The power of light - From dental materials processing to diagnostics and therapeutics.

Harnessing the power of light and its photonic energy is a powerful tool in biomedical applications. Its use ranges from biomaterials processing and fabrication of polymers to diagnostics and therapeutics. Dental light curable materials have evolved over several decades and now offer very fast (≤ 10 s) and reliable polymerization through depth (4-6 mm thick). This has been achieved by developments on two fronts: (1) chemistries with more efficient light absorption characteristics (camphorquinone [CQ], ~30 L mol-1 cm1 [ʎmax 470 nm]; monoacylphosphine oxides [MAPO], ~800 L mol-1 cm-1 [ʎmax 385 nm]; bisacylphosphine oxide [BAPO], ~1,000 L mol-1 cm-1 [ʎmax 385 nm]) as well mechanistically efficient and prolonged radical generation processes during and after light irradiation, and; (2) introducing light curing technologies (light emitting diodes [LEDs] and less common lasers) with higher powers (≤ 2 W), better spectral range using multiple diodes (short: 390-405 nm; intermediate: 410-450 nm; and long: 450-480 nm), and better spatial power distribution (i.e. homogenous irradiance). However, adequate cure of materials falls short for several reasons, including improper selection of materials and lights, limitations in the chemistry of the materials, and limitations in delivering light through depth. Photonic energy has further applications in dentistry which include transillumination for diagnostics, and therapeutic applications that include photodynamic therapy, photobiomodulation, and photodisinfection. Light interactions with materials and biological tissues are complex and it is important to understand the advantages and limitations of these interactions for successful treatment outcomes. This article highlights the advent of photonic technologies in dentistry, its applications, the advantages and limitations, and possible future developments.

On the inaccuracies of dental radiometers.

This study investigated the accuracy of sixteen models of commercial dental radiometers (DR) in measuring the output of thirty-eight LED light curing units (LCUs) compared with a 'gold standard' laboratory-grade spectrometer integrating-sphere (IS) assembly. Nineteen Type I (fiber-bundle light guide) and nineteen Type II (light source in head) LED LCUs were tested, some using different output modes and light guides, resulting in 61 test subsets per radiometer. Gold standard (GS) output measurements (n = 3) were taken using the IS and confirmed with two types of laboratory-grade power meter (PowerMax-Pro 150 HD and PM10-19C; Coherent). One DR (Bluephase Meter II, Ivoclar; BM II) allowed power (mW) as well as irradiance (mW/cm2) recordings. Irradiance readings (n = 3) for each DR/LCU were compared with the IS derived irradiance. Individual LCU irradiance values were normalized against IS data. The GS method yielded reproducible data with a 0.4% pooled coefficient of variation for the LCUs. Mean power values ranged from 0.19 W to 2.40 W. Overall power values for the laboratory-grade power meters were within 5% of GS values. Individual LCU/DR normalized irradiance values ranged from 7% to 535% of the GS; an order of magnitude greater than previous reports. BM II was the only radiometer to average within 20% of normalized pooled GS irradiance values, whereas other radiometers differed by up to 85%. Ten radiometers failed to provide any reading for 1 LCU. When tested with the PowerMax-Pro in high speed (20 kHz) mode, eight LCUs demonstrated pulsing outputs undetectable at the standard (10 Hz) data acquisition rate. Sufficient light exposure is critical for the successful curing of dental resin-based materials. Substantial discrepancies may occur between actual and estimated radiometric data using current DRs. More accurate DRs need to be developed. Manufacturers' accuracy claims for DRs should specify compatible LCUs and testing parameters.

Robust spectrometer-based methods for characterizing radiant exitance of dental LED light curing units.

OBJECTIVES: Firstly, to assess light output, from a representative range of dental light curing units (LCUs), using a new portable spectrometer based instrument (checkMARC™) compared with a "gold standard" method. Secondly, to assess possible inconsistency between light output measurements using three different laboratory-grade thermopile instruments. METHODS: The output of four blue-dental LCUs and four polywave blue-and-violet-LCUs was measured with two spectrometer-based systems: a portable spectrometer instrument and a benchtop Integrating Sphere fiber-coupled spectrometer system. Power output was also recorded with three thermopiles according to ISO 10650-2. Beam profile images were recorded of LCU output to assess for spatial and spectral beam uniformity. RESULTS: Power recorded with the portable spectrometer instrument closely matched the 'gold standard' Integrating Sphere apparatus calibrated according to International Standards. Radiant exitance for the eight LCUs differed significantly between the three thermopiles. Light source to thermopile sensor distance influenced recorded power significantly (p<0.05), indicating the severe limitations of thermopiles for absolute measurements. Polywave LCU beam profiles demonstrated output spectral heterogeneity. SIGNIFICANCE: Spectrometer-based methods are capable of overcoming the limitations inherent with thermopile-based measurement techniques. Spectrometer based measurements can fulfill the intention of ISO 10650.

Direct anterior composites: a practical guide.

UNLABELLED: For more than 40 years dentists worldwide have been using directly placed resin-bonded composite to restore damaged anterior teeth. While such techniques are invariably more conservative of tooth tissue than indirect procedures, operative techniques using direct composite can be challenging and are considered technique sensitive. Clinicians require both technical and artistic skill to provide composite restorations that restore function and aesthetics to blend seamlessly with the residual dentition. This paper provides an update on the aesthetic considerations involved in the restoration of anterior teeth with directly placed composite and outlines the contemporary materials, equipment and techniques that are available to optimize every clinical stage. CLINICAL RELEVANCE: Successful restoration of anterior teeth with direct composite is an integral component of contemporary clinical practice.

Specimen aspect ratio and light transmission in photoactive dental resins.

OBJECTIVES: To test the influence of specimen dimensions on light transmission and shrinkage strain properties of curing dental resins. MATERIALS AND METHODS: Photocurable resin specimens (Bis-GMA/TEGDMA) with aspect ratios (AR) of 2 (4mm×2mm); 4 (4mm×1mm and 8mm×2mm); 8 (8mm×1mm); 12 (AR: 12mm×1mm); and 24 (12mm×0.5mm) were light cured. Light transmission and shrinkage-strain data were recorded throughout, and upper and lower surface hardness measurements were performed following cure. RESULTS: Light transmission was significantly affected by the specimen aspect ratio even at similar thicknesses (p<0.05). By comparing light transmission through a negative control resin without photoinitiator, the lowest AR specimens showed a relative increase in transmission above 100% throughout curing, which was caused by specimen constraint. The extent of lower surface cure (as assessed by increasing hardness) was principally affected by cavity height and decreased for thicker specimens (p<0.05). Only the 2mm thick specimens showed a significantly greater lower to upper hardness ratio with increasing cavity diameter (p<0.05). The highest AR specimen showed the greatest lower to upper hardness percentage (p<0.05), and was expected since this AR was obtained by reducing the sample thickness to 0.5mm. Generally, total shrinkage strain increased and shrinkage strain per unit mass decreased with increasing AR. SIGNIFICANCE: Specimen constraint in low AR cavities may compromise light transmission as unexpected light intensity variations may occur for low configuration factors, which ultimately affect polymer conversion of light-cured resin-based restorations through depth.

Posterior composites: a practical guide revisited.

UNLABELLED: Direct placement resin composite is revolutionizing the restoration of posterior teeth. Compared to amalgam, its use not only improves aesthetics but, more importantly, promotes a minimally invasive approach to cavity preparation. Despite the benefits, the use of composite to restore load-bearing surfaces of molar and premolar teeth is not yet universally applied. This may be due to individual practitioner concerns over unpredictability, time and the fact that procedures remain technique sensitive for many, particularly with regard to moisture control, placement and control of polymerization shrinkage stress. New materials, techniques and equipment are available that may help to overcome many of these concerns. This paper describes how such techniques may be employed in the management of a carious lesion on the occlusal surface of an upper molar. CLINICAL RELEVANCE: Direct posterior composite is the treatment of choice for the conservative restoration of primary carious lesions.

Advances in light-curing units: four generations of LED lights and clinical implications for optimizing their use: Part 2. From present to future.

UNLABELLED: The first part of this series of two described the history of light curing in dentistry and developments in LED lights since their introduction over 20 years ago. Current second- and third-generation LED light units have progressively replaced their halogen lamp predecessors because of their inherent advantages. The background to this, together with the clinical issues relating to light curing and the possible solutions, are outlined in the second part of this article. Finally, the innovative features of what may be seen as the first of a new fourth-generation of LED lights are described and guidance is given for the practitioner on what factors to consider when seeking to purchase a new LED light activation unit. CLINICAL RELEVANCE: Adequate curing in depth is fundamental to clinical success with any light-activated restoration. To achieve this goal predictably, an appropriate light source needs to be combined with materials knowledge, requisite clinical skills and attention to detail throughout the entire restoration process. As dentists increasingly use light-cured direct composites to restore large posterior restorations they need to appreciate the issues central to effective and efficient light curing and to know what to look for when seeking to purchase a new light-curing unit.

Competitive light absorbers in photoactive dental resin-based materials.

OBJECTIVES: The absorbance profile of photoinitiators prior to, during and following polymerization of light curable resin-based materials will have a significant effect on the cure and color properties of the final material. So-called "colorless" photoinitiators are used in some light-activated resin-based composite restorative materials to lessen the yellowing effect of camphoroquinone (CQ) in order to improve the esthetic quality of dental restorations. This work characterizes absorption properties of commonly used photoinitiators, an acylphosphine oxide (TPO) and CQ, and assesses their influence on material discoloration. METHODS: Dimethacrylate resin formulations contained low (0.0134 mol/dm(3)), intermediate (0.0405 mol/dm(3)) or high (0.0678 mol/dm(3)) concentrations of the photoinitiators and the inhibitor, butylated hydroxytoluene (BHT) at 0, 0.1 or 0.2% by mass. Disc shaped specimens (n = 3) of each resin were polymerized for 60s using a halogen light curing unit. Dynamic measurements of photoinitiator absorption, polymer conversion and reaction temperature were performed. A spectrophotometer was used to measure the color change before and after cure. RESULTS: GLM three-way analysis of variance revealed significant differences (p<0.001), where photoinitiator concentration (df = 2; F = 618.83)>photoinitiator type (df = 1; F = 176.12)>% BHT (df = 2, F = 13.17). BHT concentration affected the rate of polymerization and produced lower conversion in some of the CQ-based resins. Significant differences between photoinitiator type and concentrations were seen in color (where TPO resins became yellower and camphoroquinone resins became less yellow upon irradiation). Reaction temperature, kinetics and conversion also differed significantly for both initiators (p<0.001). Despite TPO-based resins producing a visually perceptible color change upon polymerization, the color change was significantly less than that produced with CQ-based resins. SIGNIFICANCE: Although some photoinitiators such as TPO may be a more esthetic alternative to CQ, they may actually cause significant color contamination when used in high concentrations and therefore manufacturers should limit its concentration in order to improve its esthetic quality.

Three generations of LED lights and clinical implications for optimizing their use. 1: from past to present.

In the present era of adhesive dentistry light-curing units are essential pieces of surgery equipment for everyday practice. The success and longevity of light-activated resin sealants, photo-cured restorations and orthodontic treatments are related to the efficacy of the light-curing process. Energy efficient blue LED lights are rapidly replacing their halogen lamp predecessors as the standard light source. Manufacturers are producing materials with different initiators and not all of these materials can be properly polymerized with blue LED lights.

Formation of gaps at the filler-resin interface induced by polymerization contraction stress: Gaps at the interface.

OBJECTIVES: To investigate the movement of resin matrix with respect to the filler particles of filled composites during their photo cure without or with polymerization contraction stress (PCS). METHODS: Two types of composites were prepared. Glass beads as macroscopic fillers were placed into the center of a bis-GMA/TEGDMA resin to make single bead-embedding "composites" and a variety of fillers of different compositions, sizes, and shapes were mixed with another bis-GMA/TEGDMA resin to make lightly filled composites. They were photo cured in a cavity constructed with an acrylic or aluminum ring sitting on a polyester strip. Bonding to the ring constrained the polymerization shrinkage and thus produced a PCS. The formation of gaps between the filler and the resin was detected by optical microscopy for the glass bead-resin systems, and by light attenuation and scanning electron microscopy (SEM) for the filler-resin composites. RESULTS: In general, for composites with untreated fillers, the optical microscopy and SEM revealed gaps at the filler-resin interface only when they were cured under constrained shrinkage conditions. These composites attenuated more light when cured under constrained shrinkage conditions than when under non-constrained conditions. For the composites with silane-treated fillers, no gaps were observed. Some did not show any significant difference in light attenuation when cured under either constrained or non-constrained conditions. CONCLUSIONS: The resin tends to move away from the filler particles under the influence of PCS. Strengthening the filler-resin interaction, such as by the use of silane-treated filler, may help prevent the resin departure and thus the formation of gaps.

The flexural properties of endodontic post materials.

OBJECTIVES: To measure the flexural strengths and moduli of endodontic post materials and to assess the effect on the calculated flexural properties of varying the diameter/length (D/L) ratio of three-point bend test samples. METHODS: Three-point bend testing of samples of 2mm diameter metal and fiber-reinforced composite (FRC) rods was carried out and the mechanical properties calculated at support widths of 16 mm, 32 mm and 64 mm. Weibull analysis was performed on the strength data. RESULTS: The flexural strengths of all the FRC post materials exceeded the yield strengths of the gold and stainless steel samples; the flexural strengths of two FRC materials were comparable with the yield strength of titanium. Stainless steel recorded the highest flexural modulus while the titanium and the two carbon fiber materials exhibited similar values just exceeding that of gold. The remaining glass fiber materials were of lower modulus within the range of 41-57 GPa. Weibull modulus values for the FRC materials ranged from 16.77 to 30.09. Decreasing the L/D ratio produced a marked decrease in flexural modulus for all materials. SIGNIFICANCE: The flexural strengths of FRC endodontic post materials as new generally exceed the yield strengths of metals from which endodontic posts are made. The high Weibull modulus values suggest good clinical reliability of FRC posts. The flexural modulus values of the tested posts were from 2-6 times (FRC) to 4-10 times (metal) that of dentin. Valid measurement of flexural properties of endodontic post materials requires that test samples have appropriate L/D ratios.

The effect of clinically relevant thermocycling on the flexural properties of endodontic post materials.

OBJECTIVES: It is suggested that fibre-reinforced composite (FRC) posts have lower elastic moduli than metal posts and this will reduce the incidence of root fracture. However, the mechanical properties may be altered in the oral environment. The aims of this study were to determine the effect on the flexural properties of FRC and metal post materials produced by: (1) a thermocycling regime which was clinically relevant and representative of that which would occur during 1 year in the mouth and (2) storage for 1 year at body temperature. METHODS: Nine FRC and two metal post material samples were sealed in polythene sleeves and thermocycled between 10 degrees C and 50 degrees C for 10,000 cycles. Additional samples were stored dry at 37 degrees C for 1 year. The flexural strength and moduli were determined by three-point bending and compared with untreated control samples. RESULTS: Thermocycling and storage at 37 degrees C for 1 year decreased the mean flexural modulus of all materials. This was statistically significant for 8 of 11 materials after thermocycling, and 4 of 11 materials after storage at 37 degrees C (p<0.05). Thermocycling and storage at 37 degrees C produced a non-significant increase in yield strength for both metal post materials. Thermocycling significantly increased the flexural strength of Postec while it decreased for the other FRC materials. Storage at 37 degrees C increased the flexural strength of three FRC materials (significantly for Postec) while it was decreased among the other materials. CONCLUSIONS: Although some of the changes noticed in flexural properties were statistically significant, it is doubtful that they are of sufficient magnitude to affect clinical performance.

Oxygen inhibition and incremental layer bond strengths of resin composites.

OBJECTIVES: When dentists light cure resin composite restorations in increments or after contouring the surface layer to shape with a hand instrument the surface layer is exposed to air during polymerization. The presence of an oxygen inhibited resin surface layer may impact on clinical performance. Conflicting data has been produced in vitro regarding this topic. METHODS: To shed further light on this subject the current investigation assessed the thickness of the oxygen inhibited layer (OIL) and subsequent interfacial bond strength at various times post-cure of an "initial increment" for a range of experimental and commercial resin composites. The latter included conventional methacrylate-based composites and a novel low shrink Silorane resin chemistry product. RESULTS: A decrease in composite viscosity brought about by an increase in diluent monomer content in the matrix for the experimental composite formulations led to increase in OIL thickness. The OIL surface layer thickness for the commercial methacrylate-based RBC specimens cured in air were 19.2+/-6.3 and 13.8+/-5.3 microm, respectively and 9.0+/-6.6 microm for Silorane. No test material exhibited a measurable OIL thickness polymerized in the nitrogen atmosphere. SIGNIFICANCE: From the current findings it may be concluded that incremental bond strength is not wholly reliant on surface inhibition since no differences in bond strength following immediate placement were observed between air and nitrogen atmosphere for any experimental or commercial material. For large restorations requiring multiple increments which are placed on fresh material, the bond strength between successive layers of Silorane should be no different to conventional methacrylate materials. Repair and bonding to aged Silorane restorations may be more problematic as inferior incremental bond strengths ensued when addition was delayed.

Direct posterior composites: a practical guide.

UNLABELLED: The restoration of posterior teeth with directly placed resin-bonded composite requires meticulous operative technique in order to ensure success. Case and material selection; cavity preparation; matrix selection; isolation; bonding; management of polymerization shrinkage; placement; finishing and curing of posterior composites--all present a series of challenges that dentists must master in order to ensure high-quality, long-lasting restorations. This paper describes and discusses these aspects of the provision of composites for loadbearing situations in posterior teeth. CLINICAL RELEVANCE: Successful restoration of posterior teeth with composite is an essential component of contemporary dental clinical practice.

The mechanical properties of nanofilled resin-based composites: characterizing discrete filler particles and agglomerates using a micromanipulation technique.

OBJECTIVE: To assess the mechanical properties of discrete filler particles representative of several inorganic fillers in modern dental resin-based composites (RBCs) and to assess the validity of a novel micromanipulation technique. METHOD: RBCs with microhybrid (Filtek Z250), 'nanohybrid' (Grandio) and 'nanofilled' (Filtek Supreme), filler particle morphologies were investigated. Filler particles were provided by the manufacturer or separated from the unpolymerized resin using a dissolution technique. Filler particles (n=30) were subjected to compression using a micromanipulation technique between a descending glass probe and a glass slide. The number of distinct fractures particles underwent was determined from force/displacement and stress/deformation curves and the force at fracture and pseudo-modulus of stress was calculated. RESULTS: Agglomerated fillers ('nanoclusters') exhibited up to four distinct fractures, while spheroidal and irregular particles underwent either a single fracture or did not fracture following micromanipulation. Z-tests highlighted failure of nanoclusters to be significant compared with spheroidal and irregular particles (P<0.05). The mean force at first fracture of the nanoclusters was greater (1702+/-909 microN) than spheroidal and irregular particles (1389+/-1342 and 1356+/-1093 microN, respectively). Likewise, the initial pseudo-modulus of stress of nanoclusters (797+/-555 MPa) was also greater than spheroidal (587+/-439 MPa) or irregular (552+/-275 MPa) fillers. SIGNIFICANCE: The validity of employing the micromanipulation technique to determine the mechanical properties of filler particulates was established. The 'nanoclusters' exhibited a greater tendency to multiple fractures compared with conventional fillers and possessed a comparatively higher variability of pseudo-modulus and load prior to and at fracture, which may modify the damage tolerance of the overall RBC system.

The mechanical properties of nanofilled resin-based composites: the impact of dry and wet cyclic pre-loading on bi-axial flexure strength.

OBJECTIVES: To determine the influence of nano-sized filler particles and agglomerates of nanoparticles ('nanoclusters') in resin-based composite (RBC) materials on the bi-axial flexure strength (BFS) following cyclic pre-loading and storage in a 'dry' or 'wet' environment. METHOD: Seven commercially available RBC restoratives, Heliomolar (Ivoclar Vivadent, Schaan, Liechtenstein), Z100 MP Restorative, Filtek Z250, Filtek Supreme (3M ESPE, St. Paul, MN, USA) in Body (FSB) and Translucent (FST) shades, Grandio and Grandio Flow (VOCO, Cuxhaven, Germany), containing differing filler particle types and morphologies were investigated. Specimens were pre-loaded at 20, 50 or 100 N for 2000 cycles and stored in a 'dry' or 'wet' environment prior to BFS testing. RESULTS: A general linear model analysis of variance highlighted a reduction in the BFS following pre-loading, however, individual RBC materials responded differently. The RBCs containing agglomerated nano-sized particles or 'nanoclusters' (Filtek Supreme) demonstrated distinctive and unique patterns of response to pre-loading. Cyclic pre-loading at 20 and 50 N significantly increased the Weibull modulus of both FSB (8.53+/-1.91 and 10.23+/-2.29) and FST (16.89+/-3.78 and 10.91+/-2.45) compared with FSB and FST control (no pre-cyclic load) specimens (5.98+/-1.34 and 7.99+/-1.78, respectively). BFS of FSB and FST was maintained or significantly increased compared with the other materials following 20 and 50 N cyclic pre-load (P<0.05). SIGNIFICANCE: The 'nanoclusters' provided a distinct reinforcing mechanism compared with the microhybrid, microfill or nanohybrid RBC systems resulting in significant improvements to the strength and reliability, irrespective of the environmental storage and testing conditions. Silane infiltration within interstices of the nanoclusters may modify the response to pre-loading induced stress, thereby enhancing damage tolerance and providing the potential for improved clinical performance.

Vibration characteristics of dental high-speed turbines and speed-increasing handpieces.

OBJECTIVES: Vibrations of dental handpieces may contribute to symptoms of hand-arm vibration syndrome in dental personnel and iatrogenic enamel cracking in teeth. However, methods for measuring dental handpiece vibrations have previously been limited and information about vibration characteristics is sparse. This preliminary study aimed to use a novel approach to assess the vibrations of unloaded high-speed handpieces in vitro. METHODS: Maximum vibration displacement amplitudes of five air turbines and two speed-increasing handpieces were recorded whilst they were operated with and without a rotary cutting instrument (RCI) using a scanning laser vibrometer (SLV). RESULTS: RCI rotation speeds, calculated from frequency peaks, were consistent with expected values. ANOVA statistical analysis indicated significant differences in vibrations between handpiece models (p<0.01), although post hoc tests revealed that differences between most individual models were not significant (p>0.11). Operating handpieces with a RCI resulted in greater vibrations than with no RCI (p<0.01). Points on the head of the handpiece showed greater vibration displacement amplitudes than points along the body (p<0.01). CONCLUSIONS: Although no single measurement exceeded 4 microm for the handpieces in the current test setup (implying that these vibrations may be unlikely to cause adverse effects), this study has formed the basis for future work which will include handpiece vibration measurements whilst cutting under clinically representative loads.

Cure width potential for MOD resin composite molar restorations.

OBJECTIVES: To investigate the capability of modern light-curing units exhibiting differences in emission spectra and light source exit window dimensions, for "one-shot" full-width curing of extensive (molar MOD) resin composite restorations. METHOD: Specimens of Tetric (TT), Tetric Ceram HB (TC), Tetric Evoceram (TE) and Tetric Ceram Bleach (TB) resin composites containing varying ratios of Lucirin (TPO) and/or camphorquinone (CQ) photoinitiators were packed into a bar-shaped mould (12 mm length x 2 mm width x 2 mm thickness). Each product was irradiated using a halogen (Optilux 401; QTH), a conventional LED (LEDemetron; LED) and two so-called "third generation" oval-footprint LED light-curing units (LCUs) of the same model. The latter featured bimodal emission spectra (blue and ultraviolet diodes) with either high (unmodified output) and approximately 50% (modified output) blue light intensity (UltraLume-5; ULs, ULm, respectively). Vickers hardness number was obtained across the lateral extent of the bar at 1mm increments from the centre point on both upper and lower surfaces of the specimens. RESULTS: Significant linear relationships (R(2)=0.71-0.98) for each distance from the central position of all LCUs were identified between measured light intensity and corresponding upper and lower surface hardness values for each product (P<0.05). No significant differences (P>0.05) were recorded in total upper surface hardness of TC or TE cured with LED (68.7+/-3.2 and 70.5+/-2.5) or ULm (56.8+/-2.0 and 57.7+/-2.0). However, upper surface hardness of TT (CQ only) cured with ULm was significantly decreased (P<0.05) compared with other LCUs. When the ratio of hardness at the edge to central positions of the bar-shaped specimens for either surface was calculated, no significant difference (P>0.05) was identified for TB (containing TPO and decreased CQ) cured with either ULs or ULm (P>0.05) and was significantly increased (P<0.05) when cured with ULs compared with LED and QTH. SIGNIFICANCE: Variability in light intensity across the curing-tip face, spectral output of dental light-curing units and differences in product photoinitiator chemistry all influence curing efficiency significantly across the width of extensive resin composite geometries.

Time-resolved simultaneous measurement of group index and physical thickness during photopolymerization of resin-based dental composite.

Light-activated resin-based dental composites are increasingly replacing dental amalgam. However, these materials are limited by inefficient setting reactions as a function of depth that constrain the maximum extent of cure. Insufficient curing can contribute to an overall reduction in biocompatibility of the material. We demonstrate dynamic refractive index measurements of a commercial dental composite throughout cure using spectral domain low coherence interferometry. Our results show a linear relationship between the change in refractive index and polymerization-induced reduction in physical thickness during light-activated curing. This relationship between the optical and physical density demonstrates the potential of this technique as a unique noninvasive tool for measurement of the conversion degree of curing dental composite materials.

Trends in indirect dentistry: 6. Provisional restorations, more than just a temporary.

The provision of well-fitting, functional provisional restorations is important for a wide variety of reasons, including maintenance of the stability of inter- and intra-arch relationships and positional stability of prepared teeth, and the preservation of occlusal function of anterior provisional restorations by providing appropriate protrusive and lateral guidance. Provisional restorations should be of sufficient strength to resist the forces of occlusion and should be luted with a cement that will resist the forces of removal, yet allow easy removal at the fit appointment without leaving a residue on the prepared tooth. This paper describes the use of provisional restorations in indirect restorative dentistry and suggests some specific techniques for clinical use.