Curing light-activated composite resins through dentin

Additional chemical polymerization of dual resin cements: reality or a goal to be achieved?

Abstract Introduction This study serves as a warning to dentists and researchers that dual-cured resin cements may not polymerize completely under some prosthetic crowns. Objective The aim of this study was to analyse the polymerization degree of dual-cured resin cements under prosthetic barrier, by microhardness test. Material and method Three cements (Bistite II, RelyX ARC and Variolink II) were light-cured through different barriers, placed between the cement and the light source: G1: without barrier; G2: composite resin (Cesead); G3: Inceram alumina; G4: IPS Empress; G5: Inceram zirconia; G6: tooth fragment. Photopolymerization was carried out using a halogen light unit (650 mW/cm2); microhardness was evaluated using the Microhardness Tester FM 700, under a load of 50gf with a dwell time of 15s, at two evaluation times (30min and 24h). Result The results were submitted to ANOVA and Tukey tests (5%). Both Inceram alumina and Inceram zirconia ceramic barriers hindered polymerization. Bistite, followed by RelyX and Variolink, exhibited the highest microhardness values (p<0.05). As the highest values were obtained without a barrier, it was determined that the barrier, followed by the tooth, influenced microhardness. Both Empress and Cesead had the smallest microhardness values but with no statistically significant difference between them. Conclusion The barrier negatively affected the microhardness of dual-cured resin cements; evaluation time did not affect microhardness values for most of the conditions tested. There is a limited effect of the chemical activator on the polymerization of some dual-cured cements, and their performance is product specific.

Microhardness of composite resin cured through different primary tooth thicknesses with different light intensities and curing times: In vitro study

Objective:

The aim of this study was to evaluate the effect of increased exposure time and light intensity on microhardness of cured composite through different thicknesses of tooth structure in primary teeth.

Materials and Methods:

One hundred and seventy cylindrical resin composite specimens were prepared. All specimens were divided into 17 experimental and control groups. “Light-emitting diode” light curing unit (LCU) applied directly or through 1, 2, and 3 mm thicknesses tooth slices for experimental groups. The irradiation protocols were 25 and 50 s at 650 mW/cm² and 15 and 30 s at 1100 mW/cm². The “quartz-tungsten-halogen” LCU (400 mW/cm²) for 40 s was used in control group. Microhardness was measured by the Vickers hardness test.

Results:

Indirectly cured specimens and those cured through a 1 mm thick tooth structure, an increase in intensity caused hardness drop. In the specimens cured through 2 and 3 mm thick tooth structures, increased intensity and/or exposure time did not show any appropriate changes on microhardness.

Conclusion:

Irradiation through a 1.0 mm thick tooth slice resulted in reduced microhardness although it was still within the clinically acceptable level. The hardness values of the specimens cured through 2 or 3 mm thick tooth slices fell below the clinically acceptable level even after doubling the exposure time and/or light intensity.

Hardness comparison of bulk-filled/transtooth and incremental-filled/occlusally irradiated composite resins

STATEMENT OF PROBLEM

Use of a bulk-fill/transtooth composite resin insertion/irradiation technique may not provide as well polymerized a restoration as when using a conventional incremental placement/irradiation technique. Little information exists as to how the hardness of restorations produced by the 2 techniques compare.

PURPOSE

The purpose of this study was to determine the effect of composite resin placement and an irradiation technique on the axial hardness at various depths in a Class I composite resin to include the influence of composite resin filler classification and shade.

MATERIAL AND METHODS

Cylindrical Class I preparations were made in 70 recently extracted human molars and restored with either a light (A1) or dark shade (A4) of a microfill, microhybrid, or nanohybrid composite resin, or with a single shade of a translucent material. Half were placed using a conventional 2-mm-thick incremental-fill/occlusal irradiation technique, and half using a bulk-fill/transtooth irradiation method (n=5). Specimens were sectioned occluso-apically and axial Knoop hardness values were obtained at depths of 0.5, 1.0, 1.5, 2.0, 2.5, and 3.0 mm. Hardness at 0.5 mm was used as a control to compare to deeper readings. Statistical analyses consisted of multiple ANOVAs and Dunnett's post-hoc tests performed at appropriately determined significance levels.

RESULTS

For 3 multishaded materials tested, axial hardness values were relatively unaffected by composite resin shade or filler classification for the incremental technique, but were significantly affected by these factors when using the bulk-fill/transtooth irradiation method. A single shade translucent material was not affected in either the bulk or incremental condition.

CONCLUSIONS

Use of a bulk-fill/transtooth irradiation technique for composite resin placement does not result in axial hardness values equivalent to that of an incremental-fill/occlusal irradiation technique.

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

OBJECTIVES

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

METHOD

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

RESULTS

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

SIGNIFICANCE

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

A 6-year clinical evaluation of Class I poly-acid modified resin composite/resin composite laminate restorations cured with a two-step curing technique

OBJECTIVE

Polymerization shrinkage is still one of the main disadvantages of resin composite restorations (RC). Especially in cavities with a high C-factor, debonding can occur. A laminate restoration including a base with a more elastic behavior might result in a better adaptation. The purpose of this study was to evaluate the durability of a combination of two techniques suggested to counter the stress formation in direct RC restorations in cavities with the highest C-factor.

METHODS

Each of the 29 patients received one or two pair(s) of Class I restorations. The first restoration was a poly-acid modified resin composite/resin composite (PMRC/RC) sandwich restoration and the second a direct RC restoration. Both restorations, except for the PMRC layer, were placed with oblique layering and two-step curing technique. Ninety restorations, 23 premolar and 67 molars, were evaluated annually with slightly modified USPHS criteria during 6 years.

RESULTS

At 6 years, 41 pairs were evaluated. A cumulative failure rate of 2.4% was observed for both the RC and the laminate restorations. One laminate restoration showed non-acceptable color match, but was not replaced and one RC restoration showed non-acceptable marginal adaptation. Two cases of slight postoperative sensitivity were observed in one patient. Three restorations were partially replaced due to primary proximal caries.

SIGNIFICANCE

A high durability for and no differences, were observed between both restorative techniques in Class I cavities.

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

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

Do dental composites always shrink toward the light?

Many of the current light-curing composite restorative techniques are rationalized in compliance with the theory that composite shrinks toward the light. Shrinkage directed toward the margins is believed to be responsible for the observed improved marginal properties. However, the dental literature does not consistently support this theory. Experimental determination of contraction patterns is very difficult. In this study, a finite element technique is used to analyze the direction of composite shrinkage as it cures. The process of polymerization can be characterized by pre- and post-gel phases. The stress developed in a restoration can be relieved quickly by the flow of material still in the pre-gel phase. Residual stresses arise after gelation. Both auto- as well as photo-curing composites were analyzed. In photo-curing composites, the gel-point varies throughout the material with the intensity of the light. Experimentally determined light transmittance data for different materials were used in the simulation. Degree of cure and time-dependent shrinkage properties were also included from experimental measurements. The analysis showed that the shrinkage direction was not significantly affected by the orientation of the incoming curing light, but instead was mostly determined by the bonding of the restoration to the tooth and by the free surfaces. Consequently, differences between the contraction patterns of auto- and photo-cure were minimal. It was concluded that composite does not shrink toward the light, but that the direction is predominantly determined by cavity shape and bond quality. Improved marginal properties should be pursued by the optimization of other factors, such as the polymerization process, the curing procedure, and the bond quality. The direction of shrinkage vectors in response to light position does not seem to be an appropriate criterion for the optimization of marginal quality.

An ex vivo study of self-, light-, and dual-cured composites for orthodontic bonding

It was postulated that using a dual-cured composite to bond orthodontic brackets could result in bond strengths comparable with those of chemically-activated materials and higher than those for light-activated materials. The shear bond strength of four composite resins used to attach mesh-backed orthodontic brackets was measured at 24 hours and following mechanical insult in the ball-mill. Analysis of variance and an SNK range test showed that at 24 hours Dual-cured Porcelite gave a significantly higher mean bond strength than the other materials (P < 0.05). However, following ball-milling the mean bond strength for Right-on was apparently significantly higher than that of the other materials. (P < 0.05). In this study, the mode of bond failure is also analysed and the use of Weibull analysis in bond strength testing is described.

Cure profiles of visible-light-cured Class II composite restorations in vivo and in vitro

The degrees of conversion of posterior composite material in Class II restorations performed in vivo and in vitro were studied by means of the Raman spectroscopy method. Class II restorations in 13 contralateral pairs of premolars were analyzed. The average difference of the ratio I 1610 cm-1/I 1640 cm-1 between the in vivo- and in vitro-performed restorations was 0.42. This indicates a higher grade of conversion in the in vivo situation.

Effect on bonding of curing through dentin

The aim of this study was to investigate the effect of the thickness of dentin (1, 2, or 3 mm) placed between the light guide and the composite resin on the shear bond strength to dentin treated with a simplified Gluma system. The effects of the thickness of composite resin (2 or 3 mm), irradiation time (20, 40, or 60 sec), and shade (universal or brown) were also examined. The results showed that the thickness of dentin influenced bonding and interacted with the other three variables. It is suggested that dentin located between the light guide and composite resin may attenuate the light aimed at the bonding interface in the same manner as a layer of composite resin.

Hardening of dual-cured cements under composite resin inlays

This study was conducted to determine the extent of hardening of three dual-cured cements under composite resin inlays and to determine the effectiveness of a light-reflecting wedge in promoting curing of the cements in the proximal margin. The exposure times needed to optimally harden the cements were determined by directly exposing the cements to the curing light. Composite resin inlays were bonded in an extracted molar with Dual cement, Dicor light-activated cement, and Duo cement. Cure-Thru reflective wedges were placed in the gingival embrasure of half of the specimens. None of the cements hardened completely by 24 hours when we used an exposure time that met or exceeded that recommended by the manufacturers. The chemical-cure component did not completely cure the cements when light was attenuated by the tooth and restoration. The light-transmitting wedge had little effect on hardening of the cements.

Influence of ceramic thickness on the polymerization of light-cured resin cement

The curing of two light-activated resin cements under two ceramic materials was examined to assess the influence of ceramic thickness on polymerization. The degree of resin cure was determined by microhardness measurements (Knoop) on resin cement samples cured under five ceramic thicknesses with light exposures of 30 to 120 seconds. These cements cured under thin ceramic specimens with recommended exposures. With thick ceramics, both cements cured better under the glass-ceramic, but neither reached a level of maximum cure under the porcelain.