Effect of a 3-second Off-label Exposure on the Depth of Cure of Eight Resin-based Composites.

OBJECTIVES: This study evaluated the depth of cure (DoC) of eight resin-based composites (RBCs) photocured using one multipeak light-curing unit (LCU) on the standard output setting for the manufacturer's RBC recommended exposure time and at a higher irradiance for 3 seconds. METHODS: Three conventional RBCs: Tetric EvoCeram (Evo), Tetric N-Ceram (Cer), Tetric Prime (Pri); and five bulk-fill: Tetric N-Ceram Bulk Fill (CerBF), Opus Bulk Fill APS (OpusBF), Opus Bulk Fill Flow APS (OpusF), Tetric PowerFill (PFill) and Tetric PowerFlow (PFlow) were examined. Only PFill and PFlow are formulated to be photocured in 3 seconds. The RBCs were packed into a metal mold and photocured using a Bluephase PowerCure LCU for the RBC manufacturer's recommended exposure time on the standard mode and using the 3-second high irradiance mode. After photocuring, the specimens were immersed in a solvent for 1 hour. The length of the remaining RBC was measured and divided by 2. Data were analyzed using two-way analysis of variance (ANOVA) followed by the Tukey post hoc multiple comparison test (α=0.05). RESULTS: There was no significant difference in the DoC values for PFill and PFlow when photocured using the 3-second high irradiance protocol compared to the lower irradiance standard mode protocol. All other RBCs had significantly lower DoC values (p<0.001) when photocured off-label using the 3-second high irradiance mode. CONCLUSION: Of the eight RBCs tested, only PFill and PFlow achieved the same DoC when the high irradiance 3-second curing method was used compared to when their longer lower irradiance protocol was used.

Ability of Six Curing Lights to Photocure Four Resin-Based Composites in a MOD-Mold: A Double-Blind Study.

OBJECTIVE: The ability of six curing lights to photocure four resin-based composites (RBCs) in a mold simulating a cavity was compared visually. MATERIALS AND METHODS: Four RBCs were photocured using the: Woodpecker B for 2x10s, SmartLite Pro 2x10s, Valo Cordless 2x10s, Valo Cordless 2x3s Xtra power, Valo X 2x10s, Valo X 2x5s Xtra power, PowerCure 2x3s mode, Monet 1x1s and Monet 3x1s, in a mold representing a molar Class II restoration. Immediately after photocuring, the RBC specimens were immersed in a solvent to remove the uncured RBC, after which they were photographed and de-identified. Using a REDCap survey, these images were compared visually to compare the ability of the LCUs to photocure the restorations. RESULTS: There were significant differences in how well the LCUs had photocured the RBCs. The SmartLite Pro and Valo X used for two 10s exposures produced restorations rated as the best cured, and the Monet used for 1 s was rated the worst. CONCLUSIONS: There were visually apparent differences in how well the LCUs could photocure the RBCs. The Monet used for 1 second produced the worst results for all four RBCs.

Evaluation of 278 New Bluephase Style Light Curing Units Purchased Over Six Years.

OBJECTIVE: This study measured 278 new curing lights (LCUs) to determine if they met the manufacturer's specifications. MATERIALS AND METHODS: Over a 6-year period, the light output from 278 Bluephase Style LCUs was measured before the LCUs were given to students (41 in 2017, 44 in 2018, 46 in 2019, 48 in 2020, 50 in 2021, and 49 in 2022). The radiant exitance (mW/cm²) from each year was compared using ANOVA and Tukey- Kramer multiple comparisons test with adjustment for the unequal sample sizes (α=0.05). The results were also compared against the manufacturer's stated radiant exitance of 1200 mW/cm². RESULTS: The 278 LCUs delivered an average (± standard deviation) radiant exitance of 1203 ± 16.7 mW/cm². The lowest radiant exitance was 1149 mW/cm² and the highest was 1257 mW/cm². Although there were statistically significant differences in the LCUs from each year, these values were within the manufacturer's tolerance of values of ± 10%. Approximately 13% of the emitted light was below 420 nm, and 87% was above 420 nm. CONCLUSION: These new LCUs were all multiple peak LCUs that emitted an average radiant exitance of 1,203 mW/cm² (range 1149 to 1257 mW/cm². Purchasers of the Style LCU can be confident that their new LCU will meet the manufacturer's specifications.

In Vivo Pulp Temperature Changes During Class V Cavity Preparation and Resin Composite Restoration in Premolars.

OBJECTIVE: This in vivo study evaluated the influence of the sequence of all restorative steps during Class V preparation and restoration in human premolars on pulp temperature (PT). METHODS AND MATERIALS: Intact premolars with orthodontic extraction indication of 13 volunteers received infiltrative anesthesia and isolation with rubber dam. An occlusal preparation was made with a high-speed diamond bur under air-water spray until the pulp was minimally exposed, then a thermocouple probe was inserted within the pulp. A deep, 2.0-mm depth Class V preparation was made using a high-speed diamond bur under air-water spray. Three restorative techniques were performed (n=7): Filtek Z250 placed in two increments (10-second exposure, shade:A2, 3M ESPE, St. Paul, MN, USA), Filtek Z350 XT (40-second exposure, shade:A3D, 3M ESPE) and Tetric N Ceram Bulk Fill (10-second exposure, shade:IVA, Ivoclar Vivadent, Schaan, Liechtenstein), both placed in a single layer. Bonding layer and resin composite were exposed to light from the same Polywave LCU (Bluephase 20i, Ivoclar Vivadent). The peak PT and the difference between peak PT and baseline (ΔT) values were subjected to two-way, repeated measures analysis of variance (ANOVA), followed by the Bonferroni post-hoc test (α=0.05). RESULTS: Cavity preparation and etch & rinse procedures decreased the PT values (p<0.001). The 40-second exposure of Filtek Z350 caused the highest peak PT values (38.7±0.8°C) and the highest ΔT values (3.4±0.8°C), while Tetric N Ceram Bulk Fill showed the lowest values (-1.6±1.3°C; p=0.009). CONCLUSION: None of the evaluated procedures resulted in a PT rise near to values that could offer any risk of thermal damage to the pulp.

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<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<0.001). CONCLUSION: Applying air flow simultaneously with LED exposure prevents in vivo pulp temperature rise.