Comparison of Blue and Infrared Light Transmission Through Dental Tissues and Restorative Materials.

OBJECTIVES: The depth of cure using blue-light photocuring units (BL) is limited by tooth structure and qualities of the restorative material through which the activating wavelength must pass. Recent developments incorporate an infrared (IR) activated upconversion (UC) fluorescence of a lining agent filled with nanocrystals of NaYF4 and doped with YB+3 and Tm+3 that emit both blue and violet light locally at the interface of the liner and restorative resin. The purpose of this study was to evaluate the BL and 975 nm infrared (IR) light power transmission through dental tissues and restorative materials. METHODS AND MATERIALS: Power transmissions of the IR laser (975 nm) and a monowave blue-only light-curing unit (Bluephase 16i) through dental tissues (enamel, dentin, and enamel/dentin junction, or DEJ), eight (8) various dental resin composites, and eight (8) dental ceramics, each at four thicknesses (1, 2, 3 and 4 mm) were evaluated (n=5) using a thermopile sensor (PM10, Coherent Inc) connected to a laser power meter (Fieldmate, Coherent Inc). Power transmission values of each light source and restorative material were subjected to analysis of variance and Tukey test at a pre-set alpha of 0.05. RESULTS: A linear correlation (r=0.9884) between the supplied current and emitted IR power of the laser diode was found, showing no statistical power reduction with increased distances (collimated beam). For tooth tissues, the highest power transmissions for both light sources were observed using 1.0 mm enamel while the lowest values were found for 2.0 mm dentin and an association of 2.0 mm DEJ and 1.0 mm dentin. The only group where IR demonstrated significantly higher transmission when compared to BL was 1.0 mm enamel. For all resin composites and dental ceramics, increased thickness resulted in a reduction of IR power transmission (except for EverX Posterior fiber-reinforced composite and e.max HT ceramic). IR resulted in higher transmission through all resin composites, except for Tetric EvoCeram White. The highest BL transmission was observed for SDR Flow, at all thicknesses. Higher IR/BL ratios were observed for EverX Posterior, Herculite Ultra, and Lava Ultimate, while the lowest ratio was observed for Tetric EvoCeram White. Reduced translucency shades within the same material resulted in lower power ratio values, especially for BL transmission. Higher IR/BL ratios were observed for e.Max LT, VitaVM7 Base Dentin, and e.max CAD HT, while the lowest values were found for VitaVM7 Enamel and Paradigm C. CONCLUSION: IR power transmission through enamel was higher when compared to blue light, while no difference was observed for dentin. The power transmission of IR was higher than BL for resin composites, except for a high value and low chroma shade. Fiber-reinforced resin composite demonstrated the highest IR/BL power transmission ratio. A greater IR/BL ratio was observed for lower translucency ceramics when compared to high translucency.

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.

Effect of Operator Experience on Ability to Place Sequential, 2-mm-thick Increments of Composite.

OBJECTIVE: To measure and compare the effect of operator experience in their ability to place composite in increments that are 2 mm thick. METHODS AND MATERIALS: Fifteen volunteers from each class of freshmen, sophomores, juniors, and senior dental students and 15 clinical faculty (total number of volunteers = 75) were asked to restore a Class I preparation that was 5 mm in diameter and 8 mm deep from the cusp tips using three increments of composite that were each to be 2 mm thick. Once completed, the models were sectioned, and the thickness of each increment was measured. A repeated-measures analysis of variance (pre-set α=0.05) was used to compare the mean increment thickness with respect to operator experience level and increment sequence number. In addition, the proportion of operators placing clinically acceptable increments (between 1.75 and 2.25 mm thick), as well as the proportions from each group who placed increments that either were thinner or thicker than this range, was determined using nonparametric analyses. RESULTS: Overall, there was an increasing trend for groups with a higher experience level to provide mean incremental thickness values close to 2 mm. However, the likelihood of placing an increment that was thicker or thinner than the manufacturer-recommended thickness was not significantly different. Regardless of the increment value, only about one-third of the increments placed fell within the desired range of 1.75 to 2.25 mm. CONCLUSIONS: Operator experience had no overwhelming significant influence on the ability to place increments of composite that were between 1.75 and 2.25 mm thick. An operator has only about one chance out of three to place a composite increment within this clinically acceptable range when using no external measurement system.

Influence of Multiple Peak Light-emitting-diode Curing Unit Beam Homogenization Tips on Microhardness of Resin Composites.

This study evaluated the effect of light curing unit (LCU) guide type (regular or homogenizing) on top and bottom microhardness of conventional and bulk-fill resin-based composites (RBCs). A polywave light-emitting-diode (LED) LCU (Bluephase Style, Ivoclar Vivadent AG) was used with two different light guides: a regular tip (RT, 935 mW/cm2 emittance) and a homogenizer tip (HT, 851 mW/cm2 emittance). Two conventional RBCs (Herculite Ultra [HER], Kerr Corp; Tetric EvoCeram [TEC], Ivoclar Vivadent AG) and two bulk-fill RBCs (SonicFill [SOF], Kerr Corp; Tetric EvoCeram Bulk Fill [TBF], Ivoclar Vivadent AG) were tested. Disc-shaped samples (10 mm Ø), 2-mm thick for conventional composites and 4-mm thick for bulk-fill composites were prepared. Samples were light cured according to manufacturer-recommended times. Knoop microhardness values (KHN) were obtained on the top and bottom surfaces of each specimen at locations correlated with the output of the three LED chips emitting blue (456 nm) or violet light (409 nm). Beam profile analysis using both light guides was also performed. Microhardness of each composite was analyzed using three-way analysis of variance and Tukey honestly significant difference post hoc test (α=0.05). Beam profile images showed better light distribution across the surface of the HT light guide. Use of the HT decreased KHN of HER at the locations of the blue LED chips at bottom of the sample but had no effect on the top surface. For TEC, use of HT increased KHN of all three LED locations at the top surface. Use of the HT increased KHN of SOF at locations corresponding to one of the blue and the violet LED chips at the bottom surface. For TBF, HT increased KHN at all top surface locations. All RBCs showed higher mean KHN at the top compared with the bottom surfaces. In general, all composites presented a higher KHN at the blue LED areas regardless of the surface or the tip used. Results suggest that the homogenizer light guide resulted in significantly increased microhardness at the top, in composite resins containing alternative photoinitiators; however, that effect was not observed at the bottom surfaces.

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.

Effect of Sonic Resin Composite Delivery on Void Formation Assessed by Micro-computed Tomography.

OBJECTIVES: The aim of this study was to quantify the internal void volume formation in commercially available, resin composites inserted using conventional or sonic insertion methods, and analyzed using three-dimensional (3D) micro-computed tomography (µCT). METHODS AND MATERIALS: Four resin composites were evaluated: one conventional (Herculite, Ultra, Kerr Corporation, Orange, CA, USA), one flowable bulk fill (SureFil SDR Flow, Dentsply International, York, PA, USA), and two packable bulk fill (SonicFill, Kerr Corporation, and Tetric EvoCeram Bulk Fill, Ivoclar Vivadent Inc, Schaan, Liechtenstein). Eight groups were evaluated according to each resin composite type and insertion method (conventional or sonic; n=5). Forty ABS 3D-printed cylindrical molds, 5.0 mm in diameter and 4.0 mm in depth, were fabricated. For the conventional resin composite, the mold was filled incrementally (two layers), while for bulk-fill resin composites, insertion was performed in a single increment. The sonic insertion method was performed using a specific handpiece (SonicFill Handpiece, Kerr Corporation). Resin composites were light cured using a multipeak light-emitting diode light-curing unit (VALO, Ultradent Products Inc, South Jordan, UT, USA) in its regular mode. Samples were evaluated by µCT, and data were imported into software (Amira, version 5.5.2, VSG, Burlington, MA, USA) for 3D reconstruction, from which the percentage of void volume was calculated. Data were analyzed using two-way analysis of variance and Tukey post hoc test at a preset alpha of 0.05. RESULTS: The conventional insertion method resulted in reduced porosity, compared with sonic insertion, for SureFil SDR Flow and Tetric EvoCeram bulk fill. The sonic insertion method did not demonstrate any influence on void formation for Herculite Ultra or SonicFill. CONCLUSION: Results suggest that the sonic insertion method might increase void formation during resin composite delivery, depending on restorative material brand.

Short- and Long-Term Bond Strength Between Resin Cement and Glass-Ceramic Using a Silane-Containing Universal Adhesive.

This study aimed to evaluate the effect of various silane-containing solutions on bonding between resin cement and glass ceramic after 24 hours and after six months of water storage. Glass-ceramic plaques (IPS e.max CAD) were sandblasted with aluminum oxide, etched with 10% hydrofluoric acid (HF), and divided into five "silane treatment" groups: RelyX Ceramic Primer (RCP), RelyX Ceramic Primer and Single Bond Plus (RCP+SB), Scotchbond Universal (SBU), Clearfil Ceramic Primer (CP), and no solution (HF-only control). Each group was divided into two "storage time" subgroups: 24 hours or six months in 37°C water. Eighteen resin cement cylinders (RelyX Ultimate) were bonded to each treatment group substrate (n=18) and then subjected to microshear testing. Failure mode was analyzed using scanning electron microscopy. Debond data were analyzed using a two-way analysis of variance and the Tukey post hoc test (α=0.05) as well as Weibull distributions. The factors "silane treatment," "storage time," (p<0.0001), and their interaction were statistically significant (p<0.0010). Group means (MPa±SD), RCP (24 hours: 27.2±3.1; six months: 18.0±4.9), and HF-only control (24 hours: 21.1±3.4; six months: 15.7±5.8) showed a reduced bond strength after six months of water storage, while RCP + SB (24 hours: 23.4±4.4; six months: 22.2±5.4), SBU (24 hours: 18.8±3.0; six months: 17.2±3.6), and CP (24 hours: 21.7±4.3; six months: 17.4±4.8) remained constant. Weibull analysis revealed that more reliable bond strengths were obtained after six months for SBU and RCP + SB. Evaluation by scanning electron microscopy revealed that all groups demonstrated hydrolytic degradation at six months of storage, but RCP + SB and SBU indicated less. Use of a separate application of silane and adhesive system improved short and long-term ceramic/resin cement bond strength.

Characterization of Inorganic Filler Content, Mechanical Properties, and Light Transmission of Bulk-fill Resin Composites.

OBJECTIVES: The aims of this study were to characterize inorganic content (IC), light transmission (LT), biaxial flexural strength (BFS), and flexural modulus (FM) of one conventional (layered) and four bulk-fill composites at different depths. METHODS: Bulk-fill composites tested were Surefil SDR flow (SDR), Filtek Bulk Fill (FBF), Tetric EvoCeram Bulk Fill (TEC), and EverX Posterior (EXP). Herculite Classic (HER) was used as a control. Energy dispersive x-ray analysis and scanning electron microscopy were used to characterize filler particle composition and morphology. The LT through different composite thicknesses (1, 2, 3, and 4 mm) was measured using a laboratory-grade spectral radiometer system (n=5). For the BFS and FM tests, sets of eight stacked composite discs (0.5-mm thick) were prepared simulating bulk filling of a 4-mm-thick increment (n=8). RESULTS: SDR demonstrated larger, irregular particles than those observed in TEC or HER. Filler particles in FBF were spherical, while those in EXP were composed of fiberglass strands. The LT decreased with increased composite thickness for all materials. Bulk-fill composites allowed higher LT than the HER. Furthermore, HER proved to be the unique material, having lower BFS values at deeper regions. SDR, FBF, and TEC bulk-fill composites presented reduced FM with increasing composite depth. CONCLUSIONS: The bulk-fill composites investigated exhibited higher LT, independent of different filler content and characteristics. Although an increase in composite thickness reduced LT, the BFS of bulk-fill composites at deeper layers was not compromised.

Transmission of violet and blue light through conventional (layered) and bulk cured resin-based composites.

OBJECTIVES: This study measured the transmission of light in the 'violet' (350≤λ≤425nm) and 'blue' (425<λ≤550nm) spectral ranges from a polywave(®) LED curing light through different thicknesses of four commercial, resin-based composites (RBCs). MATERIAL AND METHODS: Samples of conventional layered RBCs (Tetric EvoCeram A2, Filtek Supreme Ultra A2B), and bulk-curing resins (Tetric EvoCeram Bulk Fill IVA, and SureFil SDR Flow U) were prepared. Three samples of each RBC were made at thicknesses of 0.1, 0.7, 1, 2, and 4-mm. The uncured RBC specimens were affixed at the entrance aperture of a 6-inch integrating sphere and light-cured once for 20s using a polywave(®) LED curing light (Bluephase G2) on its high power setting. The spectral radiant power transmitted through each RBC in the 'violet' and 'blue' regions was measured using a fiberoptic spectrometer. RESULTS: As RBC thickness increased, an exponential attenuation of transmitted light was measured (R(2)>0.98). Attenuation was greater for the 'violet' than for the 'blue' spectral regions. At the light tip, the violet light component represented 15.4% of the light output. After passing through 4-mm of RBC, the violet light represented only between 1.2-3.1% of the transmitted light depending on the RBC. Depending on RBC, approximately 100mW from the Bluephase G2 was transmitted through 0.1-mm of RBC in the 'violet' range, falling at most to 11mW after passing through 2-mm of RBC, and to only 2mW at 4-mm depth. CONCLUSIONS: Increasing RBC thickness results in an exponential decrease in light transmission. This attenuation is RBC-dependent with shorter wavelengths (violet) attenuated to a greater extent than longer wavelengths (blue). CLINICAL RELEVANCE: Despite the increased translucency of bulk curing RBCs, spectral radiant power shorter than 425nm from a curing light is unlikely to be effective at a depth of 4-mm or more.

Emission Characteristics and Effect of Battery Drain in "Budget" Curing Lights.

Recently, "budget" dental light-emitting diode (LED)-based light-curing units (LCUs) have become available over the Internet. These LCUs claim equal features and performance compared to LCUs from major manufacturers, but at a lower cost. This study examined radiant power, spectral emission, beam irradiance profiles, effective emission ratios, and the ability of LCUs to provide sustained output values during the lifetime of a single, fully charged battery. Three examples of each budget LCU were purchased over the Internet (KY-L029A and KY-L036A, Foshan Keyuan Medical Equipment Co, and the Woodpecker LED.B, Guilin Woodpecker Medical Instrument Co). Major dental manufacturers provided three models: Elipar S10 and Paradigm (3M ESPE) and the Bluephase G2 (Ivoclar Vivadent). Radiant power emissions were measured using a laboratory-grade thermopile system, and the spectral emission was captured using a spectroradiometer system. Irradiance profiles at the tip end were measured using a modified laser beam profiler, and the proportion of optical tip area that delivered in excess of 400 mW/cm(2) (termed the effective emission ratio) was displayed using calibrated beam profile images. Emitted power was monitored over sequential exposures from each LCU starting at a fully charged battery state. The results indicated that there was less than a 100-mW/cm(2) difference between manufacturer-stated average tip end irradiance and the measured output. All the budget lights had smaller optical tip areas, and two demonstrated lower effective emission ratios than did the units from the major manufacturers. The budget lights showed discontinuous values of irradiance over their tip ends. One unit delivered extremely high output levels near the center of the light tip. Two of the budget lights were unable to maintain sustained and stable light output as the battery charge decreased with use, whereas those lights from the major manufacturers all provided a sustained light output for at least 100 exposures as well as visual and audible indications that the units required recharging.

Effect of temperature on the degree of conversion and working time of dual-cured resin cements exposed to different curing conditions.

OBJECTIVES: This study evaluated the degree of conversion (DC) and working time (WT) of two commercial, dual-cured resin cements polymerized at varying temperatures and under different curing-light accessible conditions, using Fourier transformed infrared analysis (FTIR). MATERIALS AND METHODS: Calibra (Cal; Dentsply Caulk) and Variolink II (Ivoclar Vivadent) were tested at 25°C or preheated to 37°C or 50°C and applied to a similar-temperature surface of a horizontal attenuated-total-reflectance unit (ATR) attached to an infrared spectrometer. The products were polymerized using one of four conditions: direct light exposure only (600 mW/cm(2)) through a glass slide or through a 1.5- or 3.0-mm-thick ceramic disc (A2 shade, IPS e.max, Ivoclar Vivadent) or allowed to self-cure in the absence of light curing. FTIR spectra were recorded for 20 min (1 spectrum/s, 16 scans/spectrum, resolution 4 cm(-1)) immediately after application to the ATR. DC was calculated using standard techniques of observing changes in aliphatic-to-aromatic peak ratios precuring and 20-min postcuring as well as during each 1-second interval. Time-based monomer conversion analysis was used to determine WT at each temperature. DC and WT data (n=6) were analyzed by two-way analysis of variance and Tukey post hoc test (p=0.05). RESULTS: Higher temperatures increased DC regardless of curing mode and product. For Calibra, only the 3-mm-thick ceramic group showed lower DC than the other groups at 25°C (p=0.01830), while no significant difference was observed among groups at 37°C and 50°C. For Variolink, the 3-mm-thick ceramic group showed lower DC than the 1-mm-thick group only at 25°C, while the self-cure group showed lower DC than the others at all temperatures (p=0.00001). WT decreased with increasing temperature: at 37°C near 70% reduction and at 50°C near 90% for both products, with WT reduction reaching clinically inappropriate times in some cases (p=0.00001). CONCLUSION: Elevated temperature during polymerization of dual-cured cements increased DC. WT was reduced with elevated temperature, but the extent of reduction might not be clinically acceptable.

Changes in resin-infiltrated dentin stiffness after water storage.

Plasticization of polymers by water sorption lowers their mechanical properties in a manner that is predictable by the polarity of their component resins. This study tested the hypothesis that when adhesive resins were used to create resin-infiltrated dentin, the reductions in their flexural moduli after water storage would be lowered proportional to their hydrophilic characteristics. Three increasingly hydrophilic resin blends were used to fabricate polymer beams and macro-hybrid layer models of resin-infiltrated dentin for testing with a miniature three-point flexure device, before and after 1-4 weeks of water storage. Flexural modulus reductions in macro-hybrid layers were related to, and more extensive than, reductions in the corresponding polymer beams. Macro-hybrid layers that were more hydrophilic exhibited higher percent reductions in flexural modulus, with the rate of reduction proportional to the Hoy's solubility parameters for total intermolecular attraction forces (delta(t)) and polar forces (delta(p)) of the macro-hybrid layers.

Polymerization kinetics of pre-heated composite.

Temperature affects the polymerization behavior of dimethacrylate-based materials. This study describes the influence of pre-polymerization temperature and exposure duration on polymerization kinetics of a commercial dental photo-activated composite at the top and at 2-mm depth. We used the temperature-controlled stage of a diamond-attenuated-total-reflectance unit to pre-set composite temperature between 3 degrees and 60 degrees C. Composite was light-exposed by a conventional quartz-tungsten-halogen curing unit for 5, 10, 20, or 40 sec. Real-time conversion, maximum conversion rate (R(p)(max)), time to achieve R(p)(max), and conversion at R(p)(max) were calculated from infrared spectra. Composite pre-warming enhanced maximal polymerization rate and overall monomer conversion (top significantly greater than 2 mm). Time when R(p)(max) occurred did not change with temperature, but occurred sooner at the top than at 2-mm depth. Conversion at R(p)(max) increased with temperature, allowing more of the reaction to occur prior to vitrification than at room temperature.

Tubular occlusion prevents water-treeing and through-and-through fluid movement in a single-bottle, one-step self-etch adhesive model.

Water entrapment occurs at resin-dentin interfaces of one-step self-etch adhesives. We hypothesized that by preventing water fluxes from dentin, any water entrapment would be attributed to incomplete removal of adhesive solvents. We tested this hypothesis by bonding to transparent carious dentin containing occluded dentinal tubules. An experimental single-bottle, one-step self-etch adhesive was applied to flat surfaces of caries-affected dentin surrounded by sound dentin, with or without pulpal pressure. Resin-dentin interfaces were examined with TEM after silver-impregnation. Although caries-affected dentin was highly porous, adhesive layers were devoid of silver deposits when tubules were occluded. Conversely, variable extents of water-treeing and water-droplets were identified from adhesive layers in bonded sound dentin. Water-treeing and water-droplet formation, being manifestations of evaporative and convective water fluxes, can be eliminated during bonding to occluded transparent carious dentin. However, the highly porous nature of this clinically relevant substrate after bonding may lead to potentially undesirable consequences.

Monomer conversion of pre-heated composite.

The potential for maximizing conversion of room-temperature, photoactivated resin composite in the oral environment is limited. Pre-heating composite prior to light-curing is hypothesized to increase monomer conversion and reduce the duration of light exposure. Composite temperature was controlled at between 3 degrees C and 60 degrees C prior to exposure with a conventional quartz-tungsten-halogen curing unit: 5, 10, 20, or 40 sec. Monomer conversion was calculated from infrared spectra at 0 mm (top) and 2-mm-deep surfaces 5 min after light initiation. A strong, positive correlation existed between temperature and monomer conversion: top r(2) = 0.999, 2 mm r(2) = 0.998. Conversion ranged from 31.6% (3 degrees C) to 67.3% (60 degrees C). The duration of light exposure, reduced by 50 to 75% with pre-heated composite, yielded the same or significantly higher conversion (p = 0.001) than with control (22 degrees C, 20 sec). Both hypotheses were accepted: Pre-heating composite prior to photoactivation provides greater conversion requiring reduced light exposure than with room-temperature composite.

Blue light differentially modulates cell survival and growth.

Previous studies have reported that blue light (400-500 nm) inhibits cell mitochondrial activity. We investigated the hypothesis that cells with high energy consumption are most susceptible to blue-light-induced mitochondrial inhibition. We estimated cell energy consumption by population doubling time, and cell survival and growth by succinate dehydrogenase (SDH) activity. Six cell types were exposed to 5 or 60 J/cm(2) of blue light from quartz-tungsten-halogen (QTH), plasma-arc (PAC), or argon laser sources in monolayer culture. Post-light SDH activity correlated positively with population doubling time (R(2) = 0.91 for PAC, 0.76 for QTH, 0.68 for laser); SDH activity increased for cell types with the longest doubling times and was suppressed for cell types with shorter doubling times. Thus, light-induced exposure differentially affects SDH activity, cell survival, and growth, depending on cell energy consumption. Blue light may be useful as a therapeutic modulator of cell growth and survival.

Dimensional changes in acid-demineralized dentin matrices following the use of HEMA-water versus HEMA-alcohol primers.

Although dried acid-etched dentin can be reexpanded by hydroxyethyl methacrylate (HEMA)/water primers, the primed dentin collapses when the water is evaporated. Experimental HEMA/alcohol primers should stiffen the matrix and permit less shrinkage when the solvent is evaporated. The purpose of this study was to test the hypotheses that matrix shrinkage induced by solvent evaporation from HEMA primers is inversely related to solvent-induced matrix stiffness. Dentine discs were prepared from midcoronal dentine of unerupted human third molars. After demineralization in 37% phosphoric acid, the specimens were placed in the well of a linear variable differential transformer instrument, which measures changes in the matrix height and stiffness by load displacement after the application of weights. This was done in their hydrated state after water had been applied, after drying with dry nitrogen gas, and after the application of 35 vol % HEMA-water, HEMA-methanol, HEMA-ethanol, or HEMA-propanol primers. The degree of reexpansion after the application of the primers to the dentine in the dried state was found to be highest using the HEMA-water primer, followed by HEMA-methanol and HEMA-ethanol, with the HEMA-propanol primer producing no expansion. However, when the solvents were evaporated the HEMA-water-treated specimens shrank the most, the HEMA-ethanol-treated specimens shrank an intermediate amount, and the HEMA-methanol-treated specimens shrank the least. The net result of expansion minus shrinkage produced by evaporation determines how much HEMA remains in the hybrid layer just prior to polymerization.

Shedding new light on composite polymerization.

Life usually gets simpler, but in the case of photocuring dental restorative materials, just the opposite is true. Confusing and contradictory barrages of clinical claims have been made with the ever-growing variety of light-curing sources available today. Often, laboratory research or clinical studies related to these systems are lacking prior to their being introduced to the market, leaving the clinician to become the "testing ground." Manufacturers prefer to market the newest technology available, yet, depending on the type of practice and composite system in use, such "state-of-the-art" devices may offer no advantage. For some clinicians, changing to a "fast cure" composite in combination with a traditional QTH light, instead of purchasing a $4,000 PAC light, may be the only improvement in efficiency needed. However, others may want to spend as little time as possible per procedure and do not mind investing in the newest, yet "unproven" technology. Either way, today's clinician needs to be wary of the many claims made by manufacturers of all light-curing units. It is prudent that the clinician, prior to selecting a device, aggressively ask questions and dig for the truth before "buying into" a particular unit or system philosophy. At stake are the durability of restorations, the satisfaction of patient and the well-earned reputation of the operator.

Curing potential of dual-polymerizable resin cements in simulated clinical situations.

STATEMENT OF PROBLEM: Little is known about the ability of dual-polymerizable resin cements to polymerize when they are used in various clinical scenarios. Purpose. This study was conducted to determine whether any of 6 commercially available dual-polymerizable resin cements should be classified as an "all-purpose" resin cement. MATERIAL AND METHODS: Chemical conversion values (C=C converted to C-C, or the extent of the curing reaction) of 6 commercially available dual-polymerizable resin cements were determined with infrared spectroscopy in 5 clinically relevant scenarios. Scenarios included: using each cement in a dual-polymerizable mode (mixing of 2 pastes); light polymerizing curing through Mylar sheets (dual-Mylar), which served as the control; light polymerizing through 3-mm porcelain (dual-3 mm); and no exposure to light (dual-no light). The single-component light-polymerizable product was also tested as follows: exposed directly through Mylar (light-Mylar) or exposed through 3 mm of porcelain (light-3 mm). RESULTS: For each product, dual-Mylar treatment yielded the highest conversion value of all treatments (control for each product). For all products, dual-3 mm conversion was at least 97% of control and equivalent to control, with the exception of Lute-It!. Dual-no light conversion was less than control treatment but at least 86% of control for all products except for Variolink II (62% of control). For all products in dual-no light mode, except Choice and Variolink II, conversion was at least equal to the light-Mylar values. Only 1 product (Variolink II) did not demonstrate increased conversion values for dual-Mylar compared with light-Mylar treatments. For most other products (Calibra, Insure, and Lute-It!), conversion values for light-3 mm were significantly less than for light-Mylar. Conversion values for Nexus, Choice, and Variolink II were equivalent between light-Mylar and light-3 mm treatments. CONCLUSION: The choice of a dual-polymerizable cement should be based on its intended use because not all products polymerize adequately in every clinical situation. Although no cement met the stated criteria for an "all-purpose" cement, those tested did produce a range of product-specific results.

Curing potential of dual-polymerizable resin cements in simulated clinical situations.

STATEMENT OF PROBLEM: Little is known about the ability of dual-polymerizable resin cements to polymerize when they are used in various clinical scenarios. PURPOSE: This study was conducted to determine whether any of 6 commercially available dual-polymerizable resin cements should be classified as an "all-purpose" resin cement. MATERIAL AND METHODS: . Chemical conversion values (C=C converted to C-C, or the extent of the curing reaction) of 6 commercially available dual-polymerizable resin cements were determined with infrared spectroscopy in 5 clinically relevant scenarios. Scenarios included: using each cement in a dual-polymerizable mode (mixing of 2 pastes); light polymerizing curing through Mylar sheets (dual-Mylar), which served as the control; light polymerizing through 3-mm porcelain (dual-3 mm); and no exposure to light (dual-no light). The single-component light-polymerizable product was also tested as follows: exposed directly through Mylar (light-Mylar) or exposed through 3 mm of porcelain (light-3 mm). Results. For each product, dual-Mylar treatment yielded the highest conversion value of all treatments (control for each product). For all products, dual-3 mm conversion was at least 97% of control and equivalent to control, with the exception of Lute-It!. Dual-no light conversion was less than control treatment but at least 86% of control for all products except for Variolink II (62% of control). For all products in dual-no light mode, except Choice and Variolink II, conversion was at least equal to the light-Mylar values. Only 1 product (Variolink II) did not demonstrate increased conversion values for dual-Mylar compared with light-Mylar treatments. For most other products (Calibra, Insure, and Lute-It!), conversion values for light-3 mm were significantly less than for light-Mylar. Conversion values for Nexus, Choice, and Variolink II were equivalent between light-Mylar and light-3 mm treatments. CONCLUSION: The choice of a dual-polymerizable cement should be based on its intended use because not all products polymerize adequately in every clinical situation. Although no cement met the stated criteria for an "all-purpose" cement, those tested did produce a range of product-specific results.