Effect of infection control barriers on the light output from a multi-peak light curing unit

Evaluation of the information provided in the instruction manuals of dental light-curing units

OBJECTIVE

This study evaluated the completeness and accuracy of information in LCU instruction manuals from 40 manufacturers.

MATERIALS AND METHODS

Instruction manuals from 40 LCUs (20 from leading manufacturers and 20 budget units) were reviewed. Twenty-eight parameters across five categories were assessed using a binary scale (0=incorrect/missing, 1=correct). The categories and their respective evaluation scores were: LCU characteristics (43%), instructions for use (7%), safety precautions (14%), maintenance recommendations (29%), and regulatory certification (7%). These scores were combined to produce a final score.

RESULTS

Scores from leading manufacturers ranged between 46-86%, while the budget category ranged from 18-68%. All manuals provided information about the wavelength/spectrum of the LCU. Only Valo X and Valo Cordless reported power values and used the term "irradiance" instead of "intensity." Details such as LED type and active tip emission area were often missing. Instructions on how to use the LCU to photo-cure resins were frequently limited. Although most manuals addressed safety precautions, several lacked details on heat issues and general health precautions. All manuals included maintenance instructions, though information on replacement parts was often missing. Among the LCUs, 85% stated they were CE certified, 32% held both FDA and CE certification, and 63% claimed compliance with ISO and/or IEC standards.

CONCLUSIONS

There were notable differences in the completeness and accuracy of the instruction manuals. Manuals from major manufacturers generally provided more comprehensive information than their budget counterparts.

CLINICAL SIGNIFICANCE

Instruction manuals should contain accurate information to help clinicians deliver the highest standard of care. The lack of important information about the LCUs in the manuals is concerning.

Effect of duration and infection control barriers of light curing unit on hardness of Bulk Fill composite resin

Background

This study aimed to investigate the impact of the duration of light curing unit (LCU) usage and the use of infection control barriers on the hardness of Bulk Fill composite resin after curing. The hypotheses were that extended usage of the LCU would not reduces its output power and resin hardness, and that the presence of polyethylene film barriers exacerbates the reduction in resin hardness.

Methods

Based on the absence or presence of polyethylene film (PE) and the number of layers used, a 3M LED curing light (EliparTM DeepCure-S; 3M ESPE, St Paul, MN, USA) was divided into three groups: PE0, PE1, and PE3. The curing light was used 30 times daily for 20 s per exposure, at frequencies of 0, 6, and 12 months. Maximum output power tests were conducted for each group of curing lights. Custom-made plastic modules were used to stack Bulk Fill composite resin (Filtek Bulk Fill Posterior Restorative; 3M ESPE) to a thickness of 4 mm. Each group of curing lights was used to cure the modules in a direct contact manner for 20 s. Vickers hardness measurements were taken at the top and bottom surfaces of the resin specimens using a digital microhardness tester. A one-way or two-way ANOVA analyzed the power of LCUs, Vickers hardness of Bulk Fill composite resin, and hardness decrease percentage across groups. Pairwise comparisons used the Tukey test (α = 0.05).

Results

As the duration of usage increased, both the power of the curing light and the hardness of the resin significantly decreased. Significant differences were observed in power and resin hardness among the PE0, PE1, and PE3 groups. When the duration of usage was 6 months or less, only multi-layered PE films led to a significant increase in the percentage decrease of hardness of cured resin from top to bottom. However, at 12 months, both single-layer and multi-layered PE films resulted in a significant increase in the percentage decrease of hardness of cured resin from top to bottom.

Conclusion

The output power of the light curing unit decreases with prolonged usage, thereby failing to meet the curing requirements of Bulk Fill composite resin. The use of single-layer PE as an infection control barrier is recommended.

Evaluation of Radiant Power of the Light Curing Units Used in Clinics at Governmental and Privates Dental Faculties

Background

 To evaluate the radiant power of the light cure units (LCUs) in relation to their type, radiant exitance, number of years in clinical use, and condition of LCUs tips in governmental and public clinics in Dental Faculties in Sana'a City.

Materials and Methods

LCUs were collected from different colleges at Sanaa City, Yemen, then LCU data as type, clinical age (<1 year, between 1-5 and ˃ 5-years), tip condition was visually inspected for damage and adhering debris, and the radiant exitance values of the tested LCUs. Radiant exitance values were subcategorized into three groups: <400, 400-850, and >850 mW/cm², labeled as inadequate, marginal, and adequate radiant exitances, respectively. A Woodpecker radiometer was used with a mode lasting of 20 seconds was used with each LCU. Descriptive statistics of the different parameters were evaluated with SPSS version 25. One-way ANOVA and Mann-Whitney tests were performed to determine the mean difference between the groups with a significance value of ˂ 0.05 was considered.

Results

Two hundred twenty-three LCUs were surveyed, and the majority were Light-emitting diode (LED). Forty-nine (21.9%), 117 (52.4%), 57 (25.6%) recorded lesser than, 400-850, and more than 850 mW/cm², respectively. Radiant exitances of < year-old units were found to be higher than those of units used for ˃ 5 years with significant differences (p=0.001). The ANOVA test showed significant differences between the radiant exitance with clinical age and LCU tip conditions and a strong correlation p ˃ 0.050.

Conclusion

LED curing lights were the most used in the tested Dental Faculties. More than half of the used LCU offered sufficient radiant exitance. Clinical age, the presence or absence of composite buildups, and damage to curing tips showed significantly affect radiant exitance values.

Influence of different finishing, aging with coffee, and repolishing protocols on the properties of nanoparticle composite resins

Background

Considering the variability of finishing protocols for composite resins, the literature does not offer a consensus about the influence of these approaches to obtain a final polishing and whether the physical properties of these composite resins change at different analysis times. Therefore, the study analyzed the microhardness, roughness, color stability, and gloss of a nanocomposite resin with different finishing, aging with coffee, and repolishing protocols.

Material and Methods

Nanocomposite resin samples were divided into three finishing protocol groups: Diamond burs (F and FF), multi-fluted tungsten carbide burs (18 and 30 flutes), and coarse and medium abrasive discs (Soflex-3M). All protocols used spiral rubber tips (F and FF) for polishing. Knoop microhardness (KHN), roughness (Ra), color changes (ΔE00 and YI), and gloss (GU) were analyzed. Scanning electron microscopy provided images of resins and finishing and polishing instruments.

Results

Resin KHN (p<0.001) decreased, and Ra (p<0.001), ΔE00 (p<0.001), and YI (p<0.001) increased after aging with coffee, regardless of finishing protocol. Abrasive discs showed lower color changes, YI, and Ra and higher GU. Repolishing restored KHN and Ra but not ΔE00 (p>0.05) and YI (p>0.05).

Conclusions

Abrasive disc finishing reduced roughness and yellowness and increased nanocomposite resin gloss after aging with coffee. Key words:Color, Composite resins, Dental materials, Staining, Surface properties.

Mechanical and Optical Characterization of Single-shade Resin Composites Used in Posterior Teeth

OBJECTIVES

This study aimed to evaluate the optical and mechanical performance of two single-shade resin-based composites (RBCs) compared to those of a conventional RBC for restoring posterior teeth.

METHODS

Two single-shade RBCs, Omnichroma (Tukoyama) and Vittra Unique APS (FGM), and a conventional RBC, Filtek Z350XT shade A2 (3M Oral Care), were evaluated in this study. The optical shade-matching performance was measured using a spectrophotometer. The light emitted by VALO Grand (Ultradent) and transmitted through the 2.0-mm RBC specimens was evaluated using beam profiling. Knoop hardness (KH, N/mm2), degree of conversion (DC, %) at the top and bottom, flexural strength (FS, MPa), elastic modulus (E, GPa), postgel shrinkage (Shr, %), and shrinkage stress (MPa) were evaluated. Scanning electron microscopy (SEM) was used to characterize the filler. Data for FS, E, and Shr were analyzed by one-way analysis of variance (ANOVA) and KH and DC by repeated one-way ANOVA measurement followed by Tukey test (α=0.05). The modified von Mises stress values, light transmission, and SEM images were analyzed qualitatively.

RESULTS

All single-shade RBCs exhibited higher chromatic adaptation than the Filtek Z350XT (p<0.001). Omnichroma exhibited less color difference than Vittra Unique APS, irrespective of the shade. The light transmitted through Omnichroma and Vittra Unique APS increased during polymerization. KH and DC values were significantly reduced from the top to the bottom of the specimens for all RBCs (p<0.001); however, the ratio values were always higher than 80%. In general, all RBCs demonstrated similar mechanical properties. All RBCs exhibited a similar FS (p=0.083) and Shr value (p=0.144). Filtek Z350XT exhibited significantly higher E (p<0.001) than both single-shade RBCs. All RBCs exhibited similar shrinkage stress during restoration and similar residual stress during occlusal loading.

CONCLUSIONS

Single-shade Omnichroma and Vittra Unique APS increased light transmission during light-activation, demonstrating better chromatic adaptation than conventional Filtek Z350XT. In general, Omnichroma and Vittra Unique APS exhibited similar mechanical properties and shrinkage stress distributions as Filtek Z350XT during light-activation and occlusal loading.

Utilizing Light Cure Units: A Concise Narrative Review

The use of photo-curable resin composite restorations is an essential treatment modality in modern dental practice. The success and longevity of these restorations depend on achieving predictable and effective polymerization. Understanding the dynamics of the polymerization and the effect of light cure units (LCUs) on this process is paramount. The goal of this concise narrative review is to provide a simplified presentation of basic principles of composite chemistry, polymerization reactions, and photo-curing with relevant terminologies. Clinical guidelines for choosing and maintaining LCUs, as well as safety precautions and factors under the control of the clinician are listed. Finally, clinical recommendations of LCUs’ usage and monitoring are included to aid practitioners in achieving predictable polymerization during the placement of direct resin composite restorations.