Como as características dos LEDs de segunda e terceira geração podem influenciar a dureza de compósitos restauradores: uma revisão da literatura / How the second and third LED generation features can influence the hardness of restorative composites: a review of the literature.

Objetivo: Várias fontes de luz têm sido utilizadas desde que os materiais fotoativados foram introduzidos na odontologia. Diodos emissores de luz (LEDs) se popularizaram como a principal opção para a polimerização dos materiais restauradores. O objetivo nessa revisão da literatura foi avaliar a influência das fontes de luz emitidas por diodo (LEDs) de segunda e terceira geração sobre a dureza de compósitos restauradores. Revisão de literatura: Nas bases de dados PubMed e Google Scholar foram pré-selecionados 239 artigos na língua inglesa entre os anos de 2010 e 2020, utilizando os termos: lightcuring, LED light sources, and dental LEDs. Dos 239 artigos inicialmente selecionados, 37 artigos foram avaliados devido aos critérios de inclusão/exclusão no estudo. Considerações finais: Vários estudos apontaram diferenças importantes na dureza dos compósitos restauradores testados, tanto na superfície de topo quanto na base. No entanto, essas diferenças estavam mais associadas a características como: estado de conservação do LED, irradiância, tempo de ativação, espectro de emissão dos aparelhos e sua compatibilidade ao fotoiniciador presente no compósito. Assim, podemos considerar que o monitoramento das condições do aparelho, e a escolha correta da fonte de luz de acordo com o compósito a ser utilizado são essenciais para maximizar a dureza dos compósitos restauradores, pois embora os aparelhos de terceira geração sejam preferencialmente indicados para compósitos com fotoiniciadores alternativos, os aparelhos que emitem luz azul apresentam vantagens quando o compósito é ativado apenas pela Canforoquinona.(AU)

Objective: Several light sources have been used since the light-curing materials were introduced in dentistry. Light-emitting diodes (LEDs) have become popular as the main option for the polymerization of restorative materials. This literature review aimed to evaluate the influence of second and third generation Light-emitting Diode (LEDs) sources on the hardness of restorative composites. Literature Review: In the PubMed and Google Scholar databases, 239 scientific papers in English were pre-selected between 2010 and 2020 using light-curing, LED light sources, and dental LEDs. After reading, 37 articles were selected to compose the review. Several studies have pointed out significant differences in the hardness of the tested restorative composites, both on the top and base surfaces. However, these differences were more associated with characteristics such as: LED conservation conditions, irradiance, curing time, the emission spectrum of the devices and their compatibility with the photoinitiator used in the composite. Final Considerations: Thus, it can be considered that monitoring the condition of the device and the correct choice of light sources according to the composite to be used is essential to maximize the hardness of the restorative composites, because although third-generation devices are preferably indicated for composites with alternative photoinitiators, devices that emit blue light have advantages when the composite is activated only by Camphorquinone.(AU)

Effect of Light Sources on Bond Strength of Different Composite Resins Repaired with Bulk-Fill Composite / Efecto del tipo de fuente luz en la resistencia adhesiva de distintas resinas compuestas reparados con una resina bulk-fill

Abstract: The aim of this study was to evaluate and compare the effects of different light sources on shear bond strength when bulk-fill composite was used for the repair of different composite resins. A total of 126 samples made from six resin composites with different properties were aged (thermal-cycling with 5000 cycle), exposed to the same surface treatments and adhesive procedure. Then, they were repaired with a bulk-fill composite. At the polymerization step, each group was divided into three subgroups (n=7) and light cured with a QTH light source for 40s and two different LED light sources for 20s. Subsequently, the specimens were aged in distilled water at 37 ºC for 4 weeks and then subjected to shear bond strength test. Then, the specimens were examined under a stereomicroscope to identify modes of failure and visualized by Scanning Electron Microscope. Data obtained from the study were analyzed using ANOVA and Tukey HSD Test (α=0.05). In all groups, the light curing units had an impact on shear bond strength (p<0.05). Among the study groups, the greatest bond strength values were observed in the specimens repaired using the LED and the specimens repaired with the QTH light curing unit had the lowest bond strength values. It was concluded that the content of composite resins and light curing units may influence bond strength of different composites repaired with the bulk-fill composite.

Resumen: El objetivo de este estudio fue evaluar y comparar los efectos de diferentes fuentes de luz sobre la resistencia de la unión al cizallamiento cuando se utiliza una resina bulk-fill para la reparación de diferentes resinas compuestas. Se envejecieron un total de 126 muestras fabricadas con seis compuestos de resina con diferentes propiedades (ciclo térmico con 5000 ciclos), expuestas a los mismos tratamientos de superficie y procedimiento adhesivo. Luego, fueron reparadas con una resina bulk- fill. En el paso de polimerización, cada grupo fue dividido en tres subgrupos (n=7) y fotopolimerizado con una fuente de luz QTH por 40s y dos fuentes de luz LED por 20s. Posteriormente, los especímenes se envejecieron en agua destilada a 37 ºC durante 4 semanas y luego se sometieron a una prueba de resistencia adhesiva de cizalla. Luego, los especímenes fueron examinados bajo un estereomicroscopio para identificar los modos de falla y visualizados por el Microscopio Electrónico de Barrido. Los datos obtenidos del estudio fueron analizados usando el ANOVA y la prueba Tukey HSD (α=0.05). En todos los grupos, las unidades de fotopolimerización tuvieron un impacto en la fuerza de adhesión al cizallamiento (p<0,05). Entre los grupos de estudio, los mayores valores de fuerza de adhesión se observaron en los especímenes reparados utilizando el LED y los especímenes reparados con la unidad de fotopolimerización QTH tuvieron los valores de fuerza de adhesión más bajos. Se llegó a la conclusión de que el contenido de las resinas compuestas y las unidades de fotopolimerización pueden influir en la fuerza de adhesión de los diferentes compuestos reparados con resinas bulk-fill.

Comparative Evaluation of Flexural Strength of Two Newer Composite Resin Materials: An in Vitro Study

ABSTRACT Objective: To evaluate in vitro the flexural strength of two newer composite resin materials. Material and Methods: Twenty-four samples were equally divided into two groups: G1 - Brilliant EverGlow and G2: Brilliant NG. The rectangular blocks of 25 mm in length, 2 mm in width and thickness were prepared from two composite materials. Blocks were created by applying composites to a customized split mold and formed between two parallel glass plates. Before light-curing, blocks were covered with Mylar strips and rinsed for 10 seconds in water. Subsequently, they were stored in distilled water for 24 hours at 37ºC and 100% humidity before testing. Each sample was placed within a suitable framework of aluminum. The length of gap between the support was 21 mm and the speed of crosshead at 1 mm/minute. The data were subjected to an independent t-test. The level of significance was set at p <0.05. Results: A less flexural strength was observed in G1 (77.43 Mpa) compared to G2 (118.70 Mpa) (p<0.001). Conclusion: Universal nanohybrid composite resin material was found to have greater flexural strength than universal submicron hybrid composite material.

Resistência à flexão de duas resinas compostas diretas após diferentes métodos de polimerização / Flexural strength of two direct composite resins after different polymerization methods

Objetivo: avaliar a influência de diferentes modos de polimerização sobre a resistência à flexão de três pontos de duas resinas compostas. Métodos: foram confeccionadas 88 amostras, sendo divididas em dois grupos, conforme a resina composta utilizada: Filtek Z350 XT e Forma. Os grupos foram subdivididos, de acordo com diferentes modos de polimerização, em: G1- Z350 por 20s a 1.000 mw/cm²; G2- Forma por 20s a 1.000 mw/cm²; G3- Z350 por 20s a 1.000 mw/cm² e micro-ondas por 3 minutos em 450w; G4- Forma por 20s a 1.000 mw/cm² e micro-ondas por 3 minutos em 450w; G5- Z350 por 2 vezes de 3s a 3.200 mw/cm²; G6- Forma por 2 vezes de 3s a 3.200 mw/cm²; G7- Z350 por 2 vezes de 3s a 3.200 mw/cm² e micro-ondas por 3 minutos em 450w; G8- Forma por 2 vezes de 3s a 3.200 mw/cm² e micro-ondas por 3 minutos em 450w. As amostras foram submetidas ao teste de resistência à flexão de 3 pontos, sob taxa de carregamento de 50 N/min, até a falha completa. Os dados foram analisados estatisticamente por análise de variância com dois fatores (two-way ANOVA) e teste de Tukey. Resultados: não houve diferenças estatísticas entre as resinas compostas e os modos de polimerização utilizados. Conclusão: de acordo com os resultados do estudo, e dentre suas limitações, os modos de polimerização não influenciaram a resistência à flexão, independentemente da resina composta testada. (AU)

Objective: to evaluate the influence of different polymerization modes on the three-point flexural strength of two composite resins. Methods: 88 samples were produced and divided into two groups according to the composite resin used: Filtek Z350 XT and Forma. The groups were subdivided according to different polymerization modes into: G1- Z350 for 20 s at 1000 mw/cm²; G2- Forma for 20 s at 1000 mw/cm²; G3- Z350 for 20 s at 1000 mw/cm² and microwave for 3 min at 450w; G4- Forma for 20 s at 1000 mw/cm² and microwave for 3 min at 450w; G5- Z350 2x for 3 s at 3200 mw/cm²; G6- Forma 2x for 3 s at 3200 mw/cm²; G7- Z350 2x for 3 s at 3200 mw/cm² and microwave for 3 min at 450w; and G8- Forma 2x for 3 s at 3200 mw/cm² and microwave for 3 min at 450w. The samples were subjected to the three-point flexural strength test under a 50 N/min loading rate until complete failure. The data were statistically analyzed using two-way analysis of variance (two-way ANOVA) and Tukey's test. Results: there were no statistical differences between the composite resins and the polymerization modes used. Conclusion: according to the study results and within its limitations, the polymerization modes did not affect flexural strength, regardless of the composite resin tested. (AU)

Influence of activation mode, fatigue, and ceramic interposition on resin cements' diametral tensile strength

Abstract This study evaluated the influence of activation modes, on Diametral Tensile Strength (DTS) of dual cured resin cements subjected to a Mechanical Fatigue test (MF). Four dual-cured resin cements (RelyX UNICEM [U], RelyX ARC [A], ENFORCE [E] and Nexus 2 [N]) were activated by three different curing modes as follows: Self-Curing (SC), Dual Cure activation with photoactivation executed directly (DC) and Dual Cure activation with Photoactivation Through Porcelain (DCTP). After 24 hours, half of the sample was subjected to 30.000 fatigue cycles at 1 Hz frequency and 12 N load. Then, all specimens were subjected to DTS test in Instron Universal Testing Machine and data were analyzed by three-way ANOVA and Tukey's Test (5%). The results of DTS test means (MPa) and standard deviation, for each cement factor activated by SC, DC and DCTP was respectively: U (28.12 ± 5.29; 37.44 ± 6.49 and 40.10 ± 4.39), A (49.68 ± 8.42; 55.12 ± 5.16 and 63.43 ± 6.92), E (49.12 ± 3.89; 56.42 ± 8.88 and 56.96 ± 6.45) and N (61.89 ± 11.21; 59.26 ± 9.47 and 62.56 ± 10.93). Turkey's test indicated that DC is related to the highest DTS values; Nexus 2 DTS remained the same independently of activation mode and that the Porcelain disk interposition enhanced DTS only for RelyX ARC the ANOVA statistical test indicated that MF didn't alter the DTS values for all experimental groups. MF results clinical implication is that all cements tested exhibited, in an immediate loading, good cross linked bonds quality.

Otimização do procedimento de colagem de braquetes ortodônticos utilizando um recipiente fotoprotetor: passo a passo / Optimization of the bonding procedure of orthodontic brackets using a photoprotective vessel: step-by-step

A resina composta fotoativável é usualmente utilizada para o procedimento de colagem de braquetes ortodônticos. No entanto, seu uso requer cuidados antes da fotoativação, pois sua polimerização pode ocorrer precocemente por outras fontes de luz, que não a de um fotoativador dentário (e.g., luz ambiente). Foi idealizado um recipiente fotoprotetor que permite o armazenamento temporário do conjunto de pinças com os braquetes preparados com resina em sua base, evitando o processo de polimerização da resina antes do momento desejado. Objetivo: este estudo tem como objetivo apresentar uma descrição detalhada do procedimento de colagem de braquetes ortodônticos estéticos cerâmicos, quando se utiliza um recipiente fotoprotetor para otimizar o atendimento. Relato de caso: paciente do sexo feminino, 24 anos de idade, submeteu-se ao tratamento ortodôntico em clínica particular. Foram utilizados braquetes ortodônticos autoligados, cerâmicos de alumina policristalina. A colagem dos braquetes foi realizada na arcada inferior de maneira tradicional, porém se fez uso de um recipiente fotoprotetor (protótipo) para otimizar o procedimento. O recipiente teve como finalidade principal o armazenamento temporário de braquetes ortodônticos apreendidos em pinças ortodônticas, já com resina composta para colagem em suas bases. Concluiu-se a instalação do aparelho ortodôntico com a colocação de um arco ortodôntico redondo Ni-Ti 0,014". Considerações finais: a utilização do recipiente fotoprotetor mostrou-se clinicamente eficaz e apresentou um bom resultado final da satisfação tanto do profissional quanto do paciente. O seu uso foi capaz de reduzir o tempo de cadeira do paciente durante o procedimento e impediu a polimerização precoce da resina composta de colagem utilizada. (AU)

The photo-activated resin composite is usually used for the bonding procedure of orthodontic brackets. However, their use requires caution prior to photoactivation, as their polymerization may occur early by light sources other than a dental photoactivator (e.g. ambient light). A photoprotective vessel has been developed to allow temporary storage of the clamps assembly with the resin-prepared brackets, avoiding the polymerization process of the resin prior to the desired moment. Objective: this study purpose was to present a detailed description of the bonding procedure of ceramic orthodontic brackets when using a photoprotective vessel to optimize care. Case report: a 24-year-old female patient underwent orthodontic treatment in a private practice. Orthodontic brackets of polycrystalline alumina ceramics were used for treatment. Bracket bonding was performed in the lower arch in the traditional manner, however a photoprotective vessel (prototype) was used to optimize the procedure. The main purpose of the vessel was the temporary storage of orthodontic brackets- -clamps assembly, already with composite resin for bonding in their bases. The installation of the orthodontic appliance was finished with the placement of a 0.014" round Ni-Ti orthodontic arch. Final considerations: the use of the photoprotective vessel was clinically effective and with a good end result in both professional and patient satisfaction. Its use was able to reduce the patient's chair time during the procedure and prevented the early polymerization of the bonded composite resin used. (AU)

Evaluation of long-term bond strength and selected properties of self-adhesive resin cements

Abstract This study evaluated the shear bond strength (SBS) of self-adhesive resin cements (SARCs) to dentin and their physical-chemical properties. Five commercial SARCs were evaluated [SmartCem®2 - DENTSPLY (SC2); BisCem® - Bisco (BC); SeT PP® − SDI (SeT); Relyx U100® - 3M ESPE (U100) and YCEM® SA - Yller (YCEM)]. The SARCs were evaluated for SBS to dentin (n = 10) after 24 h, 6 months, and 12 months. The dentin demineralization caused by acidic monomers was observed by SEM, and pH-neutralization of eluate was observed for 24 h. Degree of conversion (DC), rate of polymerization (Rp), flexural strength (FS), and elastic modulus (E) were evaluated. Immediate SBS of SC2, SET, U100, and YCEM were statistically higher than that of BC (p < 0.001). After 12 months, all SARCs showed reduced SBS values and U100 showed values similar to those of SET and YCEM, and higher than those of BC and SC2 (p = 0.001). Demineralization pattern of SARCs was similar. At 24h, all SARCs showed no differences in the pH-value, except BC and U100 (p < 0.001). YCEM showed the highest Rp. U100, YCEM, and SC2 showed statistically higher FS (p<0.001) and E (p < 0.001) when compared with SET and BC. U100 and YCEM showed the best long-term bonding irrespective of the storage period. A significant reduction in SBS was found for all groups after 12 months. SBS was not shown to be correlated with physical-chemical properties, and appeared to be material-dependent. The polymerization profile suggested that an increased time of light activation, longer than that recommended by manufacturers, would be necessary to optimize DC of SARCs.

Effect of different bonding protocols on degree of monomer conversion and bond strength between orthodontic brackets and enamel

Abstract The objective of the present study was to evaluate the effect of different surface treatments and polymerization protocols on the bond strength of brackets to enamel, and the degree of conversion of the bonding agents. 120 bovine crowns were embedded in acrylic resin blocks and sanded. Next, the blocks were randomly assigned into 12 groups. Metal brackets were bonded to enamel according to the "surface treatment" factor (A: Phosphoric Acid; ATxt: Phosphoric Acid + Transbond XT Primer®; Tse: Transbond Plus Self Etching Primer®; and SBU: Scotchbond Universal®) and "polymerization" factor (R20: Radii-Cal®/20 seconds; V20: Valo Cordless®/20 seconds; and V3: Valo Cordless®/3 seconds). All samples were stored for 6 months (water, 37ºC) and then subjected to a shear bond strength test (SBS). Bond failures were classified according to the Adhesive Remnant Index (ARI) and analyzed with the Kruskal-Wallis and Mann-Whitney tests (5%). Using the same factors, 120 resin discs were made to assess the degree of conversion (DC) of the monomer. Data from the SBS (MPa) and DC (%) were analyzed by analysis of variance (2 factors) and Tukey's test (5%). For the SBS, the factors "polymerization" (R20 = 8.1B; V20 = 13.2A; V3 = 5.2C, p = 0.0001) and "surface treatment" (A = 3.1C; ATxt = 13.6A; Tse = 12.3A; SBU = 6.3B, p = 0.0001) were statistically significant among groups. The highest adhesion value were found for the ATxt/V20 group (22.2A) and the lowest value for the A/R20 group (1.2E). Regarding ARI, score 2 was the most prevalent in groups A, ATxt, V20 and V3, while score 4 was the most prevalent in the Tse, SBU and R20 groups, with no significant difference between them (p = 1.0). Regarding DC, the factors "polymerization" (R20 = 66.6A; V20 = 58.4B; V3 = 45.1C, p = 0.0001) and "surface treatment" (A = 52B, ATxt = 59.7A, Tse = 51.4B, SBU = 63.8A, p = 0.0001) were statistically significant. Tse was more sensitive to the variations in polymerization protocols than the other surface treatments. Treatment A did not present suitable bond strength or degree of conversion.

Multiple-peak and single-peak dental curing lights comparison on the wear resistance of bulk-fill composites

Abstract: The effects of tooth brushing could affect the long-term esthetic outcome of composite restorations. This study evaluated the effect of two different emission spectrum light-curing units on the surface roughness, roughness profile, topography and microhardness of bulk-fill composites after in vitro toothbrushing. Valo (multiple-peak) and Demi Ultra (single-peak) curing lights were each used for 10s to polymerize three bulk-fill resin composites: Filtek Bulk Fill Posterior Restorative (FBF), Tetric EvoCeram Bulk Fill (TET) and Surefil SDR Flow (SDR). After 30,000 reciprocal strokes in a toothbrushing machine, the roughness profile, surface roughness, surface morphology, and microhardness were examined. Representative SEM images were also obtained. When light-cured with the Demi Ultra, SDR showed the most loss in volume compared to the other composites and higher volume loss compared to when was light-cured with Valo. The highest surface roughness and roughness profile values were found in SDR after toothbrushing, for both light-curing units tested. FBF always had the greatest microhardness values. Light-curing TET with Valo resulted in higher microhardness compared to when using the Demi Ultra. Confocal and SEM images show that toothbrushing resulted in smoother surfaces for FBF and TET. All composites exhibited surface volume loss after toothbrushing. The loss in volume of SDR depended on the light-curing unit used. Toothbrushing can alter the surface roughness and superficial aspect of some bulk-fill composites. The choice of light-curing unit did not affect the roughness profile, but, depending on the composite, it affected the microhardness.

Influence of preheating and post-curing on a novel fiber-reinforced composite post material

Abstract The aim of this study was to investigate the influence of preheating and post-curing methods on diametral tensile strength (DTS), flexural strength (FS), knoop microhardness (KHN), and degree of conversion (DC) of an experimental fiber-reinforced composite (FRC). Specimens (30 wt% of 3-mm-short E-glass fiber, 22.5 wt% of methacrylated-based resin and 47.5 wt% of filler particles) were subjected to: P - photocuring at 1500 mW/cm2 for 40 s (control); P/M - photocuring and microwave post-curing (540W/5 minutes); P/A - photocuring and autoclave post-curing (120°C/15 minutes); PH-P - preheating (60°C) and photocuring; PH-P/M - preheating, photocuring and microwave post-curing; and PH-P/A - preheating, photocuring and autoclave post-curing. Specimens for DTS (Ø 3 x 6 mm) and FS (25 x 2 x 2 mm) were tested at Instron 5965. KHN employed a 50g load for 30s. DC was measured using FTIR spectroscopy. Statistical analysis employed: factorial analysis, normality test, one-way ANOVA and Tukey's HSD test, independent T-test and the Dunnett test. Interaction between factors was not significant (P>0.05). Preheating promoted significantly higher values of FS and KHN (p = 0.0001). Post-curing promoted significantly higher values for KHN (p = 0.0001). For DTS (p = 0.066) and DC (p= 0.724) no statistical difference was found between groups. SEM images showed that preheating promoted better interaction between glass fibers and resin matrix. Preheating increased FS, KHN and DTS, and post-curing increased KHN. DC was not affected by both methods. Preheating and post-curing methods can be used to improve some mechanical properties of FRCs' but degree of conversion remains unaffected.

Light curing resin cements containing iodonium salts promote suitable apical bonding of posts to radicular dentin

Abstract The aim of this study was to analyze the efficiency of experimental light-curing resin cements (ERCs) with a ternary photo-initiator system containing diphenyliodonium hexafluorphosphate (DPI) and different amines on retention of glass-fiber posts to dentin (GFP). ERCs formulations: a 1:1 mass ratio of 2,2-bis[4-(2-hydroxy-3-methacryloxypropoxy)phenylpropane and triethyleneglycol dimethacrylate. Camphorquinone was used as initiator. Six experimental groups were established according to the amine used: [ethyl-4-(dimethylamino)benzoate-EDMAB or 2-(dimethylamino)ethyl methacrylate-DMAEMA] and the concentration of DPI (0, 0.5 mol%, 1 mol%). The resin cements Variolink II (dual- and light-cured versions) were used as commercial reference. Eighty recently extracted bovine incisors (n = 10) were selected for this study. The roots were prepared and the fiber posts were cemented with the resin cement specified for each experimental group. Specimens from coronal, middle, and apical thirds of the root were subjected to push-out bond strength test 24 hours after bonding. Data were subjected to split-plot ANOVA and the Tukey test (p = 0.05). ERCs containing DPI showed statistically significant higher bond strengths compared with ERCs without DPI. ERCs containing DPI were statistically similar to VARIOLINK II - dual-cured and superior to VARIOLINK II - light-cured (except for EDMAB - 1DPI in the medium third and DMAEMA - 1DPI in the coronal third). Different amines did not influence post retention. The apical root region showed the lowest bond strength for the groups EDAB-0DPI, DMAEMA-0DPI and VARIOLINK II light-cured. Light-cured ERCs containing DPI were efficient for GFP retention to radicular dentin, with similar behaviour to that of dual-curing commercial resin cement.

Minimization of polymerization shrinkage effects on composite resins by the control of irradiance during the photoactivation process

Abstract High levels of shrinkage stress caused by volumetric variations during the activation process are one of the main problems in the practical application of composite resins. Objective The aim of this study is to reduce the shrinkage stress and minimize the effects caused by composite resin volumetric variation due to the photopolymerization. In this way, this work proposes a systematic study to determine the optimal dimming function to be applied to light curing processes. Material and Methods The study was performed by applying mathematical techniques to the optimization of nonlinear objective functions. The effectiveness of the dimming function was evaluated by monitoring the polymerization shrinkage stress during the curing process of five brands/models of composites. This monitoring was performed on a universal testing machine using two steel bases coupled in the arms of the machine where the resin was inserted and polymerized. The quality of the composites cured by the proposed method was analyzed and compared with the conventional photoactivation method by experiments to determine their degree of conversion (DC). Absorbance measurements were performed using Fourier-transform infrared spectroscopy (FT-IR). A T-test was performed on DC results to compare the photoactivation techniques. We also used scanning electron microscopy (SEM) to analyze in-vitro the adhesion interface of the resin in human teeth. Results Our results showed that the use of the optimal dimming function, named as exponential, resulted in the significant reduction of the shrinkage stress (~36.88% ±6.56 when compared with the conventional method) without affecting the DC (t=0.86, p-value=0.44). The SEM analyses show that the proposed process can minimize or even eliminate adhesion failures between the tooth and the resin in dental restorations. Conclusion The results from this study can promote the improvement of the composite resin light curing process by the minimization of polymerization shrinkage effects, given an operational standardization of the photoactivation process.

Structural and mechanical properties of a giomer-based bulk fill restorative in different curing conditions

ABSTRACT Objective: The main goal of this study was to compare the polymerization degree of bulk-fill giomer resin cured with three different light-curing units (LCUs): a polywave third-generation (Valo); a monowave (DemiUltra: DU); and a second-generation LED (Optima 10: Opt) LCUs by using structural and mechanical properties. Material and methods: Giomer samples of 2 and 4 mm cured with three LCUs were employed in vitro analysis. The degree of curing (DC%) was determined with Fourier-Transform Infrared Spectroscopy (FTIR). Microstructural features were observed with scanning electron microscopy (SEM). Flexural strength (FS), compression strength (CS), elastic modulus and fracturing strain were determined for mechanical properties. Surface microhardness (SMH) values were also measured. Oneway ANOVA, two-way analysis of variance and Tukey multiple comparison tests were used for statistically analyzing the FS and SMH. Results: DC% values were 58.2, 47.6, and 39.7 for the 2 mm samples cured with DU, Opt., and Valo LCUs, respectively. DC% values of the 4 mm samples were 50.4, 44.6, and 38.2 for DU, Opt, and Valo, respectively. SMH values were Valo, Opt<DU at top of the samples; Valo<DU, Opt at 2 mm, and DU, Valo<Opt at 4 mm depth. Giomer samples cured with Opt and DU exhibited higher FS values than Valo. CS values were similar but compressive modulus and fracturing strain (%) varied depending on the curing protocol. Conclusions: Based on the results, it can be concluded that curing device and protocol strongly affect crosslinking reactions and thus DC%, SMH, compressive modulus and strain at break values. Consequently, it can be deduced that curing protocol is possibly the most important parameter for microstructure formation of highly-filled composite restoratives because it may bring some structural defects and physical frailties on restorations due to lower degree of polymerization.

Immediate effects of temporary bite-raising with light-cured orthodontic band cement on the electromyographic response of masticatory muscles

Abstract Objective: To assess the immediate effects of temporary bite-raising using light-cured orthodontic band cement on the superficial masseter and anterior temporalis electromyography (EMG) activity in healthy adults. Materials and Methods: Surface EMG signals were recorded bilaterally from the superficial masseter and anterior temporalis muscles of 30 volunteers with a normal occlusion, before and after having temporary bite-raising. The bite-raising was done by adding light-cured orthodontic band cement (3x5x2 mm WxLxH) on the lingual cusps of both upper first molars. The measurements were recorded (i) at rest, (ii) while clenching in centric occluding position and (iii) while chewing on an artificial test food. The EMG activity at rest and during clenching, the maximum voltage, and the duration of the identified EMG signal burst while chewing the artificial test food before and after temporary bite-raising were statistically compared using the paired t-test or the Wilcoxon signed-rank test based on the normality of the variables. The significance level was set at 5%. Results: After temporary bite-raising, we found no significant change in integral EMG activity at rest position for the superficial masseter (mean difference (MD)=7.5 μVs) and for the anterior temporalis muscle (MD=36.8 μVs); however, the integral EMG activity during clenching was significantly reduced for the superficial masseter (MD=201.2 μVs) and for the anterior temporalis muscle (MD=151.8 μVs). During mastication, the maximum voltage of the identified burst was significantly reduced on the preferred chewing side of the superficial masseter and anterior temporalis muscles (MD=127.9 and 47.7 μV, respectively), while no significant change was found for the duration of the identified burst (MD=-34.1 and 3.4 ms, respectively) after temporary bite-raising. Conclusion: The results point to an altered neuromuscular behavior during clenching and chewing immediately after temporary bite-raising with light-cured orthodontic band cement. This information is relevant for orthodontists to inform their patients what will happen to their masticatory muscle activity when this bite-raising method is used.

Does laser diode irradiation improve the degree of conversion of simplified dentin bonding systems?

Abstract Simplified dentin-bonding systems are clinically employed for most adhesive procedures, and they are prone to hydrolytic degradation. Objective This study aimed to investigate the effect of laser diode irradiation on the degree of conversion (DC), water sorption (WS), and water solubility (WSB) of these bonding systems in an attempt to improve their physico-mechanical resistance. Material and Methods Two bonding agents were tested: a two-step total-etch system [Adper™ Single Bond 2, 3M ESPE (SB)] and a universal system [Adper™ Single Bond Universal, 3M ESPE (SU)]. Square-shaped specimens were prepared and assigned into 4 groups (n=5): SB and SU (control groups - no laser irradiation) and SB-L and SU-L [SB and SU laser (L) - irradiated groups]. DC was assessed using Fourier transform infrared spectroscopy with attenuated total reflectance. Additional uncured resin samples (≈3.0 µL, n=5) of each adhesive were also scanned for final DC calculation. For WS/WSB tests, similar specimens (n=10) were prepared and measured by monitoring the mass changes after dehydration/water storage cycles. For both tests, adhesive fluids were dropped into standardized Teflon molds (6.0×6.0×1.0 mm), irradiated with a 970-nm laser diode, and then polymerized with an LED-curing unit (1 W/cm2). Results Laser irradiation immediately before photopolymerization increased the DC (%) of the tested adhesives: SB-L>SB>SU-L>SU. For WS/WSB (μg/mm3), only the dentin bonding system (DBS) was a significant factor (p<0.05): SB>SU. Conclusion Irradiation with a laser diode improved the degree of conversion of all tested simplified dentin bonding systems, with no impact on water sorption and solubility.

Light curing in dentistry and clinical implications: a literature review

Abstract 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.

Restauração classe II com resina composta: avaliação da técnica de Pollack / Restoration class II with composite resin: evaluation of the Pollack technique

Apesar do notável aumento de restaurações posteriores com resinas compostas nos últimos anos, ainda existem dificuldades quanto à técnica restauradora em se tratando de cavidades com envolvimento da face proximal. Considera-se que a intensidade de luz que atinge os incrementos da resina na face cervical do preparo é menor do que a intensidade próxima à superfície, podendo comprometer as propriedades mecânicas e o sucesso da restauração. Objetivo: Investigar a resistência compressiva dos incrementos de resina composta de uso direto na profundidade da caixa proximal de restaurações classe II em diferentes extensões ocluso-cervicais utilizando- se a técnica incremental proposta por Pollack (1988). Métodos: Foram obtidos 40 espécimes (blocos) de resina composta, com 2 mm de dimensão ocluso-cervical, confeccionados a partir de restaurações classe II em três molares inferiores de manequim (Prodens) com dimensões de 4 mm vestíbulo-lingual, 2 mm mésio-distal e profundidades ocluso-cervical de 2 mm (G1 e G2), 4 mm (G3) e 6 mm (G4), formando 4 grupos (n=10). Para G1 (grupo controle) foi utilizada a resina autoativada (Alpha Plast) e demais grupos resina fotoativada (Z100, 3M ESPE), todos com espessura de 2mm. Após, os espécimes foram armazenados em soro fisiológico durante 30 dias e, posteriormente,submetidos ao teste de resistência à compressão em máquina universal de ensaios EMIC DL-2000, composta por um dispositivo metálico de base plana de 15mm, com célula de carga de 490N e velocidade de 0,5mm/min, aplicada sobre a face oclusal dos espécimes até a fratura.Os resultados foram analisados pelo teste ANOVA. Resultados: A média dos valores de resistência à fratura (MPa), foram: 52,86; 48,55; 44,89; 42,67 para G1, G2, G3 e G4, respectivamente. Conclusão: Não houve diferença significativa (p>0,05) na resistência à compressão entre incrementos de resina composta inseridas na base da face proximal de preparos do tipo classe II em diferentes profundidades utilizando-se o protocolo adotado.(AU)

In spite of the remarkable increase of posterior restorations with composite resins in the last years, there are still difficulties regarding the restorative technique when dealing with cavities with involvement of the proximal face. It is considered that the light intensity that reaches the resin increments in the cervical face of the preparation is smaller than the intensity close to the surface, which may compromise the mechanical properties and the success of the restoration. Objective: To investigate the compressive strength of the composite resin increments of direct use in the depth of the proximal box of class II restorations in different occlusalcervical extensions using the incremental technique proposed by Pollack (1988). Methods: 40 composite resin specimens with 2 mm occlusal-cervical dimensions were made from class II restorations in three lower molars of the manikin (Prodens) with 4 mm vestibullary, 2 mm mesio- Distal and occlusal-cervical depths of 2 mm (G1 and G2), 4 mm (G3) and 6 mm (G4), forming 4 groups (n = 10). For G1 (control group) the autoactivated resin (Alpha Plast) and other photoactivated resin groups (Z100, 3M ESPE) were used, all with a thickness of 2mm. Afterwards, the specimens were stored in saline solution for 30 days and then submitted to the compressive strength test in a universal EMIC DL-2000 test machine, consisting of a 15mm flat base metal device with a 490N load cell And velocity of 0.5 mm / min, applied on the occlusal face of the specimens until the fracture.The results were analyzed by the ANOVA test. Results: The average values of fracture resistance (MPa) were: 52.86; 48.55; 44.89; 42.67 for G1, G2, G3 and G4, respectively. Conclusion: There was no significant difference (p> 0.05) in the compressive strength between increments of composite resin inserted at the base of the proximal face of class II type preparations at different depths using the protocol adopted.(AU)

Effects of radiant exposure values using second and third generation light curing units on the degree of conversion of a lucirin-based resin composite

Abstract Alternative photoinitiators with different absorption wavelengths have been used in resin composites (RCs), so it is crucial to evaluate the effectiveness of light-curing units (LCUs) on these products. Objective Using Fourier transform infrared analysis (FTIR) in vitro, the effects of varying radiant exposure (RE) values generated by second and third generation LED LCUs on the degree of conversion (DC) and maximum rate of polymerization (Rpmax) of an experimental Lucirin TPO-based RC were evaluated. Material and Methods 1 mm or 2 mm thick silicon molds were positioned on a horizontal attenuated total reflectance (ATR) unit attached to an infrared spectroscope. The RC was inserted into the molds and exposed to varying REs (18, 36 and 56 J/cm2) using second (Radii Plus, SDI) and third generation LED LCUs (Bluephase G2/Ivoclar Vivadent) or a quartz tungsten based LCU (Optilux 501/SDS Kerr). FTIR spectra (n=7) were recorded for 10 min (1 spectrum/s, 16 scans/spectrum, resolution 4 cm-1) immediately after their application to the ATR. The DC was calculated using standard techniques for observing changes in aliphatic to aromatic peak ratios both prior to, and 10 min after curing, as well as during each 1 second interval. DC and Rpmax data were analyzed using 3-way ANOVA and Tukey’s post-hoc test (p=0.05). Results No significant difference in DC or Rpmax was observed between the 1 mm or 2 mm thick specimens when RE values were delivered by Optilux 501 or when the 1 mm thick composites were exposed to light emitted by Bluephase G2, which in turn promoted a lower DC when 18 J/cm2 (13 s) were delivered to the 2 mm thick specimens. Radii Plus promoted DC and Rpmax values close to zero under most conditions, while the delivery of 56 J/cm2 (40 s) resulted in low DC values. Conclusions The third generation LCU provided an optimal polymerization of Lucirin TPO-based RC under most tested conditions, whereas the second generation LED-curing unit was useless regardless of the RE.

Degree of conversion and bond strength of resin-cements to feldspathic ceramic using different curing modes

Abstract Resin cements have led to great advances in dental ceramic restoration techniques because of their ability to bond to both dental structures and restorative materials. Objective The aim of this study was to assess the performance of resin cements when different curing modes are used, by evaluating the degree of conversion and bond strength to a ceramic substrate. Material and Methods Three resin cements were evaluated, two dual-cured (Variolink II and RelyX ARC) and one light-cured (Variolink Veneer). The dual-cured resin cements were tested by using the dual activation mode (base and catalyst) and light-activation mode (base paste only). For degree of conversion (DC) (n=5), a 1.0 mm thick feldspathic ceramic disc was placed over the resin cement specimens and the set was light activated with a QTH unit. After 24 h storage, the DC was measured with Fourier transform infrared spectroscopy (FTIR). For microshear bond strength testing, five feldspathic ceramic discs were submitted to surface treatment, and three cylindrical resin cement specimens were bonded to each ceramic surface according to the experimental groups. After 24 h, microshear bond testing was performed at 0.5 mm/min crosshead speed until the failure. Data were submitted to one-way ANOVA followed by Tukey test (p<0.05). Scanning electron microscopy (SEM) was used for classifying the failure modes. Results Higher DC and bond strength values were shown by the resin cements cured by using the dual activation mode. The Variolink II group presented higher DC and bond strength values when using light-activation only when compared with the Variolink Veneer group. Conclusion The base paste of dual-cured resin cements in light-activation mode can be used for bonding translucent ceramic restorations of up to or less than 1.0 mm thick.

Comparing depth-dependent curing radiant exposure and time of curing of regular and flow bulk-fill composites

Abstract The effect of restoration depth on the curing time of a conventional and two bulk-fill composite resins by measuring microhardness and the respective radiosity of the bottom surface of the specimen was investigated. 1-, 3- and 5-mm thick washers were filled with Surefil SDR Flow-U (SDR), Tetric EvoCeram Bulk Fill-IVA (TEC) or Esthet-X HD-B1 (EHD), and cured with Bluephase® G2 for 40s. Additional 1-mm washers were filled with SDR, TEC or EHD, placed above the light sensor of MARC®, stacked with pre-cured 1-, 3- or 5-mm washer of respective material, and cured for 2.5~60s to mimic 2-, 4- and 6-mm thick composite curing. The sensor measured the radiosity (EB) at the bottom of specimen stacks. Vickers hardness (VH) was measured immediately at 5 locations with triplicate specimens. Nonlinear regression of VH vs EB by VH=α[1-exp(-EB/β)] with all thickness shows that the values of α, maximum hardness, are 21.6±1.0 kg/mm2 for SDR, 38.3±0.6 kg/mm2 for TEC and 45.3±2.6 kg/mm2 for EHD, and the values of β, rate parameter, are 0.40±0.06 J/cm2 for SDR, 0.77±0.04 J/cm2 for TEC and 0.58±0.09 J/cm2 for EHD. The radiosity of the bottom surface was calculated when the bottom surface of each material attained 80% of α of each material. The curing times for each material are in agreement with manufacturer recommendation for thickness. It is possible to estimate time needed to cure composite resin of known depth adequately by the radiosity and microhardness of the bottom surface.