Comparison of temperature rise in the pulp chamber with different light curing units: An in-vitro study

Temperature Changes in the Pulp Chamber During Orthodontic Bonding Using a High-Power Light-Emitting Diode Device With Two Different Exposure Times and Intensities: An In-Vitro Study

OBJECTIVE

This study used a high-power light-emitting diode (LED) device to evaluate the effects of two exposure times and intensities on pulp chamber temperature and cooling time during bracket bonding.

MATERIALS AND METHODS

Sixty upper premolars were used in the sample in this study. These premolars were split into two main groups based on the exposure time and intensity: the first group employed a traditional curing mode (TCG) for 20 seconds with an intensity of 1200 mw/cm2, whereas the second group had a quick curing mode (QCG) for 3 seconds with an intensity of 2500 mw/cm2. The pulp chamber's temperature variations and cooling times were recorded using a thermal imaging camera. The Mann-Whitney U test was used to find differences between the two-group comparison of the pulp chamber's temperature and cooling time.

RESULTS

The two groups had statistically significant differences regarding the temperature increase in the pulp chamber and cooling time (p > 0.001). The mean temperature increase in the traditional curing group was 3.52°C, which is greater than that in the quick curing group (i.e., a mean value of 1.28°C). The mean cooling time in the traditional curing group was 38.83 seconds, which is greater than that in the quick curing group (9.97 seconds).

CONCLUSIONS

Reducing the exposure time to 3 seconds and increasing the intensity to 2500 mw/cm2 is considered safer for the pulp chamber during and after the curing process.

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 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.

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.

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.

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.

Comparison of the Amount of Temperature Rise in the Pulp Chamber of Teeth Treated With QTH, Second and Third Generation LED Light Curing Units: An In Vitro Study

Introduction: This in vitro study was designed to measure and compare the amount of temperature rise in the pulp chamber of the teeth exposed to different light curing units (LCU), which are being used for curing composite restorations. Methods: The study was performed in two settings; first, an in vitro and second was mimicking an in vivo situation. In the first setup of the study, three groups were formed according to the respective three light curing sources. i.e. quartz-tungsten-halogen (QTH) unit and two light-emitting diode (LED) units (second and third generations). In the in vitro setting, direct thermal emission from three light sources at 3 mm and 6 mm distances, was measured with a k-type thermocouple, and connected to a digital thermometer. For a simulation of an in vivo situation, 30 premolar teeth were used. Class I Occlusal cavity of all the teeth were prepared and they were restored with incremental curing of composite, after bonding agent application. While curing the bonding agent and composite in layers, the intrapulpal temperature rise was simultaneously measured with a k-type thermocouple. Results: The first setting of the study showed that the heat produced by irradiation with LCU was significantly less at 6 mm distance when compared to 3 mm distance. The second setting of the study showed that the rise of intrapulpal temperature was significantly less with third generation LED light cure units than with second generation LED and QTH light cure units. Conclusion: As the distance from the light source increases, less irradiation heat is produced. Third generation LED lights cause the least temperature change in the pulp chamber of single rooted teeth.

LED Curing Lights and Temperature Changes in Different Tooth Sites

Objectives. The aim of this in vitro study was to assess thermal changes on tooth tissues during light exposure using two different LED curing units. The hypothesis was that no temperature increase could be detected within the dental pulp during polymerization irrespective of the use of a composite resin or a light-curing unit. Methods. Caries-free human first molars were selected, pulp residues were removed after root resection, and four calibrated type-J thermocouples were positioned. Two LED lamps were tested; temperature measurements were made on intact teeth and on the same tooth during curing of composite restorations. The data was analyzed by one-way analysis of variance (ANOVA), Wilcoxon test, Kruskal-Wallis test, and Pearson's χ². After ANOVA, the Bonferroni multiple comparison test was performed. Results. Polymerization data analysis showed that in the pulp chamber temperature increase was higher than that without resin. Starlight PRO, in the same condition of Valo lamp, showed a lower temperature increase in pre- and intrapolymerization. A control group (without composite resin) was evaluated. Significance. Temperature increase during resin curing is a function of the rate of polymerization, due to the exothermic polymerization reaction, the energy from the light unit, and time of exposure.

Temperature rise during polymerization of different cavity liners and composite resins

OBJECTIVE

The purpose of this study was to evaluate the thermal insulating properties of different light curing cavity liners and composite resins during light emitting diode (LED) curing.

MATERIALS AND METHODS

Sixty-four dentin discs, 1 mm thick and 8 mm in diameter, were prepared. Specimens were divided into four groups. Calcium hydroxide (Ca[OH]2), resin-modified glass ionomer cement, flowable composite and adhesive systems were applied to dentin discs according to the manufacturers' instructions. The rise in temperature during polymerization with a LED curing unit (LCU) was measured using a K-type thermocouple connected to a data logger. Subsequently, all specimens were randomly divided into one of two groups. A silorane-based composite resin and a methacrylate-based composite resin were applied to the specimens. Temperature rise during polymerization of composite resins with LCU were then measured again. Data were analyzed using one-way ANOVA and post hoc Tukey analyses.

RESULTS

There were significant differences in temperature rise among the liners, adhesives, and composite resins (P < 0.05). Silorane-based composite resin exhibited significantly greater temperature rises than methacrylate-based resin (P < 0.05). The smallest temperature rises were observed in Ca(OH)2 specimens.

CONCLUSION

Thermal insulating properties of different restorative materials are important factors in pulp health. Bonding agents alone are not sufficient to protect pulp from thermal stimuli throughout curing.

Kinetics of pulpal temperature rise during light curing of 6 bonding agents from different generations, using light emitting diode and quartz-tungsten-halogen units: An in-vitro simulation

BACKGROUND

Application of bonding agents (BA) into deep cavities and light curing them might increase pulpal temperature and threaten its health. The purpose of this study was to evaluate temperature rise of pulp by light curing six BA using two different light curing units (LCU), through a dent in wall of 0.5 mm.

MATERIALS AND METHODS

This in vitro experiment was carried out on 96 slices of the same number of human third molars (6 BAs × 2 LCUs × 8 specimens in each group). There were 6 groups of BAs: N Bond, G-Bond, OptiBond XTR, Clearfil SE, Adper Single Bond 2 and V Bond. Each group of BA (n = 16) had two subgroups of light emitting diode (LED) and quartz-tungsten-halogen light cure units (n = 8). Each of these 16 specimens were subjected to light emitting for 20 s, once without any BAs (control) and later when a BA was applied to surface of disk. Temperature rises in 140 s were evaluated. Their mean temperature change in first 20 s were calculated and analyzed using two-way repeated-measures and one-way analysis of variance (ANOVA) and Tukey (α = 0.05). Furthermore rate of temperature increase was calculated for each material and LCU.

RESULTS

Minimum and maximum temperature rises in all subgroups were 1.7 and 2.8°C, respectively. Repeated measures ANOVA showed that both of adhesive and LCU types had significant effect on temperature rise after application of adhesives. Tukey post-hoc analysis showed Clearfil SE showed significantly higher temperature rise in comparison with Adper Single bond 2 (P = 0.047) and N Bond (P = 0.038). Temperature rose in a linear fashion during first 30-40 s and after that it was non-linear.

CONCLUSION

20 s of light curing seems safe for pulpal health (with critical threshold of 5.5°C). However, in longer durations and especially when using LED units, the process should be broken to two sessions.

Temperature rise caused in the pulp chamber under simulated intrapulpal microcirculation with different light-curing modes

OBJECTIVE

To evaluate and compare intrapulpal temperature rise with three different light-curing units by using a study model simulating pulpal blood microcirculation.

MATERIALS AND METHODS

The roots of 10 extracted intact maxillary central incisors were separated approximately 2 mm below the cement-enamel junction. The crowns of these teeth were fixed on an apparatus for the simulation of blood microcirculation in pulp. A J-type thermocouple wire was inserted into the pulp chamber through a drilled access on the palatal surfaces of the teeth. Four measurements were made using each tooth for four different modes: group 1, 1000 mW/cm(2) for 15 seconds; group 2, 1200 mW/cm(2) for 10 seconds; group 3, 1400 mW/cm(2) for 8 seconds; and group 4, 3200 mW/cm(2) for 3 seconds. The tip of the light source was positioned at 2 mm to the incisor's labial surface.

RESULTS

The highest temperature rise was recorded in group 1 (2.6°C ± 0.54°C), followed by group 2 (2.57°C ± 0.62°C) and group 3 (2.35°C ± 0.61°C). The lowest temperature rise value was found in group 4 (1.74°C ± 0.52°C); this value represented significantly lower ΔT values when compared to group 1 and group 2 (P  =  .01 and P  =  .013, respectively).

CONCLUSIONS

The lowest intrapulpal temperature rise was induced by 3200 mW/cm(2) for 3 seconds of irradiation. Despite the significant differences among the groups, the temperature increases recorded for all groups were below the critical value of 5.6°C.