Comparison of Temperature Changes in the Pulp Chamber Induced by Various Light Curing Units, In Vitro

28Assessment of thermal variations in the pulpal chamber during fabrication of provisionals using two different techniques and three materials

BACKGROUND

The issue of an increase in pulpal temperature affects direct and indirect techniques, where the fabricating material will come in direct contact with the prepared teeth.

OBJECTIVE

The aim of this study was to assess the pulpal thermal variations during provisional fabrication using direct and indirect-direct techniques, with three commonly commercially available provisional fabricating materials.

METHOD

In this vitro analytical study, 120 extracted human teeth were placed in a dentulous mould and dental stone was poured, to create a working model with an embedded natural right maxillary central incisor. Recording of thermal changes in the pulp chamber during provisionalization with direct (technique 1) and indirect-direct (technique 2) using three common types of provisional crown materials. 120 provisional crowns were fabricated using polymethyl methacrylate (DPI) (Group 1), Bis-acryl composite (Protemp 4) (Group 2) and Visible-light polymerizing (VLP) Urethane Dimethacrylate (Revotek LC) (Group 3) by two techniques and recording of peak temperature changes were done. Temperature rise in the pulp chamber was recorded using a thermocouple.

RESULTS

The mean initial and final temperature of the pulp chamber recorded for Groups 1, 2 and 3 was 31.52, 32.56; 31.01, 32.34; 32.29, 34.47 for technique 1 and 29.13, 30.5; 29.29, 31.11; 30.31, 32.65 for technique 2. The mean change in temperature was higher in Group 3 compared to the other groups.

CONCLUSION

The temperature rise detected according to this study was within the safer pulpal health limits with all the investigated materials and techniques. The resin material recommended for clinical use when the direct technique is employed for the fabrication of provisional crowns is bis-acryl composite resin (Protemp-4) as it caused minimal temperature rise in the pulpal chamber.

Pulpal Temperature Variances During Step-by-step Adhesive Restorative Procedure Using Three Different High-irradiance Light-curing Units

The rise in temperature in pulp tissues is related not only to heat transfer by high-irradiance light-curing units (LCUs), but also to restorative procedures. This research aimed to compare the rise in pulp temperature (PT) induced by three LCUs at each restorative step while considering the influence of resin composite shade and thickness. To accomplish this, the investigators used a proposed experimental model replicating pulp fluid circulation with a controlled, simulated intraoral temperature in bovine incisors. The recorded external and internal PT ranged from 36.7°C to 37.1°C and 32.7°C to 33.0°C, respectively. A significant decrease of internal temperature was recorded during class V preparation, followed by a progressive and representative rise of temperature in the subsequent restorative steps. The temperature was significantly higher during light curing of the adhesive system using Valo compared to light curing using Elipar and Radii Cal. However, none of the analyzed devices produced a temperature that exceeded the pulp tolerance limit (a temperature increase over 5.5°C). The paired test showed no significant difference in pulp temperature associated with the thickness of the increment of resin composite. However, shade was found to have more influence on the amount of energy absorbed by pulp tissue-A1 samples showed significantly higher temperature variation compared to samples using the A4 shade of resin composite. To conclude, the microcirculation and the performance of procedures under constant air-water flux dissipate the heat absorbed by the pulp. Additionally, the data suggest that all three LCUs analyzed can be safely used in clinical procedures, and that the resin composite shade may influence the amount of irradiance delivered to the tooth surface and represents a significant factor in pulp temperature variance.

Pulp chamber temperature rise in light-cure bonding of brackets with and without primer, in intact versus restored teeth

OBJECTIVE

To evaluate the pulp chamber temperature rise (PCTR) in light-cure bonding of brackets with and without primer, in intact and restored mandibular central incisors (M1), maxillary first premolars (Mx4), and mandibular third molars (M8).

MATERIAL AND METHODS

Ninety human teeth were included: M1 (n=30), Mx4 (n=30), and M8 (n=30). Light-cure bonding of brackets was performed in intact (n=60) and restored (n=30) teeth, with primer (n=60) or without (n=30) primer. PCTR was defined as the difference between initial (T0) and peak temperatures (T1), recorded with a thermocouple during light-cure bonding. Differences on PCTR between bonding techniques (primer vs. no primer), teeth types (M1 vs. Mx4 vs. M8), and teeth condition (intact vs. restored) were estimated by ANCOVA, with α=5%.Results: PCTR was significantly higher with the use of primer (2.05 ± 0.08oC) than without primer (1.65 ± 0.14oC) (p=0.02), and in M1 (2.23 ± 0.22oC) compared to Mx4 (1.56 ± 0.14oC) (p<0.01). There was no difference in the PCTR in M8 (1.77 ± 0.28oC) compared to M1 or Mx4 (p>0.05), and no difference between intact (1.78 ± 0.14oC) and restored (1.92 ± 0.08oC) teeth (p=0.38). There was no influence of dentin enamel thickness in the PCTR (p=0.19).

CONCLUSION

PCTR was higher in light-cure bonding of brackets with primer, especially in M1. Light-cure bonding seems less invasive without primer.

Effect of Ceramic and Dentin Thicknesses and Type of Resin-Based Luting Agents on Intrapulpal Temperature Changes during Luting of Ceramic Inlays

The adhesive cementation of ceramic inlays may increase pulpal temperature (PT) and induce pulpal damage due to heat generated by the curing unit and the exothermic reaction of the luting agent (LA). The aim was to measure the PT rise during ceramic inlay cementation by testing different combinations of dentin and ceramic thicknesses and LAs. The PT changes were detected using a thermocouple sensor positioned in the pulp chamber of a mandibular molar. Gradual occlusal reduction obtained dentin thicknesses of 2.5, 2.0, 1.5, and 1.0 mm. Light-cured (LC) and dual-cured (DC) adhesive cements and preheated restorative resin-based composite (RBC) were applied to luting of 2.0, 2.5, 3.0, and 3.5 mm lithium disilicate ceramic blocks. Differential scanning calorimetry was used to compare the thermal conductivity of dentin and ceramic slices. Although ceramic reduced heat delivered by the curing unit, the exothermic reaction of the LAs significantly increased it in each investigated combination (5.4–7.9 °C). Temperature changes were predominantly influenced by dentin thickness followed by LA and ceramic thickness. Thermal conductivity of dentin was 24% lower than that of ceramic, and its thermal capacity was 86% higher. Regardless of the ceramic thickness, adhesive inlay cementation can significantly increase the PT, especially when the remaining dentin thickness is <2 mm.

In-vitro pulpal temperature increases when photo-curing bulk-fill resin-based composites using laser or light-emitting diode light curing units

OBJECTIVE

To evaluate the in vitro pulpal temperature rise (ΔT) within the pulp chamber when low- and high-viscosity bulk-fill resin composites are photo-cured using laser or contemporary light curing units (LCUs).

MATERIALS AND METHODS

The light output from five LCUs was measured. Non-retentive Class I and V cavities were prepared in one upper molar. Two T-type thermocouples were inserted into the pulp chamber. After the PT values reached 32°C under simulated pulp flow (0.026 mL/min), both cavities were restored with: Filtek One Bulk Fill (3 M), Filtek Bulk Fill Flow (3 M), Tetric PowerFill (Ivoclar Vivadent), or Tetric PowerFlow (Ivoclar Vivadent). The tooth was exposed as follows: Monet Laser (1 and 3 s), PowerCure (3 and 20 s), PinkWave (3 and 20 s), Valo X (5 and 20 s) and SmartLite Pro (20 s). The ΔT data were subjected to one-way ANOVA followed by Scheffe's post hoc test.

RESULTS

Monet 1 s (1.9 J) and PinkWave 20 s (30.1 J) delivered the least and the highest amount of energy, respectively. Valo X and PinkWave used for 20 s produced the highest ΔT values (3.4-4.1°C). Monet 1 s, PinkWave 3 s, PowerCure 3 s (except FB-Flow) and Monet 3 s for FB-One and TP-Fill produced the lowest ΔT values (0.9-1.7°C). No significant differences were found among composites.

CONCLUSIONS

Short 1- to 3-s exposures produced acceptable temperature rises, regardless of the composite.

CLINICAL SIGNIFICANCE

The energy delivered to the tooth by the LCUs affects the temperature rise inside the pulp. The short 1-3 s exposure times used in this study delivered the least amount of energy and produced a lower temperature rise. However, the RBC may not have received sufficient energy to be adequately photo-cured.

The effect of argon cold atmospheric plasma on the metabolism and demineralization of oral plaque biofilms

Objective

The aim of this study was to design and optimize a cold atmospheric plasma (CAP) device that could be applied in an oral environment and to study its effects on plaque biofilm metabolism and regrowth, as well as microbial flora composition and enamel demineralization.

Method

CAP was obtained through a dielectric barrier discharge device; the optical properties were analyzed using emission spectroscopy. The electrochemical analysis of plasma devices includes voltametric characteristic curves and Lissajous. The Streptococcus mutans (UA159) and saliva biofilms were treated in vitro, and the effects of CAP on biofilm metabolism were investigated using MTT and lactate dehydrogenase assays. The duration of antibacterial activity on biofilms was examined, scanning electron microscopy was used to observe the morphology of biofilms, and 16S rRNA sequencing was used to explore the influence of CAP on the microbial flora composition of saliva biofilms. An in vitro model of biofilm-enamel demineralization was designed, and the effect of CAP on enamel demineralization was evaluated by micro surface hardness and micro-CT analysis.

Results

CAP had antibacterial proliferative ability toward Streptococcus mutans biofilms and saliva biofilms and was stronger than ultraviolet under the same tested conditions. After 24 h, the antibacterial effect disappeared, which proved the short-term timeliness of its bactericidal ability. CAP can inhibit the acid production of biofilms, and its inhibitory effect on saliva biofilms can be extended to 24 h. CAP had a strong ability to regulate the composition of plaque biofilms, especially for Lactococcus proliferation, a major acid-producing bacterium in microcosm biofilms. The CAP-treated enamels were more acid-tolerant than non-treated controls.

Conclusion

CAP had an explicit bactericidal effect on caries-related biofilms, which is a short-term antibacterial effect. It can inhibit the acid production of biofilms and has a downregulation effect on Lactococcus in saliva biofilms. CAP can help reduce demineralization of enamel.

How does indirect air-cooling influence pulp chamber temperature in different volume teeth and absence/presence of resin-based composite during light curing?

Background

Light-curing of materials during restorative dental procedures poses a risk for pulp tissue overheating. Therefore, the aim of this study was to investigate the effect of indirect air-cooling on pulp chamber temperatures during light-curing of varying volume teeth and absence/presence of resin-based composite (RBC) at different exposure time.

Methods

The volume of 11 human teeth was measured by micro computed tomograph. An experimental rig controlled the thermal environment of the teeth and a thermocouple inserted retrograde into the root canal measured temperature changes. Pulp chamber temperature was measured with and without air-cooling on teeth without and with RBC at 15 s, 30 s and 60 s intervals. Generalized estimating equations were used for statistical analysis.

Results

The temperature increase with air-cooling (versus no air-cooling) was lower in teeth despite absence/presence of RBC (β = − 4.26, 95%CI − 5.33 and β = − 4.47, 95%CI − 5.60, respectively). With air-cooling, the temperature increase in teeth with RBC was lower compared to teeth without RBC (β = − 0.42, 95%CI -0.79; − 0.05). Higher teeth volume resulted in lower temperature increase with air-cooling than without air-cooling (β = − 0.04, 95%CI -0.07; − 0.01 and β = − 0.17, 95%CI -0.30; − 0.05, respectively).

Conclusions

Air-cooling resulted in lower pulp chamber temperature increase. Using air-cooling, the temperature increase was lower in teeth with RBC compared to teeth without RBC. Lower volume teeth resulted in higher temperature increase, thus they seemed to benefit more from air-cooling compared to higher volume teeth. Air-cooling could be an effective tool in controlling pulp temperature increase during light-curing, especially when the tooth volume is small.

Intrapulpal temperature changes during the cementation of ceramic veneers

Adhesive cementation of ceramic veneers may increase pulpal temperature (PT) due to the combined effect of heat generated by the curing unit and the exothermic reaction of the luting agent (LA). PT increase may induce pulpal damage. The aim was to determine the PT rise during the luting of ceramic veneers (CV) of different thicknesses with light- or dual-curing (LC, DC) adhesive cements as well as pre-heated restorative resin-based composites (PH-RBC). For this a thermocouple sensor was positioned in the pulp chamber of a prepared maxillary central incisor. LC, DC adhesive cements and PH-RBCs heated to 55 °C were used for the luting of CVs of 0.3, 0.5, 0.7, and 1.0 mm thicknesses. The exothermic reaction of LAs added significantly to the thermal effect of the curing unit. PT change ranged between 8.12 and 14.4 °C with the investigated combinations of LAs and ceramic thicknesses (p ≤ 0.01). The increase was inversely proportional to the increasing CV thicknesses. The highest rise (p ≤ 0.01) was seen with the polymerization of PH-RBCs. Temperature changes were predominantly influenced by the composition of the LA, which was followed by CV thickness.

Evaluation of Temperature Changes in the Pulp Chamber During Bulk-Fill Composite Polymerization: An In-Vitro Study

Aim:

To investigate the temperature changes occurring in the pulp chamber during the polymerization of bulk-fill resin materials cured with different light sources by using a pulpal microcirculation simulation device in vitro.

Materials and Methods:

Class I cavities of width 2 × 3 mm were prepared on 120 permanent noncarious teeth. All samples were adjusted to maintain 2 mm dentin thickness within the pulp chamber and the cavity base. Venus Bulk Fill, Tetric Evo Ceram Bulk Fill, Filtek Bulk Fill, and Filtek Z250 were used as restorative materials. Materials were polymerized with Valo Light Emitting Diode (LED), Elipar S10, and Elipar Deepcure-S devices. A j-type thermocouple with microcirculation assemblies was used for measuring the temperature increments inside the pulp chamber during the polymerization of bulk-fill composite resins. The obtained data were recorded.

Results:

Statistically significant difference was found between the light sources and the temperature changes occurring during the polymerization ( P <.05). The difference in temperature increases was found to be significant ( P <.05) between restorative materials. The highest temperature rise values were obtained from Venus Bulk Fill.

Conclusion:

All light devices used in the study caused an increase in temperature in the pulp chamber in all groups. For all resin materials used, it was observed that the temperature values arising during the polymerization via used light sources did not exceed 5.5°C, which is the critical value for pulp.

Highly efficient optical fiber sensor for instantaneous measurement of elevated temperature in dental hard tissues irradiated with an Nd:YaG laser

In this in vitro experiment, the effect of 1.064 µm pulsed laser on both enamel- and dentin-dental tissues has been investigated. A total of fifty-five dental hard tissue samples were exposed to Nd:YAG laser that possesses a pulse width of 9 ns and 850 mJ of total energy. An optical fiber sensor was put behind the samples to measure the temperature instantaneously. A novel, to the best of our knowledge, fiber sensor has been proposed and used to measure the heat generated in dental hard tissues instantaneously after the application of laser irradiation on the tissue surface. This optical sensor exhibits a fast response time of about 1 ms and high sensitivity with about 1.975 nm/°C. The findings of this study in decreasing the probability of pulpal necrosis structure while handling the tooth, whether for ablation, welding, or tooth resurfacing purposes, may establish standards for dentists and laser manufacturers (healthcare professionals) that should be followed.

Degree of conversion and in vitro temperature rise of pulp chamber during polymerization of flowable and sculptable conventional, bulk-fill and short-fibre reinforced resin composites

OBJECTIVE

Determine the degree of conversion (DC) and in vitro pulpal temperature (PT) rise of low-viscosity (LV) and high-viscosity (HV) conventional resin-based composites (RBC), bulk-fill and short-fibre reinforced composites (SFRC).

METHODS

The occlusal surface of a mandibular molar was removed to obtain dentine thickness of 2 mm above the roof of the pulp chamber. LV and HV conventional (2 mm), bulk-fill RBCs (2-4 mm) and SFRCs (2-4 mm) were applied in a mold (6 mm inner diameter) placed on the occlusal surface. PT changes during the photo-polymerization were recorded with a thermocouple positioned in the pulp chamber. The DC at the top and bottom of the samples was measured with micro-Raman spectroscopy. ANOVA and Tukey's post-hoc test, multivariate analysis and partial eta-squared statistics were used to analyze the data (p < 0.05).

RESULTS

The PT changes ranged between 5.5-11.2 °C. All LV and 4 mm RBCs exhibited higher temperature changes. Higher DC were measured at the top (63-76%) of the samples as compared to the bottom (52-72.6%) in the 2 mm HV conventional and bulk-fill RBCs and in each 4 mm LV and HV materials. The SFRCs showed higher temperature changes and DC% as compared to the other investigated RBCs. The temperature and DC were influenced by the composition of the material followed by the thickness.

SIGNIFICANCE

Exothermic temperature rise and DC are mainly material dependent. Higher DC values are associated with a significant increase in PT. LV RBCs, 4 mm bulk-fills and SFRCs exhibited higher PTs. Bulk-fills and SFRCs applied in 4 mm showed lower DCs at the bottom.

Effect of high-irradiance light curing on exposure times and pulpal temperature of adequately polymerized composite

This study investigated the effect of high-irradiance light-curing on exposure time and pulpal temperature of adequately-cured composite. Composite placed in a molar preparation was cured using high-irradiance light-curing units (Flashmax P3, Valo, S.P.E.C. 3 LED, Cybird XD) and tested for hardness occlusal-gingivally. The first group had exposure times set according to manufacturer settings (recommended), second group to yield 80% of maximum hardness at the 2 mm depth (experimental), and third group was set at 20 s (extended). Exposure time necessary to adequately polymerize the composite at 2 mm depth was 9 s for the Cybird XD and Valo and 12 s for S.P.E.C. 3 LED and Flashmax P3. None of the high-irradiance light-curing units adequately polymerized the composite at the manufacturer-recommended minimum-exposure times of 1-3 s. Exposure times necessary to adequately polymerize composite at 2 mm resulted in a maximum pulpal-temperature increase well below the temperature associated with possible pulpal necrosis.

Pulp chamber temperature variation evaluation using fiber Bragg grating sensor

The present in vitro study proposes a novel (to the best of our knowledge) methodology employing a fiber Bragg grating sensor for the evaluation of pulp chamber temperature increase during the polymerization of the composite resin induced by the light-curing process. A fiber Bragg grating temperature sensor (FBGTS) has been developed in view of its ease of insertion into the pulp chamber with minimal widening of the pulpal canal. The temperature increase in the pulpal chamber during the polymerization of the composite resin by light curing has been characterized with varying depths of cavities of 1 mm, 1.5 mm, and 2 mm employing FBGTS. Also, the increase in temperature of the pulpal chamber during the polymerization of the composite resin has been studied with variants of the light-curing device. The obtained results are expected to be an indicator towards the potential hazard caused by heat induced pulpal injuries during the polymerization of composite resins using a light-curing device.

In Vitro Infrared Thermographic Assessment of Temperature Change in the Pulp Chamber during Provisionalization: Effect of Remaining Dentin Thickness

Interim crowns and partial fixed dental prosthesis materials generate exothermic heat during polymerization. The amount of heat transmitted to the pulp chamber can be a function of several factors, including the thickness and quality of the remaining dentin after crown preparation. The aim of this in vitro study was to measure with infrared thermography the temperature changes on the adjacent surface of the chamber roof of premolar teeth extracted from young and old patients (having different thicknesses of remaining dentin after crown preparation) during fabrication of provisional resinous restorations. Twenty extracted human first and second maxillary premolar teeth (10 from young patients, with a relatively large pulp chamber, and 10 from older patients, with a relatively small pulp chamber) were used. The roots were sectioned to expose the inner side of the chamber roof, and the crowns were provisionalized after preparation for a metal-ceramic crown. Two provisional materials, Turbo Temp 2 and Luxatemp Fluorescence, were used. Temperature changes on the inner side of the chamber roof were measured at 2-second intervals using an infrared thermal imaging camera. After completion of the temperature recordings, the teeth were sectioned and the remaining dentin thickness was determined. The older group (mean thickness: 2.82 mm) and younger group (mean thickness: 1.9 mm) differed significantly in dentin thickness (P < 0.014). The mean greatest temperature increases recorded on the chamber roof of teeth with less remaining dentin were 4.07°C for Turbo Temp 2 and 3.94°C for Luxatemp Fluorescence, while increases in the premolars with greater dentin thickness were 1.69°C for Turbo Temp 2 and 1.64°C for Luxatemp Fluorescence. Significant interactions were found between tooth groups (P < 0.000001for Turbo Temp 2 and for Luxatemp Fluorescence). No significant differences were found between assessed materials regardless of the thickness of the remaining dentin (P > 0.38for the older group and P > 0.29 for the younger group). Dentin had a significant effect in limiting the temperature increase generated during polymerization of provisional materials, indicating good thermal insulating properties of this tissue. A remaining dentin thickness of 1.9 mm or more is sufficient to protect the pulp from any temperature increase during provisionalization using tested materials.

Temperatures in the pulpal cavity during orthodontic bonding using an LED light curing unit : An in vitro pilot study

PURPOSE

During bracket bonding, patients often report about thermosensitivity. The reason could be that modern light emitting diode (LED) light curing units run with intensities up to 3200 mW/cm². In this in vitro pilot study with nonpulpal circulation approaches, the temperatures in the pulpal cavity were measured.

METHODS

The study included 60 extracted teeth divided into four equal groups: lower and upper incisors, premolars and molars. Starting at 37 °C (body temperature) as the reference, the temperature increase was measured for the first series on each tooth without a bracket, without and with a recommended hygienic barrier case for the LED light curing unit, and exposition to light once versus twice. The distance between the tooth and light curing unit was 3 mm. In the second test series, a metal bracket was also bonded to each tooth. In the third series, the light exposition distance was increased to 4 mm.

RESULTS

In all three test series, significant intrapulpal temperature increase was found: The highest temperatures were recorded after exposure to light once without the hygienic barrier case. In the first test series, this approach showed temperatures even higher than 42.5 °C in the lower incisors (average 42.99 ± 2.23 °C) and premolars (average 42.94 ± 2.15 °C).

CONCLUSIONS

Significant increases in the temperature of the pulpal cavity (up to 42.5 °C) may occur during bonding brackets according to the manufacturer's recommendation with an LED light curing unit with in vitro nonpulpal circulation approaches. Therefore it could be reasonable to critically question the recommendation of the manufacturer.

Effect of different composite modulation protocols on the conversion and polymerization stress profile of bulk-filled resin restorations

OBJECTIVE

The aim of this in vitro study was to test the effect of different composite modulation protocols (pre-heating, light-curing time and oligomer addition) for bulk filling techniques on resin polymerization stress, intra-pulpal temperature change and degree of conversion.

METHODS

Class I cavities (4mm depth×5mm diameter) were prepared in 48 extracted third molars and divided in 6 groups. Restorations were completed with a single increment, according to the following groups: (1) Filtek Z250XT (room temperature - activated for 20s); (2) Filtek Z250XT (at room temperature - activated for 40s); (3) Filtek Z250XT (pre-heated at 68°C - activated for 20s); (4) Filtek Z250XT (pre-heated at 68°C - activated for 40s); (5) Filtek BulkFill (at room temperature - activated for 20s); (6) Filtek Z250XT (modified by the addition of a thio-urethane oligomer at room temperature - activated for 40s). Acoustic emission test was used as a real-time polymerization stress (PS) assessment. The intra-pulpal temperature change was recorded with a thermocouple and bottom/top degree of conversion (DC) measured by Raman spectroscopy. Data were analyzed with one-way ANOVA/Tukey's test (α=5%).

RESULTS

Pre-heating the resin composite did not influence the intra-pulpal temperature (p=0.077). The thio-urethane-containing composite exhibited significantly less PS, due to a lower number of acoustic events. Groups with pre-heated composites did not result in significantly different PS. Filtek BulkFill and the thio-urethane experimental composite presented significantly higher DC.

SIGNIFICANCE

Resin composite pre-heating was not able to reduce polymerization stress in direct restorations. However, thio-urethane addition to a resin composite could reduce the polymerization stress while improving the DC.

Influence of Bulk-Fill Composites, Polimerization Modes, and Remaining Dentin Thickness on Intrapulpal Temperature Rise

Objectives

The aim of this study was to compare the effects of different bulk-fill resin composites, polimerization modes, and the thickness of remaining dentin on the increase of intrapulpal temperature.

Methods

Human-extracted upper premolar teeth (n = 10) were used to design a single-tooth model with remaining dentin thicknesses of 1 mm and 0.5 mm. Estelite Bulk-fill Flow (Tokuyama, Japan), Surefil SDR™ Flow (Dentsply Caulk, Brazil), Filtek Bulk-Fill Posterior (3M, USA), and SonicFill™ 2 Bulk-fill (Kerr, USA) composites were applied according to the manufacturer's instructions. The standard and high modes of a light emitted diode (LED) light curing unit (LCU) (VALO™ Utradent, USA), were used for polymerization. In order to mimic the in vivo conditions of pulpal circulation, digital flowmetry (SK-600II, SK Medical, China) was used. Intrapulpal temperature rise was measured using K type thermocoupling (CEM DT 610B, Robosem Engineering, China). Data were analyzed using three-way variance analysis (ANOVA) and the independent t-test.

Results

No significant statistical differences in intrapulpal temperature rise between low viscosity bulk-fill composites (SDR and Estelite) were found. The lowest intrapulpal temperature rise was found in groups which used the Filtek Bulk-fill composite. Decreases in the remaining dentin thickness increased the intrapulpal temperature rise.

Significance

This study demonstrated that remaining dentin thickness, filler ratio of bulk-fill composites, and power and application time of the LED-LCU may affect intrapulpal temperature rise.

Temperature change in pulp chamber of primary teeth during curing of coloured compomers: an in vitro study using pulpal blood microcirculation model

Introduction

An increase in the temperature of the pulp chamber occurs during polymerisation of all types of light-curing resin-containing restorative materials, due to both the exothermic reaction of the material and the energy absorbed during the curing process. Increase in temperature of the pulp chamber of primary teeth during the curing process or the thermal conductivity properties of coloured compomers (CCs) have not yet been investigated in detail. The aim of the present study was to investigate the increase in pulpal temperature in primary teeth during curing of CCs.

Materials and Methods

A Class-II cavity was prepared on the extracted primary mandibular second molar. Pulpal microcirculation of the tooth was performed using an experimental mechanism. The study included 15 groups and 10 experiments in each. Seven different CCs: pink, blue, gold, silver, orange, lemon, green, respectively from two different manufacturers (Groups 1–7: Twinky Star; VOCO, Cuxhaven, Germany. Groups 8–14: Nova Rainbow; IMICRYL, Konya, Turkey.) and a tooth-CC (Group 15: Dyract XP; DENTSPLY, Weybridge, UK.) were applied in prepared cavity. In all groups the compomers were light cured for 40 s. Intrapulpal temperature changes (Δt) in 20th and 40th second were recorded. In Group-15 the Δt values in 10th second were also recorded as per the manufacturer’s instructions. The Kruskal–Wallis test and the Mann–Whitney-U test were used for statistical analyses.

Results

At the end of 40-s irradiation time, the orange, lemon and green colours of Nova Rainbow resulted in significantly lower Δt values than the same colours of Twinky Star (p = 0.0001), and silver, blue, lemon, green, orange, and pink CCs of Nova Rainbow and the blue and silver shades of Twinky Star demonstrated lower Δt values than the reported critical temperature increase (5.5 °C).

Conclusion

An increase in the irradiation time consequently led to an increase in the intrapulpal temperature. Therefore, manufacturers should focus on production of new CCs with shorter polimerization time.

Comparison of in vivo and in vitro models to evaluate pulp temperature rise during exposure to a Polywave® LED light curing unit

OBJECTIVES

To measure and compare in vivo and in vitro pulp temperature (PT) increase (ΔTEMP) over baseline, physiologic temperature using the same intact upper premolars exposed to the same Polywave® LED curing light.

METHODOLOGY

After local Ethics Committee approval (#255,945), local anesthesia, rubber dam isolation, small occlusal preparations/minute pulp exposure (n=15) were performed in teeth requiring extraction for orthodontic reasons. A sterile probe of a temperature measurement system (Temperature Data Acquisition, Physitemp) was placed within the pulp chamber and the buccal surface was sequentially exposed to a LED LCU (Bluephase 20i, Ivoclar Vivadent) using the following exposure modes: 10-s low or high, 5-s Turbo, and 60-s high. Afterwards, the teeth were extracted and K-type thermocouples were placed within the pulp chamber through the original access. The teeth were attached to an assembly simulating the in vivo environment, being similarly exposed while real-time temperature (°C) was recorded. ΔTEMP values and time for temperature to reach maximum (ΔTIME) were subjected to two-way ANOVA and Bonferroni's post-hoc tests (pre-set alpha 0.05).

RESULTS

Higher ΔTEMP was observed in vitro than in vivo. No significant difference in ΔTIME was observed between test conditions. A significant, positive relationship was observed between radiant exposure and ΔTEMP for both conditions (in vivo: r2=0.917; p<0.001; in vitro: r2=0.919; p<0.001).

CONCLUSION

Although the in vitro model overestimated in vivo PT increase, in vitro PT rise was close to in vivo values for clinically relevant exposure modes.

Controlling In Vivo, Human Pulp Temperature Rise Caused by LED Curing Light Exposure

Objective:

The objective of this study was to evaluate the in vivo effectiveness of air spray to reduce pulp temperature rise during exposure of intact premolars to light emitted by a high-power LED light-curing unit (LCU).

Methods and Materials:

After local Ethics Committee approval (#255945), intact, upper first premolars requiring extraction for orthodontic reasons from five volunteers received infiltrative and intraligamental anesthesia. The teeth (n=9) were isolated using rubber dam, and a minute pulp exposure was attained. The sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted directly into the coronal pulp chamber. Real-time pulp temperature (PT) (°C) was continuously monitored, while the buccal surface was exposed to a polywave LED LCU (Bluephase 20i, Ivoclar Vivadent) for 30 seconds with simultaneous application of a lingually directed air spray (30s-H/AIR) or without (30s-H), with a seven-minute span between each exposure. Peak PT values were subjected to one-way, repeated-measures analysis of variance, and PT change from baseline (ΔT) during exposure was subjected to paired Student's t-test (α=0.05).

Results:

Peak PT values of the 30s-H group were significantly higher than those of 30s-H/AIR group and those from baseline temperature (p&lt;0.001), whereas peak PT values in the 30s-H/AIR group were significantly lower than the baseline temperature (p=0.003). The 30s-H/AIR group showed significantly lower ΔT values than did the 30s-H group (p&lt;0.001).

Conclusion:

Applying air flow simultaneously with LED exposure prevents in vivo pulp temperature rise.

Effect of Simulated Pulpal Microcirculation on Temperature When Light Curing Bulk Fill Composites

Objectives:

To evaluate the effect of light curing bulk fill resin composite restorations on the increase in the temperature of the pulp chamber both with and without a simulated pulpal fluid flow.

Methods and Materials:

Forty extracted human molars received a flat occlusal cavity, leaving approximately 2 mm of dentin over the pulp. The teeth were restored using a self-etch adhesive system (Clearfil SE Bond, Kuraray) and two different bulk fill resin composites: a flowable (SDR, Dentsply) and a regular paste (AURA, SDI) bulk fill. The adhesive was light cured for 20 seconds, SDR was light cured for 20 seconds, and AURA was light cured for 40 seconds using the Bluephase G2 (Ivoclar Vivadent) or the VALO Cordless (Ultradent) in the standard output power mode. The degree of conversion (DC) at the top and bottom of the bulk fill resin composite was assessed using Fourier-Transform Infra Red spectroscopy. The temperature in the pulp chamber when light curing the adhesive system and resin composite was measured using a J-type thermocouple both with and without the presence of a simulated microcirculation of 1.0-1.4 mL/min. Data were analyzed using Student t-tests and two-way and three-way analyses of variance (α=0.05 significance level).

Results:

The irradiance delivered by the light-curing units (LCUs) was greatest close to the top sensor of the MARC resin calibrator (BlueLight Analytics) and lowest after passing through the 4.0 mm of resin composite plus 2.0 mm of dentin. In general, the Bluephase G2 delivered a higher irradiance than did the VALO Cordless. The resin composite, LCU, and region all influenced the degree of cure. The simulated pulpal microcirculation significantly reduced the temperature increase. The greatest temperature rise occurred when the adhesive system was light cured. The Bluephase G2 produced a rise of 6°C, and the VALO Cordless produced a lower temperature change (4°C) when light curing the adhesive system for 20 seconds without pulpal microcirculation. Light curing SDR produced the greatest exothermic reaction.

Conclusions:

Using simulated pulpal microcirculation resulted in lower temperature increases. The flowable composite (SDR) allowed more light transmission and had a higher degree of conversion than did the regular paste (AURA). The greatest temperature rise occurred when light curing the adhesive system alone.

Influence of Class V preparation on in vivo temperature rise in anesthetized human pulp during exposure to a Polywave® LED light curing unit

OBJECTIVE

This in vivo study evaluated pulp temperature (PT) rise in human premolars having deep Class V preparations during exposure to a light curing unit (LCU) using selected exposure modes (EMs).

METHODS

After local Ethics Committee approval, intact first premolars (n=8) requiring extraction for orthodontic reasons, from 8 volunteers, received infiltrative and intraligamental anesthesia and were isolated using rubber dam. A minute pulp exposure was attained and sterile probe from a wireless, NIST-traceable, temperature acquisition system was inserted into the coronal pulp chamber to continuously monitor PT (°C). A deep buccal Class V preparation was prepared using a high speed diamond bur under air-water spray cooling. The surface was exposed to a Polywave^® LED LCU (Bluephase 20i, Ivoclar Vivadent) using selected EMs, allowing 7-min span between each exposure: 10-s in low (10-s/L), 10-s (10-s/H), 30-s (30-s/H), or 60-s (60-s/H) in high mode; and 5-s-Turbo (5-s/T). Peak PT values and PT increases over physiologic baseline levels (ΔT) were subjected to 1-way, repeated measures ANOVAs, and Bonferroni's post-hoc tests (α=0.05). Linear regression analysis was performed to establish the relationship between applied radiant exposure and ΔT.

RESULTS

All EMs produced higher peak PT than the baseline temperature (p<0.001). Only 60-s/H mode generated an average ΔT of 5.5°C (p<0.001). A significant, positive relationship was noted between applied radiant exposure and ΔT (r²=0.8962; p<0.001).

SIGNIFICANCE

In vivo exposure of deep Class V preparation to Polywave^® LED LCU increases PT to values considered safe for the pulp, for most EMs. Only the longest evaluated EM caused higher PT increase than the critical ΔT, thought to be associated with pulpal necrosis.

Light curing in dentistry and clinical implications: a literature review

Contemporary dentistry literally cannot be performed without use of resin-based restorative materials. With the success of bonding resin materials to tooth structures, an even wider scope of clinical applications has arisen for these lines of products. Understanding of the basic events occurring in any dental polymerization mechanism, regardless of the mode of activating the process, will allow clinicians to both better appreciate the tremendous improvements that have been made over the years, and will also provide valuable information on differences among strategies manufacturers use to optimize product performance, as well as factors under the control of the clinician, whereby they can influence the long-term outcome of their restorative procedures.

Intrapulpal Thermal Changes during Setting Reaction of Glass Carbomer® Using Thermocure Lamp

Objectives. To measure the temperature increase induced during thermocure lamp setting reaction of glass carbomer and to compare it with those induced by visible light curing of a resin-modified glass ionomer and a polyacid-modified composite resin in primary and permanent teeth. Materials and Methods. Nonretentive class I cavities were prepared in extracted primary and permanent molars. Glass carbomer (GC) was placed in the cavity and set at 60°C for 60 sn using a special thermocure lamp. Resin-modified glass ionomer (RMGIC) and polyacid-modified composite resin (PMCR) were placed in the cavities and polymerized with an LED curing unit. Temperature increases during setting reactions were measured with a J-type thermocouple wire connected to a data logger. Data were examined using two-way analysis of variance and Tukey's honestly significant difference tests. Results. The use of GC resulted in temperature changes of 5.17 ± 0.92°C and 5.32 ± 0.90°C in primary and permanent teeth, respectively (p > 0.05). Temperature increases were greatest in the GC group, differing significantly from those in the PMCR group (p < 0.05). Conclusion. Temperature increases during polymerization and setting reactions of the materials were below the critical value in all groups. No difference was observed between primary and permanent teeth, regardless of the material used.

Pulp Chamber Heating: An In Vitro Study Evaluating Different Light Sources and Resin Composite Layers

Abstract The aim of the present in vitro study was to evaluate the temperature variation inside the pulp chamber during light-activation of the adhesive and resin composite layers with different light sources. Cavities measuring 8x10 mm were prepared on the buccal surface of bovine incisors, leaving a remaining dentin thickness of 1 mm. Specimens were placed in a 37±1 °C water bath to standardize the temperature. The temperature in the pulp chamber was measured every 10 s during 40 s of light activation of the adhesive system (SBMP-3M/ESPE) and in the three consecutive 1-mm-thick layers of resin composite (Z250-3M/ESPE). Three light source devices were evaluated: Elipar 2500 (QTH), LD Max (LED low irradiance) and VALO (LED high irradiance). The results were submitted to one-way ANOVA with repeated measures and Tukey's test, both with p<0.001. The exothermic reaction warming was observed in the Z250 increments, but not in the SBMP. The high irradiance LED showed a higher temperature average (42.7±1.56 °C), followed by the quartz-tungsten-halogen light (40.6±0.67 °C) and the lower irradiance LED (37.8±0.12 °C). Higher temperature increases were observed with the adhesive and the first resin composite increment light-activation, regardless of the employed light source. From the second increment of Z250, the restorative material acted as a dispersive structure of heat, reducing temperature increases. Regardless the light source and restorative step, the temperature increased with the irradiation time. It may be concluded that the light source, irradiation time and resin composite thickness interfered in the temperature variation inside the pulp chamber.

Light-curing units used in dentistry: factors associated with heat development-potential risk for patients

Objectives

To investigate how heat development in the pulp chamber and coronal surface of natural teeth with and without cusps subjected to irradiance using light-emitting diode (LED)–light-curing units (LCUs) is associated with (i) irradiance, (ii) time, (iii) distance, and (iv) radiant exposure.

Materials and methods

Three different LED-LCUs were used. Their irradiance was measured with a calibrated spectrometer (BlueLight Analytics Inc., Halifax, Canada). An experimental rig was constructed to control the thermal environment of the teeth. The LED-LCU tip position was accurately controlled by a gantry system. Tooth surface temperature was measured by thermography (ThermaCAM S65 HS, FLIR Systems, Wilsonville, USA) and pulp chamber temperature with a thermocouple. LED-LCU tip distance and irradiation times tested were 0, 2, and 4 mm and 10, 20, and 30 s, respectively. Ethical permission was not required for the use of extracted teeth.

Results

Maximum surface and pulp chamber temperatures were recorded in tooth without cusps (58.1 °C  ± 0.9 °C and 43.1 °C ± 0.9 °C, respectively). Radiant exposure explained the largest amount of variance in temperature, being more affected by time than irradiance.

Conclusions

At all combinations of variables tested, repeated measurements produced consistent results indicating the reliability of the method used. Increased exposure time seems to be the factor most likely to cause tissue damage.

Clinical relevance

Risk of superficial tissue damage at irradiances >1200 mW/cm² is evident. There is a risk of pulp damage when only thin dentin is left at higher irradiances (>1200 mW/cm²). Clinicians should be aware of LED-LCU settings and possible high temperature generated.

Effect of new innovative restorative carbomised glass cement on intrapulpal temperature rise: an ex-vivo study

This study aimed to evaluate the temperature changes that occurred in the pulp chamber when using GCP Glass Carbomer Fill (GCP) and two different resin-modified glass-ionomer (RGI) restorative materials at different dentin thicknesses. A standardized Class I occlusal cavity with 1 mm or 2 mm dentin thickness was prepared in the extracted human molar teeth. RGI and GCP fills were placed in the cavities and cured with two different light-curing units. This study included a total of 120 samples, with 20 samples in each group. The pulp microcirculation method was used for measuring the intrapulpal temperature changes. Statistical analysis was performed using the two-way ANOVA and Tukey HSD multiple comparison tests. Statistically significant differences were observed between 1 mm and 2 mm dentin thicknesses (p < 0.001). The GCP groups (both 1 mm and 2 mm dentin thicknesses) exhibited higher temperatures than the other groups (p < 0.001), and Fuji II LC and Photac Fil Quick Aplicap showed similar values (p > 0.05). The highest temperature changes were observed with 1 mm dentin thickness. While RGI materials in both dentin thicknesses did not cause temperature changes that were harmful to the pulp, GCP CarboLED LCU caused the highest intrapulpal temperature rise, and these values were borderline harmful to the dental pulp.

Influence of Cavity Preparation, Light-curing Units, and Composite Filling on Intrapulpal Temperature Increase in an In Vitro Tooth Model

This study examined the effect of both the tooth substance and restorative filling materials on the increase in pulp chamber temperature when using light-curing units with different power densities.

The tip of a temperature sensor was positioned on the pulpal dentinal wall of the buccal side of a maxillary premolar. Metal tubes were inserted in the palatal and buccal root of the tooth, one for water inflow and the other for water outflow. Polyethylene tubes were connected from the metal tubes to a pump to control the flow rate. For the unprepared tooth group (group 1), the tooth was light-cured from the buccal side using two light-curing units (three curing modes): the VIP Junior (QTH, BISCO, Schaumburg, IL, USA) and the Bluephase LED light-curing units (two modes: LEDlow and LEDhigh; Ivoclar Vivadent, Schaan, Liechtenstein). The power densities of each light-curing unit for the LEDlow, QTH, and LEDhigh modes were 785 mW/cm2, 891 mW/cm2, and 1447 mW/cm2, respectively. All light-curing units were activated for 60 seconds. For the prepared tooth group (group 2), a Class V cavity, 4.0 mm in width by 4.0 mm in height by 1.8 mm in depth in size, was prepared on the buccal surface of the same tooth for the temperature measurement. The light-curing and temperature measurements were performed using the same methods used in group 1.

The cavity prepared in group 2 was filled with a resin composite (Tetric N Ceram A3 shade, Ivoclar Vivadent) (group 3) or a flowable composite (Tetric N Flow with A3 shade, Ivoclar Vivadent) (group 4). The light-curing and temperature measurements were performed for these groups using the same methods used for the other groups.

The highest intrapulpal temperature (TMAX) was measured, and a comparison was conducted between the groups using two-way analysis of variance with a post hoc Tukey test at the 95% confidence level.

The TMAX values were as follows: 38.4°C (group 1), 39.0°C (group 2), 39.8°C (group 3), and 40.3°C (group 4) for the LEDlow mode. For the QTH mode, the TMAX values were 40.1°C (group 1), 40.4°C (group 2), 40.9°C (group 3), and 41.4°C (group 4). For the LEDhigh mode, the TMAX values were 43.3°C (group 1), 44.5°C (group 2), 44.7°C (group 3), and 45.3°C (group 4). The statistical analysis revealed the following: the TMAX values were arranged by mode in the following manner: LEDlow &lt; QTH &lt; LEDhigh (p&lt;0.05) and group 1 &lt; group 2 ≤ group 3 ≤ group 4 (p&lt;0.05).

Evaluation of shear bond strength of orthodontic brackets using trans-illumination technique with different curing profiles of LED light-curing unit in posterior teeth

Background

Although using light-cured composites for bonding orthodontic brackets has become increasingly popular, curing light cannot penetrate the metallic bulk of brackets and polymerization of composites is limited to the edges. Limited access and poor direct sight may be a problem in the posterior teeth. Meanwhile, effectiveness of the trans-illumination technique is questionable due to increased bucco-lingual thickness of the posterior teeth. Light-emitting diode (LED) light-curing units cause less temperature rise and lower risk to the pulpal tissue. The purpose of this study was to evaluate the clinical effectiveness of trans-illumination technique in bonding metallic brackets to premolars, using different light intensities and curing times of an LED light-curing unit.

Methods

Sixty premolars were randomly divided into six groups. Bonding of brackets was done with 40- and 80-s light curing from the buccal or lingual aspect with different intensities. Shear bond strengths of brackets were measured using a universal testing machine. Data were analyzed by one-way analysis of variance test and Duncan's post hoc test.

Results

The highest shear bond belonged to group 2 (high intensity, 40 s, buccal) and the lowest belonged to group 3 (low intensity, 40 s, lingual). Bond strength means in control groups were significantly higher than those in experimental groups.

Conclusions

In all experimental groups except group 6 (80 s, high intensity, lingual), shear bond strength was below the clinically accepted values. In clinical limitations where light curing from the same side of the bracket is not possible, doubling the curing time and increasing the light intensity during trans-illumination are recommended for achieving acceptable bond strengths.

Temperature Rise during Primer, Adhesive, and Composite Resin Photopolymerization of a Low-Shrinkage Composite Resin under Caries-Like Dentin Lesions

Objective. This study evaluated temperature rise of low-shrinkage (LS) self-etch primer (P), LS self-etch adhesive (A), and P90 silorane-based composite resin systems, photopolymerized under normal and artificially demineralized dentin. Methods. Forty 1.5 mm-thick dentin discs were prepared from sound human molars, half of which were demineralized. Temperature rise was measured during photopolymerization using a K-type thermocouple under the discs: 10 s and 40 s irradiation of the discs (controls/groups 1 and 2); 10 s irradiation of primer (P), 10 s irradiation of adhesive (A), 40 s irradiation of P90 without P and A, and 40 s irradiation of P90 with P and A (groups 3 to 6, resp.). The samples were photopolymerized using an LED unit under 550 mW/cm² light intensity. Data was analyzed using repeated measures ANOVA and paired-sample t-test (α = 0.05). Results. There were no significant differences in temperature rise means between the two dentin samples for each irradiation duration (P > 0.0001), with significant differences between the two irradiation durations (P > 0.0001). Temperature rise measured with 40 s irradiation was significantly higher than that of 10 s duration for undemineralized and demineralized dentin P < 0.0001). Conclusions. Light polymerization of P90 low-shrinkage composite resin resulted in temperature rise approaching threshold value under artificially demineralized and undemineralized dentin.

Thermal irritation of teeth during dental treatment procedures

While it is reasonably well known that certain dental procedures increase the temperature of the tooth's surface, of greater interest is their potential damaging effect on the pulp and tooth-supporting tissues. Previous studies have investigated the responses of the pulp, periodontal ligament, and alveolar bone to thermal irritation and the temperature at which thermal damage is initiated. There are also many in vitro studies that have measured the temperature increase of the pulp and tooth-supporting tissues during restorative and endodontic procedures. This review article provides an overview of studies measuring temperature increases in tooth structures during several restorative and endodontic procedures, and proposes clinical guidelines for reducing potential thermal hazards to the pulp and supporting tissues.

Characterization of heat emission of light-curing units

OBJECTIVES

This study was designed to analyze the heat emissions produced by light-curing units (LCUs) of different intensities during their operation. The null hypothesis was that the tested LCUs would show no differences in their temperature rises.

METHODS

FIVE COMMERCIALLY AVAILABLE LCUS WERE TESTED: a "Flipo" plasma arc, "Cromalux 100" quartz-tungsten-halogen, "L.E. Demetron 1" second-generation light-emitting diode (LED), and "Blue Phase C5" and "UltraLume 5" third-generation LED LCUs. The intensity of each LCU was measured with two radiometers. The temperature rise due to illumination was registered with a type-K thermocouple, which was connected to a computer-based data acquisition system. Temperature changes were recorded in continues 10 and 20 s intervals up to 300 s.

RESULTS

The Flipo (ARC) light source revealed the highest mean heat emission while the L.E. Demetron 1 LED showing the lowest mean value at 10 and 20 s exposure times. Moreover, Cromalux (QTH) recorded the second highest value for all intervals (12.71, 14.63, 14.60) of heat emission than Blue Phase C5 (LED) (12.25, 13.87, 13.69), interestingly at 20 s illumination for all intervals the highest results (18.15, 19.27, 20.31) were also recorded with Flipo (PAC) LCU, and the lowest (6.71, 5.97, 5.55) with L.E. Demetron 1 LED, while Blue Phase C5 (LED) recorded the second highest value at the 1st and 2nd 20 s intervals (14.12, 11.84, 10.18) of heat emission than Cromalux (QTH) (12.26, 11.43, 10.26). The speed of temperature or heat rise during the 10 and 20 s depends on light intensity of emitted light. However, the QTH LCU was investigated resulted in a higher temperature rise than LED curing units of the same power density.

CONCLUSION

The PAC curing unit induced a significantly higher heat emission and temperature increase in all periods, and data were statistically different than the other tested groups (p < .05). LED (Blue Phase C5) was not statistically significant (p < .05) (at 10 s) than QTH units, also LED (Blue Phase C5, UltraLume 5) generates obvious heat emission and temperature rises than QTH units (at 20 s) except for those which have lower power density of LED curing units (first generation). Thus, the null hypothesis was rejected.

Parameters influencing increase in pulp chamber temperature with light-curing devices: curing lights and pulpal flow rates

This laboratory study examined the effects of curing lights with different light intensities and changing flow rate on the increase in pulpal temperature during the light curing process and the rate of the subsequent decrease in temperature after the termination of light curing. The tip of a temperature sensor was positioned on the pulpal dentinal wall of the buccal side of the maxillary premolar. Metal tubes were inserted in the palatal and buccal root of the tooth, one for water inflow and the other for water outflow. The tubes were connected to a pump to control the flow rate. The water flow rate was set to 4.2 microl/minute, 28 microl/minute or 70 microl/minute. At each flow rate, the unprepared tooth was light cured from the buccal side 1 mm from the buccalsurface, using four different curing lights. The temperature data were recorded and stored on a computer every second for three minutes. The curing lights that were used were: Astralis 10 (QTH(high), Ivoclar Vivadent), Bluephase 16i (LED(conv), Ivoclar Vivadent) and two experimental LED-curing lights (LED(exp2000), LED(exp3000), Ivoclar Vivadent). The power densities were 1200 mW/cm2, 1600 mW/cm2, 2000 mW/cm2 and 3000 mW/cm2, respectively. The curing lights, LED(conv), LED(exp2000) and LED(exp3000) were activated for 60 seconds, and the QTH(high) was activated for 30 sec- onds. The maximum intrapulpal temperature (TM) and rate of temperature change at 30 seconds after turning off the light (S(30LO)) were analyzed by two-way ANOVA with a post-hoc Tukey test (p < 0.05). The influencing factors were the flow rates and curing lights.

RESULTS

The T(MAX) ranged from 41.0 degrees C to 53.5 degrees C. There was a difference between the curing lights (p < 0.05), with LED(exp3000) > LED(exp2000) > LED(conv) > QTH(high). There was no difference in T(MAX) between the different flow rates (p > 0.05). Both the curing lights and flow rates affected the SE(30LO) (p < 0.05). The S(30LO) was LED(exp3000) < LED(exp2000) > LEDon, , QTH(high) (p < 0.05). The S(30LO) at 70 microl/minutes was higher than at 4.2 pd/minutes and 28 microl/minutes (p < 0.05).

CLINICAL IMPLICATION

Because the increase in temperature is directly related to the light intensity and exposure time, curing devices with high power density (> 1200 mW/cm2) should only be activated for a short period of time (< 15 seconds) even in teeth without cavity preparation. The flow rate had only a negligible effect on the temperature increase.

Pulpal-temperature Rise and Polymerization Efficiency of LED Curing Lights

This paper provides practitioners with useful information on the importance of aligning the spectra of the LCU and the material in terms of polymerization efficiency and temperature rise in the pulp chamber.

Influence of the degree of dentine mineralization on pulp chamber temperature increase during resin-based composite (RBC) light-activation

OBJECTIVES

To analyse the influence of the degree of dentine mineralization on the pulp chamber temperature increase during composite light-activation.

METHODS

Dentine discs (2mm thick) obtained from recently extracted teeth or those with extensive dentine sclerosis were analysed by FT-IR spectrometry in order to choose the two discs with the greatest difference in the degree of mineralization. A model tooth was set up with the dentine discs between a molar with the pulp chamber exposed and a crown with a standardized class II cavity. A K-type thermocouple was introduced into the molar root until it came into contact with the dentine discs and the cavity was filled with P60 resin composite. The temperature rise was measured for 120s after light-activation began: Standard (S) 600 mW/cm(2)/40s; Ramp (R) 0-->800 mW/cm(2)/10s+800 mW/cm(2)/10s; Boost (B) 85 0mW/cm(2)/10s and LED (L) 1.300 mW/cm(2)/40s (n=10). The same protocol was repeated after grinding the dentine discs to 1.0 and 0.5mm thickness.

RESULTS

The temperature increase was significantly higher in dentine with high degree of mineralization (p<0.05). With respect to the dentine thickness, the following result was found: 2mm<1mm<0.5mm (p<0.05). The light-activation mode also presented significant difference as follows: S>R=L>B (p<0.05).

CONCLUSIONS

The higher the degree of dentine mineralization the greater the increase in pulp chamber temperature. The temperature increase was influenced by the light-polymerization mode and dentine thickness.

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.