Knoop hardness depth profiles and compressive strength of selected dental composites polymerized with halogen and LED light curing technologies

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.

Properties of indirect composites polymerized with laboratory light-emitting diode units

This study evaluated the light intensity of light-emitting diode (LED) units and the effects of five laboratory polymerization units on hardness and flexural strength. Two indirect composite materials (Cesead N and Solidex Hardura) were polymerized with five units (α-Light II, Hyper LII, LED Cure Master, Twinkle LED, and α-Light V). The light intensity of the devices was measured with a spectroradiometer. After light exposure, Knoop hardness number, flexural strength, and elastic modulus were determined. Evaluation of light intensity, using a wavelength range of 400 to 500 nm, revealed that the α-Light V and Hyper LII units had the highest light intensity. For the top surface of the two composites, the Knoop hardness number was significantly higher for the α-Light V and Hyper LII. For the two composite materials, flexural strength did not differ among the five polymerizing units. The present results indicate that the Cesead N and Solidex Hardura composites can be adequately polymerized with laboratory LED units.

Use of Artificial Neural Network in Determination of Shade, Light Curing Unit, and Composite Parameters' Effect on Bottom/Top Vickers Hardness Ratio of Composites

Objective

To assess the influence of light emitting diode (LED) and quartz tungsten halogen (QTH) light curing unit (LCU) on the bottom/top (B/T) Vickers Hardness Number (VHN) ratio of different composites with different shades and determination of the most significant effect on B/T VHN ratio of composites by shade, light curing unit, and composite parameters using artificial neural network.

Method

Three composite resin materials [Clearfil Majesty Esthetic (CME), Tetric N Ceram (TNC), and Tetric Evo Ceram (TEC)] in different shades (HO, A2, B2, Bleach L, Bleach M) were used. The composites were polymerized with three different LED LCUs (Elipar S10, Bluephase 20i, Valo) and halogen LCU (Hilux). Vickers hardness measurements were made at a load of 100 g for 10 sec on the top and bottom surfaces and B/T VHN ratio calculated. The data were statistically analyzed with three-way ANOVA and Tukey test at a significance level of 0.05. The obtained measurements and data were then fed to a neural network to establish the correlation between the inputs and outputs.

Results

There were no significant differences between the B/T VHN ratio of LCUs for the HO and B shades of CME (p>0.05), but there were significant differences between the B/T VHN ratio of LCUs for shade A2 (p<0.05). No significant difference was determined between the B/T VHN ratio of LCUs for all shades of TNC (p>0.05). For TEC, there was no significant difference between the B/T VHN ratio of halogen and LED LCUs (p>0.05), but a significant difference was determined among the LED LCUs (p<0.05). The artificial neural network results showed that a combination of the curing light and composite parameter had the most significant effect on the B/T VHN ratio of composites. Shade has the lowest effect on the B/T VHN ratio of composites.

Conclusion

The B/T VHN ratio values of different resin-based composite materials may vary depending on the light curing device. In addition, the artificial neural network results showed that the LCU and composite parameter had the most significant effect on the B/T VHN ratio of the composites. Shade has the lowest effect on the B/T VHN ratio of composites.

Tris(trimethylsilyl)silane as a co-initiator for dental adhesive: Photo-polymerization kinetics and dynamic mechanical property

OBJECTIVES

The purpose of this study was to evaluate the polymerization behavior of a model dentin adhesive with tris(trimethylsilyl)silane (TTMSS) as a co-initiator, and to investigate the polymerization kinetics and mechanical properties of copolymers in dry and wet conditions.

METHODS

A co-monomer mixture based on HEMA/BisGMA (45/55, w/w) was used as a model dentin adhesive. The photoinitiator system included camphorquinone (CQ) as the photosensitizer and the co-initiator was ethyl-4-(dimethylamino) benzoate (EDMAB) or TTMSS. Iodonium salt, diphenyliodonium hexafluorophosphate (DPIHP) serving as a catalyst, was selectively added into the adhesive formulations. The control and the experimental formulations were characterized with regard to the degree of conversion (DC) and dynamic mechanical properties under dry and wet conditions.

RESULTS

In two-component photoinitiator system (CQ/TTMSS), with an increase of TTMSS concentration, the polymerization rate and DC of CC double bond increased, and showed a dependence on the irradiation time and curing light intensity. The copolymers that contained the three-component photoinitiator system (CQ/TTMSS/DPIHP) showed similar dynamic mechanical properties, under both dry and wet conditions, to the EDMAB-containing system.

SIGNIFICANCE

The DC of formulations using TTMSS as co-initiator showed a strong dependence on irradiation time. With the addition of TTMSS, the maximum polymerization rate can be adjusted and the network structure became more homogenous. The results indicated that the TTMSS could be used as a substitute for amine-type co-initiator in visible-light induced free radical polymerization of methacrylate-based dentin adhesives.

The effects of light curing units and environmental temperatures on C 000000000000 000000000000 000000000000 111111111111 000000000000 111111111111 000000000000 000000000000 000000000000 C conversion of commercial and experimental bonding agents

BACKGROUND AND PURPOSE

Polymerization of bonding agents (BA) is a critical factor in determining the success of bonded restorations. We aimed to assess the effects of two light curing units and two temperatures on the extent of polymerization (EP) of a commercial BA and an experimental BA.

METHODS

Forty BA specimens were randomly divided into 8 subgroups of n = 5 to compare the polymerization of two BAs (experimental/Scotchbond) based on the variables: temperature (23/37 °C) and light-curing unit (quartz-tungsten-halogen/light-emitting diode). The EP (%) was measured using differential scanning calorimetry, and analyzed using the t-test, two- and three-way analyses of variance (ANOVA), and the Bonferroni test (α = 0.05).

RESULTS

There were significant differences between the EP results between the two BAs (P = 0.012) and due to the different temperatures (P = 0.001), but not between the different light-curing units (P = 0.548). The interaction between BA and temperature was significant (P < 0.001). The other interactions were nonsignificant.

CONCLUSIONS

The two light-curing units had similar effects on the EP. The EP values were better when curing was performed at human body temperature.

Incremental filling technique and composite material--part II: shrinkage and shrinkage stresses

OBJECTIVES

Finite element analysis (FEA) was used to study polymerization shrinkage stress in molars restored with composites and to correlate those stresses with experimentally measured tooth deformation.

METHODS

Three composites (Filtek LS, Aelite LS Posterior, Filtek Supreme) and three filling techniques (bulk, 2.0-mm increments, and 1.0-mm increments) for restoring a molar were simulated in a two-dimensional FEA. Polymerization shrinkage was modeled using post-gel shrinkage, which was measured using the strain gauge technique (n=10). Cuspal tooth deformation, measured at the buccal and lingual surfaces with strain gauges in a laboratory study, was used to validate the analysis. Residual shrinkage stresses were expressed in modified von Mises equivalent stresses. Linear Pearson correlations were determined between the laboratory and FEA results.

RESULTS

Post-gel shrinkage values (in volume %) were: Filtek LS (0.11 ± 0.03) < Aelite LS Posterior (0.51 ± 0.02) < Filtek Supreme (0.62 ± 0.09). The 1.0-mm increment filling caused substantially higher stresses and strains in the cervical enamel region. Significant correlations were found between: elastic modulus and FEA strain, elastic modulus and FEA stress, post-gel shrinkage and FEA strain, post-gel shrinkage and FEA stress, FEA strain and cuspal deformation by strain gauge, and FEA stress and cuspal deformation by strain gauge (p<0.05).

CONCLUSIONS

Increasing the number of increments and high post-gel shrinkage and/or elastic modulus values caused higher stresses in the remaining tooth structure and tooth/restoration interface. Cuspal deformation measured with the strain gauge method validated the finite element analyses.

Effect of temperature on the mass and color stability of additional photoinitiatorcontaining composite resins

The purpose of this study was to evaluate how the temperature affects the stability of polymerized additional photoinitiator-containing composite resins. Five resin products were light-cured using a quartz-tungsten-halogen, and single and dual emission peaks lightemitting diodes. The degree of conversion (DC) and water sorption, solubility, and color change of the specimens were evaluated after immersion in the solutions of different temperatures (4, 37, and 60ºC) for 14 days. On the top surface, the light-curing units had no significant influence on DC of the tested specimens. On the bottom surface, the influence was inconsistent. As the solution temperature increased, water sorption also consistently increased in all specimens, whereas solubility changed inconsistently. Water sorption and solubility had a high linear correlation only at low temperature solution. Color change of the specimens was similar, mostly slight, and statistically inconsistent regardless of solution temperature. The restored composite resins are needed to avoid contact with hot solutions for durable dental restoration.

Effect of reduced exposure times on the cytotoxicity of resin luting cements cured by high-power led

Objective

Applications of resin luting agents and high-power light-emitting diodes (LED) light-curing units (LCUs) have increased considerably over the last few years. However, it is not clear whether the effect of reduced exposure time on cytotoxicity of such products have adequate biocompatibility to meet clinical success. This study aimed at assessing the effect of reduced curing time of five resin luting cements (RLCs) polymerized by high-power LED curing unit on the viability of a cell of L-929 fibroblast cells.

Material and Methods

Disc-shaped samples were prepared in polytetrafluoroethylene moulds with cylindrical cavities. The samples were irradiated from the top through the ceramic discs and acetate strips using LED LCU for 20 s (50% of the manufacturer's recommended exposure time) and 40 s (100% exposure time). After curing, the samples were transferred into a culture medium for 24 h. The eluates were obtained and pipetted onto L-929 fibroblast cultures (3x10⁴ per well) and incubated for evaluating after 24 h. Measurements were performed by dimethylthiazol diphenyltetrazolium assay. Statistical significance was determined by two-way ANOVA and two independent samples were compared by t-test.

Results

Results showed that eluates of most of the materials polymerized for 20 s (except Rely X Unicem and Illusion) reduced to a higher extent cell viability compared to samples of the same materials polymerized for 40 s. Illusion exhibited the least cytotoxicity for 20 s exposure time compared to the control (culture without samples) followed by Rely X Unicem and Rely X ARC (90.81%, 88.90%, and 83.11%, respectively). For Rely X ARC, Duolink and Lute-It 40 s exposure time was better (t=-1.262 p=0,276; t=-9.399 p=0.001; and t=-20.418 p<0.001, respectively).

Conclusion

The results of this study suggest that reduction of curing time significantly enhances the cytotoxicity of the studied resin cement materials, therefore compromising their clinical performance.

Influence of light curing units on failure of directcomposite restorations

Light polymerizable tooth colored restorative materials are most widely preferred for advantages such as esthetics, improved physical properties and operator's control over the working time. Since the introduction of these light polymerizable restorative materials, there has been a concern about the depth of appropriate cure throughout the restoration. Photopolymerization of the composite is of fundamental importance because adequate polymerization is a crucial factor for optimization of the physical and mechanical properties and clinical results of the composite material. Inadequate polymerization results in greater deterioration at the margins of the restoration, decreased bond strength between the tooth and the restoration, greater cytotoxicity, and reduced hardness. Therefore, the dentist must use a light curing unit that delivers adequate and sufficient energy to optimize composite polymerization. Varying light intensity affects the degree of conversion of monomer to polymer and depth of cure.

Curing efficiency of high-intensity light-emitting diode (LED) devices

We evaluated the curing efficiency of 4 high-intensity light-emitting diode (LED) devices by assessing percentage of residual C=C (%RDB), surface microhardness (SM), depth of cure (DC), percentage of linear shrinkage-strain (%LS), and percentage of wall-to-wall contraction (%WWC). The light-curing units tested were a QTH light, the Elipar TriLight (3M/ESPE), and 4 LED devices - the Allegro (Denmat), the Bluephase (Ivoclar/Vivadent), the FreeLight2 (3M/ESPE), and The Cure TC-01 (Spring Health Products). The %RDB was measured by microFTIR spectroscopy. Microhardness measurements (Vickers) were performed at the surface (H0) and at depths of 3 mm (H3) and 5 mm (H5) of cylindrical specimens. Depth of cure was expressed as the ratio of microhardness at each depth, relative to the corresponding surface value (H3/H0 and H5/H0). The bonded disc method was used to evaluate %LS. For the %WWC evaluation, cylindrical resin restorations were imaged by high resolution micro-CT and the %WWC was calculated at depths of 0 mm and 2 mm. There were no statistical differences among the LEDs in %RDB or %LS. The Bluephase and Allegro had the highest SM values. As compared with the other LEDs, the Bluephase and The Cure TC-01 had lower values for depth of cure at depths of 3 mm and 5 mm. There were no significant differences in %WWC among the LEDs at either depth, and the QTH had the lowest %WWC at both depths.

Hardening of a dual-cure resin cement using QTH and LED curing units

OBJECTIVE

This study evaluated the surface hardness of a resin cement (RelyX ARC) photoactivated through indirect composite resin (Cristobal) disks of different thicknesses using either a light-emitting diode (LED) or quartz tungsten halogen (QTH) light source.

MATERIAL AND METHODS

Eighteen resin cement specimens were prepared and divided into 6 groups according to the type of curing unit and the thickness of resin disks interposed between the cement surface and light source. Three indentations (50 g for 15 s) were performed on the top and bottom surface of each specimen and a mean Vickers hardness number (VHN) was calculated for each specimen. The data were analyzed using two-way ANOVA and Tukey-Kramer test was used for post-hoc pairwise comparisons.

RESULTS

Increased indirect resin disk thickness resulted in decreased mean VHN values. Mean VHN values for the top surfaces of the resin cement specimens ranged from 23.2 to 46.1 (QTH) and 32.3 to 41.7 (LED). The LED curing light source produced higher hardness values compared to the QTH light source for 2- and 3-mm-thick indirect resin disks. The differences were clinically, but not statistically significant. Increased indirect resin disk thickness also resulted in decreased mean VHN values for the bottom surfaces of the resin cement: 5.8 to 19.1 (QTH) and 7.5 to 32.0 (LED). For the bottom surfaces, a statistically significant interaction was also found between the type of curing light source and the indirect resin disk thickness.

CONCLUSION

Mean surface hardness values of resin cement specimens decreased with the increase of indirect resin disk thickness. The LED curing light source generally produced higher surface hardness values.

Physical properties of self-, dual-, and light-cured direct core materials

The objective of this study is to evaluate flexural strength, flexural modulus, compressive strength, curing temperature, curing depth, volumetric shrinkage, water sorption, and hygroscopic expansion of two self-, three dual-, and three light-curing resin-based core materials. Flexural strength and water sorption were measured according to ISO 4049, flexural modulus, compressive strength, curing temperature, and curing depth according to well-proven, literature-known methods, and the volumetric behavior was determined by the Archimedes' principle. ANOVA was calculated to find differences between the materials' properties, and correlation of water sorption and hygroscopic expansion was analysed according to Pearson (p < 0.05). Clearfil Photo Core demonstrated the highest flexural strength (125 ± 12 MPa) and curing depth (15.2 ± 0.1 mm) and had the highest flexural modulus (≈12.6 ± 1.2 GPa) concertedly with Multicore HB. The best compressive strength was measured for Voco Rebilda SC and Clearfil DC Core Auto (≈260 ± 10 MPa). Encore SuperCure Contrast had the lowest water sorption (11.8 ± 3.3 µg mm(-3)) and hygroscopic expansion (0.0 ± 0.2 vol.%). Clearfil Photo Core and Encore SuperCure Contrast demonstrated the lowest shrinkage (≈2.1 ± 0.1 vol.%). Water sorption and hygroscopic expansion had a very strong positive correlation. The investigated core materials significantly differed in the tested properties. The performance of the materials depended on their formulation, as well as on the respective curing process.

Measurement of the full-field polymerization shrinkage and depth of cure of dental composites using digital image correlation

OBJECTIVES

The aim of this study was to measure the full-field polymerization shrinkage of dental composites using optical image correlation method.

METHODS

Bar specimens of cross-section 4mm x 2mm and length 10mm approximately were light cured with two irradiances, 450 mW/cm(2) and 180 mW/cm(2), respectively. The curing light was generated with Optilux 501 (Kerr) and the two different irradiances were achieved by adjusting the distance between the light tip and the specimen. A single-camera 2D measuring system was used to record the deformation of the composite specimen for 30 min at a frequency of 0.1 Hz. The specimen surface under observation was sprayed with paint to produce sufficient contrast to allow tracking of individual points on the surface. The curing light was applied to one end of the specimen for 40s during which the painted surface was fully covered. After curing, the cover was removed immediately so that deformation of the painted surface could be recorded by the camera. The images were then analyzed with specialist software and the volumetric shrinkage determined along the beam length.

RESULTS

A typical shrinkage strain field obtained on a specimen surface was highly non-uniform, even at positions of constant distance from the irradiation surface, indicating possible heterogeneity in material composition and shrinkage behavior in the composite. The maximum volumetric shrinkage strain of approximately 1.5% occurred at a subsurface distance of about 1mm, instead of at the irradiation surface. After reaching its peak value, the shrinkage strain then gradually decreased with increasing distance along the beam length, before leveling off to a value of approximately 0.2% at a distance of 4-5mm. The maximum volumetric shrinkage obtained agreed well with the value of 1.6% reported by the manufacturer for the composite examined in this work. Using irradiance of 180 mW/cm(2) resulted in only slightly less polymerization shrinkage than using irradiance of 450 mW/cm(2).

SIGNIFICANCE

Compared to the other measurement methods, the image correlation method is capable of producing full-field information about the polymerization shrinkage behavior of dental composites.

A material model for internal stress of dental composites caused by the curing process

OBJECTIVE

To compare the build-up of internal stresses in four different dental composites (Venus, Tetric Ceram, Ceram X mono and Filtek Supreme) during the curing reaction, based on the results of a former paper on polymerization kinetics, and to characterize the developing mechanical behavior for different modes of activation using experimental methods and simulation tools.

METHODS

A four-parameter viscoelastic model combined with a curing model and a kinetic model was developed to simulate the mechanical behavior in three dimensions using the finite element software ABAQUS. In order to study the influence of slow polymerization behavior on the mechanical properties, the length of the activation period was doubled at half intensity of the curing light.

RESULTS

Using a model which describes the complex interplay of stiffness, flowability, curing speed and activation intensity during the curing process gives deeper insight into the spatial and temporal build-up of stresses. An advantageous reaction kinetic or a lower stiffness can compensate for the effect of a higher polymerization shrinkage on the resulting peak stress. The evolution of stress is not directly proportional to the level of shrinkage of the composites.

SIGNIFICANCE

A material model which includes the developing mechanical characteristics of a curing dental composite can be used to develop and optimize dental materials and to assess the effect of different treatment strategies (i.e. mode of photo-polymerization, filling geometries, interfacial strength).

Effect of exposure time on curing efficiency of polymerizing units equipped with light-emitting diodes

A study was conducted to evaluate the top and bottom hardness of two composites cured using polymerizing units equipped with light-emitting diodes [LED] (LEDemetron; Elipar FreeLight, Coltolux LED) and one quartz-tungsten halogen device [QTH] (Optilux 501) under different exposure times (20, 40 and 60 sec). A matrix mold 5 mm in diameter and 2 mm in depth was made to obtain five disc-shaped specimens for each experimental group. The specimens were cured by one of the light-curing units (LCUs) for 20, 40 or 60 sec, and the hardness was measured with a Vickers hardness-measuring instrument (50 g/30 sec). Data were subjected to three-way ANOVA and Tukey's test (alpha = 0.05). LED LCUs were as effective as the QTH device for curing both composites. A significant increase in the microhardness values were observed for all light LCUs when the exposure time was changed from 20 sec to 40 sec. The Z250 composite showed hardness values that were usually higher than those of the Charisma composite under similar experimental conditions. LED LCUs are as efficient for curing composites as the QTH device as long as an exposure time of 40 sec or higher is employed. An exposure time of 40 sec is required to provide composites with a uniform and high Knoop hardness when LED light-curing units are employed.

In vitro effect of light-emitting diode light polymerization on the color stability of three resin-based restorative materials

OBJECTIVE

To investigate the color stability of resin-based restorative materials when polymerized with light-emitting diode (LED) curing light in the constant or exponential mode.

MATERIAL AND METHODS

Eight specimens of Admira (AD), Compoglass F (CO), and Tetric EvoCeram (TE) constantly cured or exponentially cured with a high-powered LED curing light for 10, 20, or 60 s. The CIE-Lab values (L*, a*, b*) were measured prior to and after performing the water storage or color stability test according to EN ISO 7491 (Suntest).

RESULTS

Statistical analysis showed significant changes in the color values after each of the aging processes, as well as between DeltaL, Deltaa, Deltab, and DeltaE of the materials, which were dependent on curing time, mode, and aging condition (p<0.05). CO performed very well during water storage, but AD and TE exceeded the clinically relevant limit DeltaE=1. After the Suntest and 180 d additional water storage, TE showed the highest mean (SD) DeltaE=4.4 (1.1) to 5.4 (1.9). Although AD and CO performed best in the constant mode, they exceeded DeltaE=1. All materials shifted to more red.

CONCLUSIONS

The extent of discoloration depended on (a) the curing mode, (b) the curing time, and (c) the aging condition. Not all materials performed clinically acceptably in all tests; TE even showed unacceptable DeltaE>3.3. The optimal curing time was 20 s for both curing modes and all tested materials.

Effect of light curing type on cytotoxicity of dentine-bonding agents

AIM

To compare the cytotoxic effects of dentine-bonding agents (DBAs) polymerized with two different curing units at 24 h and 72 h on L-929 cells.

METHODOLOGY

Disc-shaped test samples of light-activated DBAs were prepared according to manufacturers' instructions and cured with either conventional quartz tungsten halogen or light-emitting diode light curing units (LCUs). After curing, the samples were transferred into a culture medium for 24 h. Eluates were obtained and pipetted onto L-929 mouse fibroblast cultures (3 x 10(4) cells per well), incubated for evaluation after 24 and 72 h. After both incubation periods, measurements were performed by an dimethylthiazol diphenyltetrazolium assay. The degree of cytotoxicity for each sample was determined according to the reference value represented by the cells with a control (culture without sample). Statistical significance was determined by a three-way analysis of variance followed by the Mann-Whitney U-test.

RESULTS

No significant three-factor interaction occurred amongst LCUs, DBAs and time factors (P = 0.955). LCUs and DBAs had a significant two-factor interaction (P < 0.001). In general, the test materials cured with the light-emitting diode LCU demonstrated higher cell survival rates when compared with the those cured with the quartz tungsten halogen.

CONCLUSIONS

Differential toxic effects of the DBAs cured with the quartz tungsten halogen or the light-emitting diode on the fibroblast cells may prove to be very important when suitable DBAs or LCUs are used for operative restorations.

Microleakage beneath ceramic and metal brackets photopolymerized with LED or conventional light curing units

OBJECTIVE

To test the null hypotheses that (1) the type of light curing unit used (quartz-tungsten-halogen [QTH] or light-emitting diode [LED]) would not affect the amount of microleakage observed beneath brackets, and (2) the bracket type used (ceramic or metal) would not influence the amount of microleakage observed beneath brackets.

MATERIALS AND METHODS

40 freshly-extracted human premolars were randomly assigned into 4 bonding groups (n = 10/group): group 1, metal bracket + LED-cured Transbond XT; group 2, ceramic bracket + LED-cured Transbond XT; group 3, metal bracket + QTH-cured Transbond XT; and group 4, ceramic bracket + QTH-cured Transbond XT. The teeth were kept in distilled water for 1 month, and thereafter subjected to 500 thermal cycles. Then, specimens were sealed with nail varnish, stained with 0.5% basic fuchsin for 24 hours, sectioned, and photographed under a stereomicroscope. Microleakage was scored with regard to the adhesive-tooth interface and the bracket-adhesive interface at both incisal and gingival margins. Statistical analysis was accomplished by Kruskal-Wallis and Mann-Whitney U-tests with Bonferroni correction.

RESULTS

Microleakage was observed in all groups. When an LED curing unit was used for adhesive polymerization, ceramic brackets displayed significantly less microleakage than metal brackets in both tooth-adhesive and bracket-adhesive interfaces. When a QTH curing unit was used, ceramic brackets displayed significantly less microleakage than metal brackets in the bracket-adhesive interface in both gingival and incisal margins.

CONCLUSIONS

Ceramic brackets cured with LED units were the best combination, demonstrating the lowest microleakage scores.

Light-emitting diode curing light irradiance and polymerization of resin-based composite

BACKGROUND

Light-emitting diode (LED) curing lights are becoming popular; however, questions about their efficiency remain. The authors performed a comprehensive analysis of the properties of resin-based composites cured with LED lights.

METHODS

The authors evaluated seven LED lights and one quartz-tungsten-halogen light (control). They measured intensity, depth of cure (DOC), degree of conversion (DC), hardness and temperature rise. They used three shades of a hybrid resin-based composite and a microfill composite, as well as one shade of another hybrid composite.

RESULTS

Two LED lights required additional cure time to reach a DOC similar to that of the control light. DC at the top of the samples was independent of the light used. At 2.0 millimeters, the DC for several LED lights was significantly lower than that for the control light and was correlated strongly to the light's intensity. The bottom-to-top ratio for hardness of resin-based composites cured by all but one light was greater than 0.80. All LED lights except one had smaller temperature rise than did the control light.

CONCLUSIONS

Six of the seven LED curing lights performed similarly to a quartz-tungsten-halogen curing light in curing resin-based composites. Clinical Implications. While LED curing lights and a quartz-tungsten-halogen light could cure resin-based composites, some resin-based composites cured with LED lights may require additional curing time or smaller increments of thickness.

Comparison of different test models for the assessment of cytotoxicity of composite resins

This study compared the use of different test models to assess the cytotoxicity of a dental composite. The cytotoxicity of a composite polymerized using two halogen-based light-curing units (LCUs) (Max LC and Astralis) and two light-emitting diode LCUs (E-light and Freelight) served as the basis of comparison. Disk-shaped specimens (7 mm diameter, 2 mm high) were fabricated using the four different light sources. The specimens were used in several cytotoxicity test models: direct and indirect contact tests as well as an extract test with an established cell line L-929. The cells were stained with neutral red after cell-material contact for 48 h. Neutral red-stained areas (in mm2, for direct and indirect tests) and absorbance readings (for extract tests) were analysed statistically using ANOVA and the Tukey post hoc test, with P < 0.05 considered to be significantly different. Good correlation between direct and indirect contact tests (r = 0.903) was found. The extract test was the least correlated among the three tests. It was found that the E-light + Freelight-cured composite elicited cytotoxicity from the correlated studies. Uncured specimens were most detrimental to the cells in all tests. Our data demonstrated that composite cured with light-emitting diode LCUs were cytotoxic to L-929 cells. Different test models were found to give rise to different findings. Thus, a good cell-material contact method would replicate more closely the physiological situation in vivo. This in turn would give more clinically relevant results.

Molar extinction coefficients and the photon absorption efficiency of dental photoinitiators and light curing units

OBJECTIVES

The light absorption of dental photoinitiators should correlate with the spectral emission profiles of dental light curing units compared on an equivalent basis. Spectral data of dental photoinitiators and light curing units can be used to define the photon absorption efficiency (PAE) obtained by integrating the product of the absorption and emission spectra in terms of photons. This parameter can be used to identify the best performance for photochemical process with specific photoinitiators.

METHODS

The efficiency of two LED and one QTH lamps were tested comparing their performances with the photoinitiators camphorquinone (CQ); phenylpropanedione (PPD); monoacylphosphine oxide (Lucirin TPO); and bisacylphosphine oxide (Irgacure 819). Absorption and emission spectra of the photoinitiators and the LED (Ultrablue I and Ultrablue IS) and QTH (Optilux 401) LCUs were determined in the 360-550nm range.

RESULTS

CQ exhibited an absorption centered in the blue region and, although the maxima of PPD, MAPO, and BAPO were in the UV-A region, their absorption extended to the visible region. Power output maxima of the LCUs were at 467 (Ultrablue I), 454 (Ultrablue IS) and 493nm (Optilux 401), and the total power densities were 170+/-1, 470+/-4 and 444+/-4mW/cm(2), respectively.

SIGNIFICANCE

The use of the PAE allows a prediction of the most efficient photoinitiator/LCU systems. For similar photoinitiator concentrations, Lucirin and CQ are most efficiently photoinitiated by the QTH unit, whereas the high-power LED device is more efficient for Irgacure. PPD is photoactivated similarly by both LCUs.

The effect of different light-curing units on fatigue behavior and degree of conversion of a resin composite

OBJECTIVES

The aim of this study was to investigate the effect of different light-curing units and irradiation modes on the mechanical fatigue strength and degree of conversion of a restorative resin composite.

METHODS

Conventional halogen, plasma arc and blue LED light-curing units were used for polymerization of a resin composite (Tetric) Ceram, Ivoclar, Vivadent, Liechtenstein). Initial fracture strength (FS) and flexural fatigue limit (FFL) as well as degree of conversion (DC) were measured. The FFL was determined under cyclic loading for 10(5) cycles in terms of a staircase approach. The specimens were stored for 14 days in 37 degrees C distilled water prior to testing. The curing efficiency was observed with Fourier transform infrared micromultiple internal reflectance spectroscopy. The measurements were carried out at 0.5 and 2.5 mm distance from the directly irradiated surface after 14 days storage in dark and dry conditions at 37 degrees C.

RESULTS

The highest FS, FFL and DC were observed from high energy curing devices and from extended curing intervals. The conventional halogen light exhibited the most homogenous in-depth curing efficiency along with a low loss of mechanical resistance under cyclic fatigue.

SIGNIFICANCE

Evaluation of flexural fatigue limit and curing efficiency correlate in terms of decreased mechanical strength due to insufficient light-curing intervals or light intensities. Initial promising fracture strengths do not correlate with a clinically more relevant fatigue loading and with the in-depth degree of conversion, both accounting for a significantly reduced strength performance.

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.

Time dependence of composite shrinkage using halogen and LED light curing

OBJECTIVES

The polymerization shrinkage of light cured dental composites presents the major drawback for these aesthetically adaptable restorative materials. LED based light curing technology has recently become commercially available. Therefore, the aim of the present study was to investigate if there was a statistically significant difference in linear and volumetric composite shrinkage strain if a LED LCU is used for the light curing process rather than a conventional halogen LCU.

METHODS

The volumetric shrinkage strain was determined using the Archimedes buoyancy principle after 5, 10, 20, 40 s of light curing and after 120 s following the 40 s light curing time period. The linear shrinkage strain was determined with a dynamic mechanical analyzer for the composites Z100, Spectrum, Solitaire2 and Definite polymerized with the LCUs Trilight (halogen), Freelight I (LED) and LED63 (LED LCU prototype). The changes in irradiance and spectra of the LCUs were measured after 0, 312 and 360 min of duty time.

RESULTS

In general there was no considerable difference in shrinkage of the composites Z100, Spectrum or Solitaire2 when the LED63 was used instead of the Trilight. There was, however, a statistically significant difference in shrinkage strain when the composite Definite was polymerized with the LED63 instead of the Trilight. The spectrum of the Trilight changed during the experiment considerably whereas the LED63 showed an almost constant light output. The Freelight I dropped considerably in irradiance and had to be withdrawn from the study because of technical problems.

SIGNIFICANCE

The composites containing only the photoinitiator camphorquinone showed similar shrinkage strain behaviour when a LED or halogen LCU is used for the polymerization. The irradiance of some LED LCUs can also decrease over time and should therefore be checked on a regular basis.

Effectiveness of composite resin polymerization using light-emitting diodes (LEDs) or halogen-based light-curing units

The clinical performance of composite resins is greatly influenced by the quality of the light-curing unit used. The aim of this study was to compare the efficiency of a commercial light-emitting diode (LED) with that of a halogen-based light-curing unit by means of dye penetration of a micro hybrid composite resin. The composite resin evaluated was Filtek Z250 (3M Dental). The composite was filled into acrylic moulds that were randomly polymerized for 40 seconds by each of the light-emitting systems: light-emitting diode Ultraled (Dabi Atlante) or halogen light Degulux (Degussa Hüls) curing units. Immediately after polymerization, each specimen was individually immersed in 1 ml of 2% methylene blue solution at 37°C ± 2°C. After 24 hours, the specimens were rinsed under running distilled water for 1 minute and stored at 37°C ± 2°C at relative humidity for 24 hours. The composite resins were removed from the moulds and individually triturated before being immersed in new test tubes containing 1 ml of absolute alcohol for 24 hours. The solutions were filtered and centrifuged for 3 minutes at 4,000 rpm and the supernatant was used to determine absorbance in a spectrophotometer at 590 nm. To verify the differences between groups polymerized by LED or halogen light t-test was applied. No significant differences were found between composite resins light-cured by LED or halogen light-curing unit (p > 0.05). The commercially LED-based light-curing unit is as effective to polymerize hybrid composite resins as the halogen-based unit.

The influence of storage and indenter load on the Knoop hardness of dental composites polymerized with LED and halogen technologies

OBJECTIVES

The mechanical properties of light cured dental composites are greatly influenced by the light curing unit (LCU) used for the polymerization. Previous studies have shown that for some composites lower mechanical properties were obtained if light emitting diode (LED) LCUs were used for the polymerization instead of halogen LCUs. Previous studies have also shown that light cured composites improve their mechanical properties through a post-curing process after the initial illumination with the LCUs. Therefore, this study investigated the post-curing process, to ascertain if it can compensate for the lower mechanical properties of composites polymerized with LED LCUs.

METHODS

The Knoop hardness was measured for four dental composites (Z100, Spectrum, Definite, Solitaire2) polymerized with an LED LCU (LED63 prototype) or a halogen LCU (Trilight), directly after the curing process and after 5 days of storage. In addition, the load on the indenter was varied from 200 to 400 gf to investigate the influence of the load on the measured hardness on the top and bottom of the 2 mm thick samples.

RESULTS

In general the Knoop hardness at the bottom of the stored samples, cured with the LED LCU, was the same or statistically significantly greater than for the samples cured with the halogen LCU. A statistically significantly lower (p<0.0001) Knoop hardness was obtained on the top of the samples if the composite Definite was polymerized with the LED LCU instead of the halogen LCU. The load of 200 or 400 gf on the indenter had a statistically significant influence (p<0.0001) on the measured Knoop hardness for the composite Z100. The Knoop hardness measured with an indenter load of 400 gf increased statistically significantly (p<0.0001) for all composites after the 5 days' storage, whether cured with the LED LCU or halogen LCU.

SIGNIFICANCE

The post-curing effect cannot compensate for the lower hardness of composites containing co-initiators if polymerized with an LED LCU instead of a halogen LCU. The indenter load had a statistically significant influence on the measured Knoop hardness of composites and has the potential to falsify results if not selected carefully.

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.

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.

Polymerization and light-induced heat of dental composites cured with LED and halogen technology

Most commercial light curing units (LCUs) for dental applications use conventional halogen bulbs. Commercial LCUs using light emitting diodes (LEDs) have recently become established on the market, even though some aspects of their performance have not been fully investigated. Temperature rise of dental composites during the light-induced polymerization is considered to be a potential hazard for the pulp of the tooth. This study, therefore, investigated the temperature rise in three different composites (Z100, Durafill, Solitaire2) in two shades (A2, A4) polymerized for 40s with two LED LCUs (Freelight, custom-made LED LCU prototype) and two halogen LCUs (Trilight, Translux). The Trilight was used in the standard and soft-start mode. The temperature rise within the composites were recorded for 60s with a thermocouple and also observed with a high-resolution infrared (HRIR) camera. The factors LCU (p < 0.0001), composite (p < 0.0001) and shade (p = 0.0014) had statistically significant influences on the temperature rise. All composites cured with the halogen LCUs reached at a depth of 2 mm, a statistically significant higher temperature (p < 0.0001) than those cured with the LED LCUs. Only one composite showed a statistically significant lower temperature rise for the halogen LCUs at the 95% confidence level, when the soft-start mode was used instead of the standard mode. In general, the composites with the lighter shade (A2) reached higher temperatures than the darker shade (A4), if the LED LCUs were used. When the halogen LCUs were used, the situation was reversed, the composites with the darker shade (A4) reaching higher temperatures than the lighter shade (A2). This study showed that a HRIR camera represents a powerful tool for the observation of temperature propagation on small samples. This study also showed that LED LCUs represent a viable alternative to halogen LCUs for the light polymerization of dental composites because of a generally lower temperature increase within the composite.