimens investigated. Micro-Raman spectroscopy was used to determine the degree of conversion at the top and bottom surfaces of a composite restorative (Z100, [3M ESPE]) at 60 minutes post-light polymerization. Five specimens were made for each cure mode. The results were analyzed using ANOVA/Scheffe's post-hoc test and Independent Samples t-tests at significance level 0.05. The degree of conversion ranged from 55.98 +/- 2.50 to 59.00 +/- 2.76% for the top surface and 51.90 +/- 3.36 to 57.28 +/- 1.56% for the bottom surface. No significant difference in degree of conversion was observed for the 10 light curing regimens when compared to MX (control). The curing efficiency of LED lights was comparable to halogen lights regardless of curing modes.     

Composite cure and pulp-cell cytotoxicity associated with LED curing lights

This study compared the cure and pulp-cell cytotoxicity of composites polymerized with light-emitting diode (LED) and halogen-based light curing units. A mini-filled resin composite (Tetric Ceram, Vivadent), two LED (E-light [EL], GC and Freelight [FL], 3M-ESPE), a conventional halogen (Max [MX], Dentsply) and a high-intensity halogen light (Astralis 10 [AS], Vivadent) were evaluated. Cure associated with the different lights was determined by measuring the top and bottom surface hardness (KHN; n = 5) of 2-mm thick specimens using a digital microhardness tester (load = 500 gf; dwell time = 15 seconds). Pulp-cell cytotoxicity was assessed using a direct contact method involving incisor tooth slices dissected from 28-day old Wistar rats maintained in Dulbecco's Modified Eagle's Medium (DMEM) and 1% agarose. The bottom surfaces of the cured composite specimens (7-mm diameter and 2-mm deep) were placed in contact with the openings of each tooth slice. After incubation in 5% CO2 atmosphere at 37 degrees C for 48 hours, the tooth slices were fixed, demineralized and processed for histological examination. Pulp fibroblasts and odontoblasts were counted histomorphometrically at 400x magnification within a 1500 microm2 area using a computerized micro-imaging system. Eighteen readings were obtained for each curing light. Data was subjected to ANOVA/Scheffe's test and Pearson's correlation at significance level 0.05 and 0.01, respectively. At the top surfaces, the cure with AS was significantly greater than the other curing lights, with MX and FL being significantly greater than EL. At the bottom surfaces, MX, AS and FL had significantly better cure than EL. Specimens cured with MX were less cytotoxic than those polymerized with other curing lights. Specimens cured with AS and EL were significantly less cytotoxic than FL. Composite cure and cytotoxicity associated with LED lights is device dependent. Composite cure was not correlated to pulp-cell cytotoxicity. The response of pulpal fibroblasts to unreacted/leached components of composites differs somewhat from odontoblasts.     

Influence of curing lights and modes on cross-link density of dental composites

This study investigated the influence of curing lights and modes on the cross-link density of dental composites. Four LED/halogen curing lights (LED-Elipar Freelight [FL], 3M-ESPE and GC e-light [EL], GC; high intensity halogen-Elipar Trilight [TL], 3M-ESPE; very high intensity halogen-Astralis 10 [AS], Ivoclar Vivadent) were selected for this study. Pulse (EL1), continuous (FL1, EL2, TL1), turbo (EL3, AS) and soft-start (FL2, EL4, TL2) curing modes of the various lights were examined. A conventional, continuous cure halogen light (Max [MX], Dentsply-Caulk) was used for comparison. Six composite (Z100, 3M-ESPE) specimens were made for each light-curing mode combination. After polymerization, the specimens were stored in air at 37 degrees C for 24 hours and subjected to hardness testing using a digital microhardness tester (load=500 g; dwell time=15 seconds). The specimens were then placed in 75% ethanol-water solution at 37 degrees C for 24 hours and post-conditioning hardness was determined. Mean hardness (HK)/change in hardness (deltaHK) was computed and the data subjected to analysis using one-way ANOVA/Scheffe's test and Independent Samples t-test (p<0.05). Softening upon storage in ethanol (deltaHK) was used as a relative indication of cross-link density. Specimens polymerized with AS, TL2 and all modes of both LED lights were significantly more susceptible to softening in ethanol than specimens cured with MX. No significant difference in cross-link density was observed among the various modes of EL and FL. For TL, curing with continuous mode resulted in specimens with significantly higher cross-link density than curing with the soft-start mode.     

Curing efficacy of a new generation high-power LED lamp

This study investigated the curing efficacy of a new generation high-power LED lamp (Elipar Freelight 2 [N] 3M-ESPE). The effectiveness of composite cure with this new lamp was compared to conventional LED/halogen (Elipar Freelight [F], 3M-ESPE; Max [M], Dentsply-Caulk) and high-power halogen (Elipar Trilight [T], 3M-ESPE; Astralis 10 [A], Ivoclar Vivadent) lamps. Standard continuous (NS, FS, TS; MS), turbo (AT) and exponential (NE, FE, TE) curing modes of the various lights were examined. Curing efficacy of the various lights and modes were determined by measuring the top and bottom surface hardness of 2-mm thick composite specimens (Z100, 3M-ESPE) using a digital microhardness tester (n=5; load=500 g; dwell time=15 seconds) one hour after light polymerization. The hardness ratio was computed by dividing HK (Knoops Hardness) of the bottom surface by HK of the top surface. The data was analyzed using one-way ANOVA/Scheffe's test and Independent Samples t-test at significance level 0.05. Results of the statistical analysis were as follows: HK top--E, FE, NE > NS and NE > AT, TS, FS; HK bottom--TE, NE > NS; Hardness ratio--NS > FE and FS, TS > NE. No significant difference in HK bottom and hardness ratio was observed between the two modes of Freelight 2 and Max. Freelight 2 cured composites as effectively as conventional LED/halogen and high-power halogen lamps, even with a 50% reduction in cure time. The exponential modes of Freelight 2, Freelight and Trilight appear to be more effective than their respective standard modes.     

The Knoop hardness of a composite resin polymerized with different curing lights and different modes

AIM: The purpose of this study was to compare the surface hardness of a hybrid composite resin polymerized with different curing lights. METHODS AND MATERIALS: Two 3.0 mm thick composite resin discs were polymerized in a prepared natural tooth mold using: (1) a conventional quartz-tungsten halogen light (QTH- Spectrum 800); (2) a high-intensity halogen light, Elipar Trilight (TL)-standard/exponential mode; (3) a high-intensity halogen light, Elipar Highlight (HL)-standard/soft-start mode; (4) a light-emitting diode, Elipar Freelight (LED); and (5) a plasma-arc curing light, Virtuoso (PAC). Exposure times were 40 seconds for the halogen and LED lights, and three and five seconds for the PAC light. Following polymerization, the Knoop hardness was measured at the bottom and the top surfaces of the discs. RESULTS: Significant differences were found between top and bottom Knoop Hardness number (KHN) values for all lights. The hardness of the top and bottom surfaces of both specimens cured by the PAC light was significantly lower than the other lights. No significant hardness differences were observed between the remaining curing units at the top of the 2.0 mm specimens. Significant differences were found between the LED and two modes of HL on the bottom surfaces. For the 3.0 mm thick samples, while significant differences were noted between LED and TL standard mode and between the two TL curing modes on the top, significant differences were only observed between QTH and the standard modes of TL and HL at the bottom.     

Elution of leachable components from composites after LED and halogen light irradiation

This study investigated the influence of curing lights and modes on the elution of leachable components from dental composites. Four LED/halogen curing lights (LED-Elipar Freelight [FL], 3M-ESPE and GC e-light [EL], GC; high intensity halogen-Elipar Trilight [TL], 3M-ESPE; very high intensity halogen-Astralis 10 [AS], Ivoclar Vivadent) were selected for this study. Pulse (EL1), continuous (FL1, EL2, TL1), turbo (EL3, AS) and soft-start (FL2, EL4, TL2) curing modes of the various lights were examined. A conventional continuous cure halogen light (Max [MX], Dentsply-Caulk) was used for comparison. Three composite (Z100, 3M-ESPE) specimens (6.5 mm in diameter and 1-mm thick) were made for each curing light-mode combination. After polymerization, the specimens were stored in air at 37 degrees C for 24 hours and incubated in acetonitrile at 37 degrees C for 24 hours. BisGMA and TEGDMA extracts were isolated by high performance liquid chromatography (HPLC). Data were subjected to analysis using one-way ANOVA/Scheffe's post-hoc test and Independent Samples t-test at significance level 0.05. The total monomer (BisGMA and TEGDMA) eluted ranged from 8.75 to 27.97 ppm for FL1 and AS, respectively. Significantly more unreacted monomers were leached from composites cured with all modes of EL and AS when compared to MX. No significant difference in the total monomer eluted was observed between the two modes of FL/TL and MX Although composites cured with EL2 released significantly less monomer than EL1, 3 and 4, no significant difference in the total monomer eluted was observed between the continuous and soft-start modes of FL and TL. The elution of leachable components from composites appears to be curing light specific rather than light source (LED or halogen) and curing mode specific.     

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.     

Composite cure and shrinkage associated with high intensity curing light

This study investigated the effectiveness of cure and post-gel shrinkage of three visible light-cured composite resins (In Ten-S [IT], Ivoclar Vivadent; Z100 [ZO], 3M-ESPE; Tetric Ceram [TC], Ivoclar Vivadent) when polymerized with a very high intensity (1296 +/- 2 mW/cm2) halogen light (Astralis 10, Ivoclar Vivadent) for 10 seconds. Irradiation with a conventional (494 +/- 3 mW/cm2) halogen light (Spectrum, Dentsply) for 40 seconds was used for comparison. The effectiveness of cure was assessed by computing the hardness gradient between the top and bottom surfaces of 2-mm composite specimens after curing. A strain-monitoring device was used to measure the linear polymerization shrinkage associated with the various composites and curing lights. A sample size of five was used for both experiments. Data was analyzed using ANOVA/Scheffe's post-hoc and Independent Samples t-tests at significance level 0.05. Results showed that the effect of the curing method on the effectiveness of cure and shrinkage was material-dependent. Polymerization of IT and TC with Spectrum for 40 seconds resulted in significantly more effective cure than polymerization with Astralis for 10 seconds. Polymerization of ZO with Spectrum for 40 seconds resulted in significantly more shrinkage than polymerization with Astralis for 10 seconds. In view of the substantial time saving, using high intensity lights may be a viable method to polymerize composites.     

Effectiveness of composite cure with pulse activation and soft-start polymerization

The study investigated the effectiveness of composite cure with pulse activation and soft-start polymerization. A light-cure unit (BISCO VIP, BISCO Dental Products, Schaumburg, IL 60193, USA) that allowed for independent command over time and intensity was used. The six light-curing modes examined were: Control (C)-400 mW/cm2 [40 seconds]; Pulse Delay I (PDI) -100 mW/cm2 [3 seconds] --> delay [3 minutes] --> 500 mW/cm2 [30 seconds]; Pulse Delay II (PDII) - 200 mW/cm2 [20 seconds] --> delay [3 minutes] --> 500 mW/cm2 [30 seconds]; Soft-start (SS) - 200 mW/cm2 [10 seconds] --> 600 mW/cm2 [30 seconds]; Pulse Cure I (PCI) - 400 mW/cm2 [10 seconds] --> delay [10 seconds] --> 400 mW/cm2 [10 seconds] --> delay [10 seconds] --> 400 mW/cm2 [20 seconds]; and Pulse Cure II (PCII) - 400 mW/cm2 [20 seconds] --> delay [20 seconds] --> 400 mW/cm2 [20 seconds]. Effectiveness of cure with the different modes was determined by measuring the top and bottom surface hardness of 2 mm thick composite (Z100) specimens using a digital microhardness tester (load=500 gf; dwell time=15 seconds). The effectiveness of cure of the bottom surface of the composite was also established by Fourier Transform Infrared (FTIR) spectroscopy using the KBr technique. Data obtained was analyzed using one-way ANOVA/Scheffe's post-hoc test (p<0.05). No significant difference in top Knoops Hardness Number KHN wa s observed except for PDIand PDII. At the bottom surfaces, KHN obtained with the control was significantly greater than with PDII, SS and PCII. FTIR results ranked well with the hardness of the bottom surfaces. The absorbance ratio of carbon double bonds to aromatic ring obtained with the control group was significantly greater than with PDII and PCII. Effectiveness of the cure at the bottom surfaces of composites may be reduced by some pulse activation and soft-start polymerization regimens.     

Curing of pit & fissure sealants using Light Emitting Diode curing units

Light Emitting Diode (LED) curing units are attractive to clinicians, because most are cordless and should create less heat within tooth structure. However, questions about polymerization efficacy have surrounded this technology. This research evaluated the adequacy of the depth of cure of pit & fissure sealants provided by LED curing units. Optilux (OP) and Elipar Highlight (HL) high intensity halogen and Astralis 5 (A5) conventional halogen lights were used for comparison. The Light Emitting Diode (LED) curing units were Allegro (AL), LE Demetron I (DM), FreeLight (FL), UltraLume 2(UL), UltraLume 5 (UL5) and VersaLux (VX). Sealants used in the study were UltraSeal XT plus Clear (Uclr), Opaque (Uopq) and Teethmate F-1 Natural (Kclr) and Opaque (Kopq). Specimens were fabricated in a brass mold (2 mm thick x 6 mm diameter) and placed between two glass slides (n=5). Each specimen was cured from the top surface only. One hour after curing, four Knoop Hardness readings were made for each top and bottom surface at least 1 mm from the edge. The bottom to top (B/T) KHN ratio was calculated. Groups were fabricated with 20 and 40-second exposure times. In addition, a group using a 1 mm-thick mold was fabricated using an exposure time of 20 seconds. Differences between lights for each material at each testing condition were determined using one-way ANOVA and Student-Newman-Keuls Post-hoc test (alpha=0.05). There was no statistical difference between light curing units for Uclr cured in a 1-mm thickness for 20 seconds or cured in a 2 mm-thickness for 40 seconds. All other materials and conditions showed differences between light curing units. Both opaque materials showed significant variations in B/T KHN ratios dependent upon the light-curing unit.     

Polymerization and polymerization shrinkage stress: fast cure versus conventional cure.

Dentists nowadays have a choice of conventional halogen lights, halogen lights with more sophisticated curing cycles (step-cure, rapid-cure, ramp-cure & pulse-cure), fast halogen lights, laser lights, plasma arc lights (PAC) and, lately, LED lights. While the manufacturers of some of the curing units try to improve on the operational reliability of their lights with a slower initial rate of cure, other manufacturers simply wish to offer as fast a curing time as possible. The conventional approach to cure accepts that sufficient light intensity of at least 400 mW/cm2 at a wavelength of 400-500 nm, and an exposure time of at least 40 seconds is needed to cure a 2-mm layer of composite. When a halogen light with higher or very high intensity is used, alternative curing strategies provide for an initial slower cure to allow flow, and after that a higher-intensity cure to improve the degree of cure. In contrast, in the fast-cure or rapid-cure approach it is suggested that a layer of composite can be cured for only 5- 10 seconds at >2000 mW/cm2. Some go so far as to say that an exposure time of 3 seconds per layer may be enough. This contradictory approach is compounded by the fact that this support for fast cure does not seem to consider the negative consequences. Therefore, to address these concerns, this review discusses the possible effects of a fast cure approach compared to a more conventional approach in polymerization and polymerization shrinkage, and the consequences there-off. Other factors that play an influencing role in polymerization shrinkage stress are also included in the discussion.     

Influence of light energy density on effectiveness of composite cure

This study investigated the influence of light energy density (intensity x time) on the effectiveness of composite cure in view of the curing profiles of new light-polymerization units. This investigation used a digital microhardness tester to evaluate the hardness of the top/bottom surfaces and hardness ratio of 2 mm thick composite specimens after exposure to different light energy densities. Parameters included five light intensities (200, 300, 400, 500 and 600 mW/cm2) and nine irradiation times (10, 20, 30, 40, 60, 80, 100, 120 and 180 seconds). Six samples were evaluated for each light energy density. KHN values and the hardness ratio obtained with 40 seconds cure at 400 mW/cm2 was used as control. Results were analyzed with one-way ANOVA and Scheffe's post-hoc test at significance level (0.05). Correlation between curing time and hardness values and ratio was done using Pearson's correlation at significance level 0.01. Results showed that the adequate hardness for surface finishing could be obtained with 20 seconds irradiation at lower intensities of 200 or 300 mW/cm2. Optimal cure of the bottom surfaces could not be achieved with 200 mW/cm2, but was attained with 300 mW/cm2 only after 120 seconds of irradiation. Optimal cure of the bottom surfaces was possible with 30 and 20 seconds irradiation at 500 and 600 mW/cm2, respectively. Effective cure was not achieved with low light intensities (200 to 300 mW/cm2) but could be achieved with high intensities (500 and 600 mW/cm2) after 30 seconds of irradiation.     

Effect of LED curing modes on the microleakage of a pit and fissure sealant

PURPOSE: To evaluate in vitro the curing effect of a very high intensity light-emitting diode (LED) unit and a conventional LED unit (including "soft-start" modes) on the microleakage of a pit and fissure sealant. METHODS: 120 intact caries-free human molars were randomly divided into six groups (n=20), sealed with Fissurit-F and polymerized using either a conventional halogen unit (Optilux) (Control group) in standard mode (40 seconds @ 600 mW/cm2); a very high intensity LED unit (Mini LED) in fast (10 seconds @ 1,100 mW/cm2) or soft-start mode (pulse mode: ten 1-second flashes @ 1,100 mW/cm2; exponential mode: exponential increase from 0 to 1,100 mW/cm2 within 10 seconds followed by 10 seconds @1,100 mW/cm2); or a conventional LED unit (Elipar Freelight) in standard (40 seconds @ 400 mW/cm2) or exponential mode (exponential increase from 0 to 400mW/cm2 within 12 seconds followed by 28 seconds @ 400 mW/cm2). Restored specimens were stored in distilled water at 37 degrees C for 24 hours. Specimens were then immersed in a 0.5% fuchsin dye solution for 24 hours, with half of the specimens from each group subjected to thermocycling (5/55 degrees C; x 1000) prior to dye immersion. After removal from the dye solution, specimens were sectioned and the degree of dye penetration scored. Data was statistically analyzed using the Kruskal-Wallis H test and the Mann-Whitney U-test (P< 0.05). RESULTS: There was no statistically significant difference in microleakage of pit and fissure sealant polymerized using various curing techniques. Thermocycling regimens had no effect on either LED- or halogen-cured specimens.     

Polymerization efficiency of different photocuring units through ceramic discs

This study compared the ability of a variety of light sources and exposure modes to polymerize a dual-cured resin composite through ceramic discs of different thicknesses by depth of cure and Vickers microhardness (VHN). Ceramic specimens (360) (Empress 2 [Ivoclar Vivadent], color 300, diameter 4 mm, height 1 or 2 mm) were prepared and inserted into steel molds according to ISO 4049, after which a dual-cured composite resin luting material (Variolink II [Ivoclar Vivadent]) with and without self-curing catalyst was placed. The light curing units used were either a conventional halogen curing unit (Elipar TriLight [3M/ESPE] for 40 seconds), a high-power halogen curing unit (Astralis 10 [Ivoclar Vivadent] for 20 seconds), a plasma arc curing unit (Aurys [Degré K] for 10 seconds or 20 seconds) or different light emitting diode (LED) curing units (Elipar FreeLight I [3M/ESPE] for 40 seconds, Elipar FreeLight II [3M/ESPE] for 20 seconds, LuxOmax [Akeda] for 40 seconds, e-Light [GC] for 12 seconds or 40 seconds). Depth of cure under the ceramic discs was assessed according to ISO 4049, and VHN at 0.5 and 1.0 mm distance from the ceramic disc bottom was determined (ISO 6507-1). Medians and the 25th and 75th percentiles were determined for each group (n=10), and statistical analysis was performed using the Mann-Whitney-U-test (p < or = 0.05). The results showed that increasing ceramic disc thickness had a negative effect on the curing depth and hardness of all light curing units, with hardness decreasing dramatically under the 2-mm thick discs using LuxOmax, e-Light (12 seconds) or Aurys (10 seconds or 20 seconds). The use of a self-curing catalyst is recommended over the light-curable portion only, because it produced an equivalent or greater hardness and depth of cure with all light polymerization modes.     

Influence of curing methods and matrix type on the marginal seal of class II resin-based composite restorations in vitro

This study determined the influence of light curing protocols and matrix type on the margin quality and marginal seal of Class II resin-based composite restorations. In extracted human molars, box-shaped MOD cavities with 1 mm wide interproximal bevels were prepared with cervical margins located at least 1 mm coronal to the cemento-enamel junction. The prepared teeth were mounted in a jig featuring artificial training teeth that served as adjacent teeth. A contoured sectional metal matrix band was placed in one interproximal area, and a section of a contoured transparent matrix band was placed in the opposite interproximal area. Both were kept in position using wooden wedges. After etching (35% H3PO4 gel) and the application of a three-step etch & rinse dentin adhesive (Optibond FL, Kerr), a thin layer of flowable resin-based composite (Revolution, Kerr) was applied to the interproximal margins. The cavities were restored by placing one horizontal and two oblique increments of a fine hybrid resin-based composite (Herculite XRV, Kerr). The curing protocols included one standard halogen protocol (Elipar Trilight, 3M ESPE, 40 seconds @ 800 mW/cm2), 3 halogen soft-start protocols (Step: Elipar HiLight, 3M ESPE; 10 seconds @ 150 mW/cm2, 30 seconds @ 850 mW/cm2; Ramp: Elipar TriLight, 3M ESPE, 5 seconds @ 100 mW/cm2, exponential increase for 10 seconds, 25 seconds @ 800 mW/cm2; Pulse delay: VIP Light, BISCO, cervical increment: 10 seconds @ 500 mW/cm2, occlusal increments: 3 seconds @ 200 mW/cm2, final irradiation after a 5 minute interval: 30 seconds @ mW/cm2) and 2 plasma arc high intensity protocols (PAC: Lightning Cure, ADT, 10 seconds @ 1400 mW/cm2; APO: Apollo 95E, DMDS, 2 x 3 seconds @ 1570 mW/cm2). The restored teeth were stored in 0.9% saline at 37 degrees C for 4 weeks and submitted to thermal cycling [TC] with 2500 cycles between 5 degrees C and 55 degrees C after 2 weeks. The margin quality before and after TC was analyzed in SEM using the replica technique, and the marginal seal was determined using the dye penetration test (50% AgNO3, 2 hours) at the end of the study. The matrix type did not significantly influence the quality and seal of the respective margins. For the complete restoration margin, one of the high intensity protocols (APO) produced a higher percentage of "continuous margin" compared to pulse delay irradiation after TC and lower percentages of "marginal opening" compared to halogen standard irradiation before and after TC. Halogen step irradiation produced a superior marginal seal compared to pulse delay curing at the occlusal margins; equivalent results were observed for all curing modes at the cervical margins. Neither a general advantage of soft-start irradiation nor a general disadvantage of high intensity curing was confirmed.     

Should my new curing light be an LED?

The new generation LED curing light units have significantly improved curing performance compared to first generation lights, and even some second generation LED curing light units. This study compared the curing performance of 10 new generation LED light curing units (FLASH-lite 1401, LE Demetron 1, Coltolux, Ultra-Lume 5, Mini LED, bluephase, Elipar FreeLight 2, Radii, Smartlite IQ and Allegro) for depth of cure against a high-powered halogen curing light unit (Optilux 501). Depth of cure measurements were utilized per the ANSI/ADA No 27 standard to detect differences between the lights at three time intervals (10, 20 and 40 seconds). A total of 660 samples were prepared (n=10/group). A full factorial ANOVA and Tukey's HSD test showed FLASH-lite 1401 performed significantly better than the other lights at 10- and 20-second time intervals (p<0.01). This study also demonstrated that an exposure time of 20 seconds or longer assures a better depth of cure, 40 seconds being the optimal polymerization time for all of the curing light units.     

Post-gel shrinkage with pulse activation and soft-start polymerization

This study investigated the influence of pulse activation and soft-start polymerization regimens on the post-gel shrinkage of a visible light-activated composite resin (Z100). A light-cure unit (BISCO VIP) that allowed for independent command over time and intensity was used. The six light-curing modes that were examined include: Control (C)-400 mW/cm2 [40 seconds]; Pulse Delay I (PDI)-100 mW/cm2 [3 seconds], delay [3 minutes], 500 mW/cm2 [30 seconds]; Pulse Delay II (PDII)-200 mW/cm2 [20 seconds], delay [3 minutes], 500 mW/cm2 [30 seconds]; Soft-start (SS)-200 mW/cm2 [10 seconds], 600 mW/cm2 [30 seconds]; Pulse Cure I (PCI)--two 400 mW/cm2 [10 seconds] and one 400 mW/cm2 [20 seconds] pulses with 10 seconds interval between; and Pulse Cure II (PCII)-two 400 mW/cm2 [20 seconds] pulses with 20 seconds interval between. A strain-monitoring device measured the linear polymerization shrinkage associated with the various cure modes during and post light polymerization up to 60 minutes. Five specimens were made for each cure mode. Data was analyzed using one-way ANOVA and Scheffe's post-hoc test at significance level 0.05. Post-gel shrinkage associated with PDI was significantly lower than with PDII, SS and PCI immediately post light-polymerization. At one-minute post light polymerization, PDI had significantly lower shrinkage compared to PDII and SS. Significant differences in shrinkage were observed between PDI and SS only at 10, 30 and 60 minutes. At all time intervals, no significance in post-gel shrinkage was observed between the control and all-pulse activation/soft-start polymerization regimens.     

Comparison of composite curing parameters: effects of light source and curing mode on conversion, temperature rise and polymerization shrinkage

This study analyzed the degree of conversion, temperature increase and polymerization shrinkage of two hybrid composite materials polymerized with a halogen lamp using three illumination modes and a photopolymerization device based on blue light emitting diodes. The degree of conversion of Tetric Ceram (TC) (Ivoclar Vivadent) and Filtek Z 250 (F) (3M/ESPE) was measured by Fourier transformation infrared spectroscopy at the surface and 2-mm depth; temperature rise was measured by digital multimeter, and linear polymerization shrinkage was measured during cure by digital laser interferometry. Composite samples were illuminated by quartz-tungsten-halogen curing unit (QTH) (Astralis 7, Ivoclar Vivadent) under the following modes: "high power" (HH) 40 seconds at 750 mW/cm2, "low power" (HL) 40 seconds at 400 mW/cm2 and "pulse/soft-start" (HP) increasing from 150 to 400 mW/cm2 during 15 seconds followed by 25 seconds pulsating between 400 and 750 mW/cm2 in 2-second intervals and by light emitting diodes (LED) (Lux-o-Max, Akeda Dental) with emitted intensity 10 seconds at 50 mW/cm2 and 30 seconds at 150 mW/cm2. A significantly higher temperature increase was obtained for both materials using the HH curing mode of halogen light compared to the HP and HL modes and the LED curing unit after 40 seconds. Significantly lower temperature values after 10-second illumination were obtained when LED was used compared to all halogen modes. For all curing modes, there was no significant difference in temperature rise between 20 and 40 seconds of illumination. Results for the degree of conversion measurements show that there is a significant difference in the case of illumination of resin composite samples with LED at the surface and 2 mm depth. For polymerization shrinkage, lower values after 40 seconds were obtained using LED compared to QTH.