An interferometric-based tensile tester to resolve damage events within reconstituted multi-filaments collagen bundles.

Understanding how mechanical damage propagates in load-bearing tissues such as skin, tendons and ligaments, is key to developing regenerative medicine solutions for when these tissues fail. For collagenous tissues in particular, damage is typically assessed after mechanical testing using a broad range of microscopy techniques because standard tensile testing systems do not have the time and force sensitivity to resolve mechanical damage events. Here we introduce an interferometric detection scheme to measure the displacement of a cantilever with a resolution of 0.03% of full scale at a sampling rate of 5000 samples/s. The system is validated using collagen fibers engineered to mimic mammalian tendons. The system can detect sudden decrease in force due to slippage between collagen filaments, one to five microns in diameter, within a fiber in air. It can also detect yield events associated with local collagen unfolding or sliding within collagen fibrils within a fiber in liquid. This is opening the road to the sub-failure study of damage propagation within a broad range of hierarchical biomaterials.

Effect of thickness on the degree of conversion of two bulk-fill and one conventional posterior resin-based composites at high irradiance and high temporal resolution.

OBJECTIVES: This study: 1) measures the effect of sample thickness and high irradiance on the depth-dependent time delay before photopolymerization reaction onset; 2) determines if exposure reciprocity exists; 3) measures the conversion rate at four irradiance levels; 4) determines the time, t0, at which the maximum DC rate is reached for two bulk-fill and one conventional posterior resin-based composites (RBCs). METHODS: Tetric PowerFill IVA shade (Ivoclar Vivadent) and Aura bulk-fill ultra universal restorative (SDI), and one conventional posterior resin-based composite (RBC), Heliomolar A3 (Ivoclar Vivadent), that were either 0.2 mm, 2 mm, or 4 mm thick were photocured using a modified Bluephase G4 (Ivoclar Vivadent) light-curing unit (LCU) that delivered a single emission band (wavelength centered at 449 nm). The same radiant exposure of 24 J/cm2 was delivered at irradiances ranging from 0.5 to 3 W/cm2 by adjusting the exposure time. PowerFill was also photocured for 3 s or 6 s using a Bluephase PowerCure LCU (Ivoclar Vivadent) on the 3 s mode setting. The degree of conversion (DC) was measured in real-time at a high temporal resolution at 30 °C using Attenuated Total Reflection (ATR) FTIR spectroscopy with a sampling rate of 13 DC data points per second. The DC data were analyzed using a phenomenological autocatalytic model. The RBC viscosity was measured at 21 °C and 30 °C. Light transmission through the RBC samples at 22 °C was monitored with time to calculate the extinction coefficients of the RBCs. RESULTS: The time delay before photopolymerization started increased as the RBC thickness increased and the irradiance decreased. An autocatalytic model described the DC data. The time t0 was less than 77 ms for the 0.2 mm thick samples of PowerFill irradiated using the highest irradiance of 3 W/cm2. Among the three RBCs for each sample thickness and irradiance level, the PowerFill had the smallest time t0. There was a time delay of 0.59 s and 1.25 s before the DC started to increase at the bottom of 4 mm thick samples for the PowerFill and Aura, respectively, when an irradiance of 1 W/cm2 was delivered. The time delay increased to 3.65 s for the Aura when an irradiance of 0.5 W/cm2 was delivered. The extinction coefficients near 449 nm were 0.78 mm-1, 0.76 mm-1, and 1.55 mm-1 during the first 2 s after the start of photocuring of PowerFill, Aura, and Heliomolar, respectively. Only PowerFill followed exposure reciprocity. At T = 30 °C, the viscosity was 3400, 17000, and 5200 Paˑs for PowerFill, Aura, and Heliomolar, respectively. SIGNIFICANCE: The time delay between when photopolymerization starts at the top and bottom of 2- or 4-mm thick RBC restorations may affect the structural integrity of the bond between the tooth and the bottom of the restoration. Only PowerFill followed exposure reciprocity between irradiance levels of 0.5 to 3 W/cm2. Exposure reciprocity did not occur for Aura or Heliomolar, neither of which are optimized for short light exposure or high irradiance conditions.

The potential 'blue light hazard' from LED headlamps.

Many dental personnel use light-emitting diode (LED) headlamps for hours every day. The potential retinal 'blue light hazard' from these white light headlamps is unknown. METHODS: The spectral radiant powers received from direct and indirect viewing of an electronic tablet, an LED curing light, a halogen headlamp, and 6 brands of LED headlamps were measured using integrating spheres attached to fiberoptic spectroradiometers. The spectral radiant powers were measured both directly and indirectly at a 35 cm distance, and the maximum daily exposure times (tMAX) were calculated from the blue weighted irradiance values. RESULTS: The headlamps emitted very different radiant powers, emission spectra, and color temperatures (K). The total powers emitted at zero distance ranged from 47 mW from the halogen headlamp to 378 mW from the most powerful LED headlamp. The color temperatures from the headlamps ranged from 3098 K to 7253 K. The tMAX exposure times in an 8 h day when the headlamps were viewed directly at a distance of 35 cm were: 810 s from the halogen headlamp, 53 to 220 s from the LED headlamps, and 62 s from the LED curing light. Light from the LED headlamps that was reflected back from a white reference tile 35 cm away did not exceed the maximum permissible exposure time for healthy adults. Using a blue dental dam increased the amount of reflected blue light, but tMAX was still greater than 24 h. CONCLUSIONS: White light LED headlamps emit very different spectra, and they all increase the retinal 'blue light hazard' compared to a halogen source. When the headlamps were viewed directly at a distance of 35 cm, the 'blue light hazard' from some headlamps was greater than from the LED curing light (tMAX = 62 s). Depending on the headlamp brand, tMAX could be reached after only 53s. The light from the LED headlamps that was reflected back from a white surface that was 35 cm away did not exceed the maximum permissible ocular exposure limits for healthy adults. CLINICAL RELEVANCE: Reflected white light from dental headlamps does not pose a blue light hazard for healthy adults. Direct viewing may be hazardous, but the hazard can be prevented by using the appropriate blue-light blocking glasses.

Photo-polymerization kinetics of a dental resin at a high temporal resolution.

OBJECTIVES: This study: 1) aims to measure with high temporal resolution the intrinsic rate of the degree of conversion (DC) of a dental resin-based composite (RBC) photo-cured at two irradiances; 2) aims to determine the transition time at which the DC rate is maximum; 3) used two different irradiances to measure the shift in transition time; 4) aims to compare transition times measured using DC and shrinkage strain. METHODS: Samples (n = 20) 1 mm thick by 10 mm diameter of Filtek One bulk-fill restorative A2 shade (3M Oral Care) were photocured for 20 s with a single emission peak (wavelength centered at 455 nm) light-emitting-diode-based light-curing unit at irradiance levels of 890 mW/cm2 and 209 mW/cm2, and initial sample temperature of T = 23 °C. The DC was measured in real-time using Attenuated Total Reflection (ATR) FTIR spectroscopy with a sampling rate of 13 DC data points per second. The data were analyzed within a phenomenological autocatalytic model. In addition, the axial shrinkage strain was measured using 3 samples of the RBC with the same outer dimensions and under similar experimental conditions using the bonded disk method and an interferometric technique. RESULTS: For the 890 mW/cm2 and 209 mW/cm2 irradiance levels, the DC with time was found to agree with the model enabling the determination of transition times of 0.66 ± 0.05 s and 2.3 ± 0.2 s, and the DC at these times of 5.5 ± 0.2% and 6.4 ± 0.2%. The maximum linear strain rate at 0.76 ± 0.01 s and 1.98 ± 0.02 s for the 890 mW/cm2 and 209 mW/cm2 irradiance levels, respectively, are within two standard deviations of the corresponding transition times. SIGNIFICANCE: At an irradiance level much greater than 1000 mW/cm2, the photo-polymerization kinetics of a dental RBC may be too fast to be measured accurately using ATR-FTIR spectroscopy. A viable alternative to monitor the kinetics is through the measurements of the axial shrinkage strain employing the bonded disk method and an interferometric technique.

A standardized method to determine the effect of polymerization shrinkage on the cusp deflection and shrinkage induced built-in stress of class II tooth models.

OBJECTIVES: Using standardized aluminum tooth models, this study: 1) measured the deflection along the cusp wall of models with a Class II cavity restored using either bulk filling or horizontal incremental filling techniques, and 2) calculated the cusp deflection and built-in stress within the restored tooth models for both filling techniques using a finite element (FE) model. METHODS: Standardized tooth models with Class II cavities 4 mm deep, 4 mm high and 6 mm wide were machined out of aluminum. The models were restored using Filtek Posterior Restorative A2 shade resin-based composite (RBC). Both bulk filling and horizontal incremental filling techniques were used to restore the tooth models. After photocuring for 20 s from a single peak wavelength light-curing unit (LCU) with a radiant exitance of 1.25 W/cm2, the deflection of the cusp wall surface was measured using a profilometer. A FE model was used to predict the cuspal deflection and built-in stress of the restored tooth models. RESULTS: The elastic modulus within the FE model was parameterized using cusp deflection data obtained on a bulk filled tooth model. An agreement was found between the measured and predicted cusp deflection only when considering partial stress relaxation within the first incremental layer for the two-layer incremental filling technique. The calculated built-in stress was significantly reduced within the RBC and along the cavity walls when the cavity was filled incrementally in a horizontal direction compared to when it was bulk filled, resulting in a significantly smaller cusp deflection. SIGNIFICANCE: The FE model was first calibrated and then validated using measured cusp deflection data. Partial stress relaxation may play a significant role in the horizontal incremental filling technique. The model can be used to predict where the built-in stress within the tooth model occurs. This study explains why for a given RBC, a horizontal incremental filling and curing technique results in lower built-in stress within the restored tooth and lower cusp deflection compared to the bulk curing technique.

Post-curing in dental resin-based composites.

OBJECTIVE: To determine the post-curing in six commercial contemporary resin-based composites (RBCs) using axial shrinkage, the degree of conversion, and Vickers hardness. METHODS: Five Bulk Fill and one conventional RBCs from three companies were selected with a wide range of filler volume content. The axial shrinkage of samples that were 1.00mm thick by 9-10mm diameter was measured using a modified bonded disk method over a time between 15h and 19h at temperatures of 26°C and 34°C (mouth temperature). The degree of conversion (DC) was collected continuously for 10min using mid-infrared spectroscopy in the attenuated total reflectance geometry. Vickers hardness was measured at 1h post-irradiation using a load of 300gf. For all three tests, the samples were irradiated at five exposure times, 20, 5, 3, 1.5 and 1s with a light curing unit radiant exitance of 1.1W/cm2. Three samples (n=3) were used for each experimental condition. RESULTS: After light exposure, the axial shrinkage and degree of conversion exhibited a functional time dependence that was proportional to the logarithm of time. This suggests an out-of-equilibrium polymer composite glass that is transitioning to thermal equilibrium. At a sufficiently long time and among the RBCs investigated, the shrinkage related physical aging rate was found to vary between 1.34 and 2.00µm/log(t). The rate was a function of the filler content. Furthermore, 15h after light exposure, the post-curing shrinkage was estimated to be an additional 22.5% relative to the shrinkage at 100s for one RBC at T=34°C. The hardness in the photo-cured RBC was varied by using different light exposure times. The first two experimental techniques show that the higher the initial DC 10min after light exposure, the smaller is the post-curing shrinkage related and DC related physical aging rates. A direct correlation was observed between the shrinkage related and the DC related physical aging rates. SIGNIFICANCE: Post-curing shrinkage should be evaluated for longer than 1h. The post-curing shrinkage 15h after light exposure in dental RBCs can be appreciable. The long-term development of built-in stress within the tooth wall structure may shorten the restoration's lifespan.

Effect of tooth brushing on gloss retention and surface roughness of five bulk-fill resin composites.

OBJECTIVES: To determine the effects of tooth brushing on five bulk-fill resin based composites (RBCs). METHOD: Ten samples of Filtek Supreme Enamel (control), Filtek One Bulk Fill, Tetric EvoCeram Bulk Fill, SonicFill 2, SDR flow+, and Admira Fusion X-tra were light cured for 20 seconds using the Valo Grand curing light. After 24 hours storage in air at 37°C, specimens were brushed in a random order using Colgate OpticWhite dentifrice and a soft toothbrush. Surface gloss was measured prior to brushing, after 5,000, 10,000 and 15,000 back and forth brushing cycles. Surface roughness was measured after 15,000 brushing cycles using atomic force microscopy (AFM) and selected scanning electron microscope (SEM) images were taken. The data was examined using ANOVA and pair-wise comparisons using Scheffe's post-hoc multiple comparison tests (α = 0.05). RESULTS: Surface gloss decreased and the surface roughness increased after brushing. Two-way ANOVA showed that both the RBC and the number of brushing cycles had a significant negative effect on the gloss. One-way ANOVA showed that the RBC had a significant effect on the roughness after 15,000 brushing cycles. For both gloss and roughness, brushing had the least effect on the nano-filled control and nano-filled bulk-fill RBC, and the greatest negative effect on Admira Fusion X-tra. The SEM images provided visual agreement. There was an excellent linear correlation (R2 = 0.98) between the logarithm of the gloss and roughness. CONCLUSION: After brushing, the bulk-fill RBCs were all rougher than the control nano-filled RBC. The nano-filled bulk-fill RBC was the least affected by brushing. CLINICAL SIGNIFICANCE: Bulk-fill RBCs lose their gloss faster and become rougher than the nanofilled conventional RBC, Filtek Supreme Ultra. The nanofilled bulk-fill RBC was the least affected by tooth brushing.

Shrinkage stress kinetics of Bulk Fill resin-based composites at tooth temperature and long time.

OBJECTIVE: To determine the shrinkage stress kinetics at up to 12h after light exposure and at tooth temperature during placement of selected Bulk Fill resin-based composites (RBCs). METHODS: Five representative Bulk Fill RBCs from four companies were chosen with a wide range of viscosity and filler volume content. The shrinkage stress kinetics at T=33°C was measured continuously over a period of 12h using a modified tensometer with the ability to measure the cantilever beam deflection to better than 40nm accuracy at a sampling rate of up to 200 samples/s, and thermally stable resulting in a measurement accuracy better than 0.05MPa at 12h. The tensometer compliance was 0.105µm/N. A custom made heater was used to control the RBC sample temperature at T=33°C with a temperature gradient across the sample of less than 1°C. The samples were irradiated for 20s with irradiance of 1.1W/cm2 and total energy density of 22J/cm2. Three samples (n=3) were used for each RBCs. RESULTS: The shrinkage stress at 12h for the five Bulk Fill RBCs ranged from 2.21 to 3.05MPa, maximum stress rate ((dS/dt)M) varied from 0.18 to 0.41MPa/s, time at which the maximum stress rate occurred (tMax) were between 1.42 to 3.24s and effective gel time (tgel) varied from 50 to 770ms. Correlations were observed between (dS/dt)M and tMax (r=-0.946), tMax and filler volume fraction (r=-0.999), and between the shrinkage stress at 12h and tgel (r=0.994). However, no correlation was observed between the stress at 12h and filler volume fraction. SIGNIFICANCE: The shrinkage stress for four of the five Bulk Fill RBCs were not significantly different (p<0.05) at 6h and beyond after photo-curing and that fully developed stress induced by photo-cured RBCs may only be reached at times longer than 12h.

The dental curing light: A potential health risk.

Powerful blue-light emitting dental curing lights are used in dental offices to photocure resins in the mouth. In addition, many dental personnel use magnification loupes. This study measured the effect of magnification loupes on the "blue light hazard" when the light from a dental curing light was reflected off a human tooth. Loupes with 3.5x magnification (Design for Vision, Carl Zeiss, and Quality Aspirator) and 2.5x magnification (Design for Vision and Quality Aspirator) were placed at the entrance of an integrating sphere connected to a spectrometer (USB 4000, Ocean Optics). A model with human teeth was placed 40 cm away and in line with this sphere. The light guide tip of a broad-spectrum Sapphire Plus (Den-Mat) curing light was positioned at a 45° angle from the facial surface of the central incisor. The spectral radiant power reflected from the teeth was recorded five times with the loupes over the entrance into the sphere. The maximum permissible cumulative exposure times in an 8-hr day were calculated using guidelines set by the ACGIH. It was concluded that at a 40 cm distance, the maximum permissible cumulative daily exposure time to light reflected from the tooth was approximately 11 min without loupes. The weighted blue irradiance values were significantly different for each brand of loupe (Fisher's PLSD p < 0.05) and were up to eight times greater at the pupil than when loupes were not used. However, since the linear dimensions of the resulting images would be 2.5 to 3.5x larger on the retina, the image area was increased by the square of the magnification and the effective blue light hazard was reduced compared to without the loupes. Thus, although using magnification loupes increased the irradiance received at the pupil, the maximum cumulative daily exposure time to reflected light was increased up to 28 min. Further studies are required to determine the ocular hazards of a focused stare when using magnification loupes and the effects of other curing lights used in the dental office.

Effect of a broad-spectrum LED curing light on the Knoop microhardness of four posterior resin based composites at 2, 4 and 6-mm depths.

OBJECTIVE: To measure the Knoop microhardness at the bottom of four posterior resin-based composites (RBCs): Tetric EvoCeram Bulk Fill (Ivoclar Vivadent), SureFil SDR flow (DENTSPLY), SonicFill (Kerr), and x-tra fil (Voco). METHODS: The RBCs were expressed into metal rings that were 2, 4, or 6-mm thick with a 4-mm internal diameter at 30°C. The uncured specimens were covered by a Mylar strip and a Bluephase 20i (Ivoclar Vivadent) polywave(®) LED light-curing unit was used in high power setting for 20s. The specimens were then removed and placed immediately on a Knoop microhardness-testing device and the microhardness was measured at 9 points across top and bottom surfaces of each specimen. Five specimens were made for each condition. RESULTS: As expected, for each RBC there was no significant difference in the microhardness values at the top of the 2, 4 and 6-mm thick specimens. SureFil SDR Flow was the softest resin, but was the only resin that had no significant difference between the KHN values at the bottom of the 2 and 4-mm (Mixed Model ANOVA p<0.05). Although the KHN of SureFil SDR Flow was only marginally significantly different between the 2 and 6-mm thickness, the bottom at 6-mm was only 59% of the hardness measured at the top. CLINICAL SIGNIFICANCE: This study highlights that clinicians need to consider how the depth of cure was evaluated when determining the depth of cure. SureFil SDR Flow was the softest material and, in accordance with manufacturer's instructions, this RBC should be overlaid with a conventional resin.

Examining exposure reciprocity in a resin based composite using high irradiance levels and real-time degree of conversion values.

OBJECTIVE: Exposure reciprocity suggests that, as long as the same radiant exposure is delivered, different combinations of irradiance and exposure time will achieve the same degree of resin polymerization. This study examined the validity of exposure reciprocity using real time degree of conversion results from one commercial flowable dental resin. Additionally a new fitting function to describe the polymerization kinetics is proposed. METHODS: A Plasma Arc Light Curing Unit (LCU) was used to deliver 0.75, 1.2, 1.5, 3.7 or 7.5 W/cm(2) to 2mm thick samples of Tetric EvoFlow (Ivoclar Vivadent). The irradiances and radiant exposures received by the resin were determined using an integrating sphere connected to a fiber-optic spectrometer. The degree of conversion (DC) was recorded at a rate of 8.5 measurements a second at the bottom of the resin using attenuated total reflectance Fourier Transform mid-infrared spectroscopy (FT-MIR). Five specimens were exposed at each irradiance level. The DC reached after 170s and after 5, 10 and 15 J/cm(2) had been delivered was compared using analysis of variance and Fisher's PLSD post hoc multiple comparison tests (alpha=0.05). RESULTS: The same DC values were not reached after the same radiant exposures of 5, 10 and 15 J/cm(2) had been delivered at an irradiance of 3.7 and 7.5 W/cm(2). Thus exposure reciprocity was not supported for Tetric EvoFlow (p<0.05). SIGNIFICANCE: For Tetric EvoFlow, there was no significant difference in the DC when 5, 10 and 15J/cm(2) were delivered at irradiance levels of 0.75, 1.2 and 1.5 W/cm(2). The optimum combination of irradiance and exposure time for this commercial dental resin may be close to 1.5 W/cm(2) for 12s.

Correlation between the beam profile from a curing light and the microhardness of four resins.

OBJECTIVE: To demonstrate the effect of localized irradiance and spectral distribution inhomogeneities of one LED-based dental light-curing unit (LCU) on the corresponding microhardness values at the top, and bottom surfaces of four dental resin-based composites (RBCs), which contained either camphorquinone (CQ) alone or a combination of CQ and monoacylphosphine oxide (TPO) as photoinitiators. METHODS: Localized irradiance beam profiles from a polywave LED-based LCU were recorded five times using a laser beam analyzer, without and with either a 400 nm or 460 nm narrow bandpass filter placed in front of the camera lens. Five specimens of each of the four RBCs (two containing CQ/TPO and two containing CQ-only) were exposed for 5-, 10-, or 30-s with the light guide directly on the top surface of the RBC. After 24 h, Knoop microhardness values were measured at 45 locations across the top and bottom surfaces of each specimen. Microhardness readings for each RBC surface and exposure time were correlated with localized patterns of the LCU beam profile, measured using the 400 nm and 460 nm bandpass filters. Spearman rank correlation was used to avoid relying on an assumption of a bivariate normal distribution for the KHN and irradiance. RESULTS: The local irradiance and spectral emission values were not uniformly distributed across the light tip. There was a strong significant positive correlation with the irradiance beam profile values from the LCU taken through bandpass filters and the microhardness maps of the RBC surfaces exposed for 5 and 10 s. The strength of this correlation decreased with increasing exposure time for the RBCs containing CQ only, and increased for the RBCs containing both CQ and TPO. CONCLUSIONS: Localized beam and spectral distributions across the tip end of the light guide strongly correlated with corresponding areas of microhardness in both the top and bottom surfaces among four RBCs with different photoinitiator contents. Significance: A light-curing unit with a highly inhomogeneous light output can adversely affect localized microhardness of resin-based composites and this may be a contributing factor for premature failure of a restoration.

Localised irradiance distribution found in dental light curing units.

OBJECTIVE: To measure the localised irradiance and wavelength distributions from dental light curing units (LCUs) and establish a method to characterise their output. METHODS: Using a laboratory grade integrating sphere spectrometer system (Labsphere and Ocean Optics) the power, irradiance, and spectral emission were measured at the light tips of four LCUs: one plasma-arc (PAC) unit, one single peak blue light-emitting diode (blue-LED) unit, and two polywave LED (poly-LED) units. A beam profiler camera (Ophir Spiricon) was used to record the localised irradiance across the face of the light tips. The irradiance-calibrated beam profile images were then divided into 45 squares, each 1mm(2). Each square contained the irradiance information received from approximately 3200 pixels. The mean irradiance value within each square was calculated, and the distribution of irradiance values among these 45 squares across the tip-ends was examined. Additionally, the spectral emission was recorded at various regions across each light tip using the integrating sphere with a 4-mm diameter entrance aperture. RESULTS: The localised irradiance distribution was inhomogeneous in all four lights. The irradiance distribution was most uniformly distributed across the PAC tip. Both the irradiance and spectral emission from the poly-LED units were very unevenly distributed. CONCLUSIONS: Reporting a single irradiance value or a single spectral range to describe the output from a curing light is both imprecise and inappropriate. Instead, an image of both the irradiance distribution and the distribution of the spectral emission across the light tip should be provided. CLINICAL SIGNIFICANCE: The localised beam irradiance profile at the tip of dental LCUs is not uniform. Poly-LED units may deliver spectrally inhomogeneous irradiance profiles. Depending on the photoinitiator used in the RBC and the orientation of the LCU over the tooth, this non-uniformity may cause inadequate and inhomogeneous resin polymerisation, leading to poor physical properties, and premature failure of the restoration.

Intra- and inter-brand accuracy of four dental radiometers.

This study measured the accuracy and precision of four commercial dental radiometers. The intra-brand accuracy was also determined. The light outputs from 14 different curing lights were measured three times using four brands of dental radiometers and the results were compared to two laboratory-grade power meters that were used as the "gold standard". To ensure proper representation, three examples of each brand of dental radiometer were used. Data collected was analyzed using ANOVA, with 95% confidence intervals, comparing the laboratory-grade meters to the dental radiometers. Bioequivalence was established where the confidence interval for the irradiance values was within ±20% of the "gold standard" reading. Forest plots were used to highlight bioequivalence values. The two laboratory-grade meters differed by less than 0.6%. Overall, all three examples of the Bluephase and SDI radiometers as well as two examples of the LEDRadiometer and one CureRite meter were bioequivalent to the gold standard. However, the type of curing light measured had a significant effect on the accuracy of the radiometer. There was significant variability of the irradiance readings between radiometer brands, and between irradiance values recorded by the three samples of each brand studied. This made it impossible to definitively rank the radiometer brands for accuracy. Within the ±20% bioequivalence limits of this study, there was a clinically significant difference in the irradiance readings between radiometer brands and the choice of curing light affected the results. There was also significant variation in irradiance readings reported by different examples of the same brand of radiometer. Whether in clinical practice or in research, dental radiometers should not be used when either the irradiance or energy delivered needs to be accurately known.

Evaluation of ocular hazards from 4 types of curing lights.

OBJECTIVE: To assess the risk of ocular damage from 4 types of light curing units (LCUs) and to estimate the maximum permissible ocular exposure times from each LCU during an 8-hour workday. METHODS: Extracted human maxillary teeth were mounted in a dentoform. Four types of LCUs (plasma arc, low-power and high-power light-emitting diode, and quartz-tungsten-halogen) were used to cure a simulated restoration in the maxillary central incisor from the facial and palatal aspects. To simulate ocular exposure, the spectral irradiance (W/[cm2 · nm]) from the LCUs was measured 5 times at each of 3 distances (30 cm, 50 cm and 100 cm) from the tooth, using a cosine-corrected probe attached, via a fibre optic cable, to a calibrated spectroradiometer. The weighted blue-light and effective ultraviolet (UV) irradiances that would be received by the eye from each LCU were calculated. RESULTS: The maximum permissible daily exposure limits for UV light exceeded 8 hours at all distances and orientations. The maximum permissible cumulative daily exposure time to blue light was as low as 6 seconds when curing from the palatal aspect with the plasma arc LCU and as high as 1.5 hours when the low-power light-emitting diode LCU was used from the facial aspect. CONCLUSIONS: The 4 LCUs tested did not pose a risk of UV-mediated ocular damage. The higher-powered lamps showed potential to cause blue-light-mediated ocular damage at shorter distances, with damage potentially occurring after cumulative viewing of only 6 seconds at the 30-cm distance during an 8-hour workday.

Effect of distance on irradiance and beam homogeneity from 4 light-emitting diode curing units.

PURPOSE: To quantify the effect of distance on the irradiance and beam homogeneity from 4 curing lights. METHODS: Four light-emitting diode curing lights were evaluated: Fusion, Bluephase 16i, Demi and FlashLite Magna. The irradiance at the centre of the light beam (ICB) was measured at 1.0 to 9.0 mm from the emitting tip using a 3.9-mm diameter probe connected to a spectrometer. The uniformity of the beam from each curing light was characterized by means of the "top hat factor" at 2.0, 4.0, 6.0 and 8.0 mm from the emitting tip. The useful beam diameter, within which irradiance values were greater than 400 mW/cm2, was calculated. The ICB, top hat factor and useful beam diameter were compared by analysis of variance and Fisher's protected least significant difference test at α = 0.01. RESULTS: At all distances, the ICB was lowest for the FlashLite Magna and highest for the Fusion. Only the Fusion maintained an ICB above 1000 mW/cm2 at the 8.0 mm distance. For distances between 2.0 and 8.0 mm, the top hat factors were similar for the Fusion and the Demi, lower for the Bluephase 16i and lowest for the FlashLite Magna. CONCLUSIONS: Beam homogeneity, top hat factors and ICB varied significantly among the curing lights. These results indicate that deep restorations may not be adequately cured if the curing time is based on data obtained when the curing light is positioned close to the radiometer or resin. In addition, a single irradiance value cannot be used to describe the light output from a curing light.

Irradiance differences in the violet (405 nm) and blue (460 nm) spectral ranges among dental light-curing units.

PROBLEM: Previous studies identified nonuniformity in the irradiance at the tip end of a variety of dental light-curing units (LCUs) and correlated those differences with potential clinical implications, but the spectral dependence of the irradiance uniformity has not yet been addressed. PURPOSE: This study examined the irradiance uniformity across emitting tips of LCUs at two emission wavelengths, 405 and 460 nm. Two broadband emission light units (quartz-tungsten-halogen [QTH] and plasma arc [PAC]), and four commercial light-emitting diode (LED)-type LCUs were examined. MATERIALS AND METHODS: The spectral radiant power from six LCUs was measured using a laboratory grade spectroradiometer (Ocean Optics, Dunedin, FL, USA). The spatial and spectral characteristics of irradiance across the emitting tips of these light units were recorded through 10-nm wide bandpass filters (centered at 405 nm [violet] or 460 nm [blue]) using a laser beam analyzer (Ophir-Spiricon, Logan, UT, USA). Irradiance distributions were reported using two-dimensional contour and three-dimensional isometric color-coded images. Irradiance uniformity at the tip end was determined using the Top Hat Factor (THF) for each filtered wavelength. RESULTS: Irradiance distributions from the QTH and PAC units were uniformly distributed across the tip end of the light guide, and THF values, measured through the 405 and 460-nm filters, were not significantly different. However, the three polywave LED units delivered non-uniform irradiance distributions with THF values differing significantly between the 405 and 460-nm emission wavelengths for each unit. Areas of nonuniformity were attributed to the locations of the various types of LED chips within the LCUs. CONCLUSION: All three polywave LED units delivered a nonuniform irradiance distribution across their emitting tip ends at the two important emission wavelengths of 405 nm and 460 nm, whereas the broadband light sources (QTH and PAC) showed no evidence of spectral inhomogeneity at these wavelengths.

Irradiance uniformity and distribution from dental light curing units.

PROBLEM: The irradiance from dental light-curing units (LCUs) is commonly reported as a single number, but this number does not properly describe the light output. PURPOSE: This study examined the irradiance uniformity and distribution from a variety of LCUs as well as the effect of different light guides. MATERIALS AND METHODS: Five LCUs representing quartz-tungsten-halogen, plasma arc, and light emitting diode units were evaluated. One LCU was evaluated using two different light guides (Standard or Turbo style). The total power emitted from each LCU was measured and the irradiance calculated using conventional methods (I(CM)). In addition, a beam profiler was used to determine the optically active emitting area, the mean irradiance (I(BP)), the irradiance distribution, and the Top Hat Factor (THF). Five replications were performed for each test and compared using analysis of variance with Fisher's PLSD tests at a pre-set alpha of 0.05. RESULTS: The spatial distribution of the irradiance from LCUs was neither universally symmetrical nor was it uniformly distributed across the tip end. Significant differences in both the emitted power and THF were found among the LCUs. The THF values ranged from a high of 0.74 +/- 0.01 to a low of 0.32 +/- 0.01. Changing from a standard to a turbo light guide increased the irradiance, but significantly reduced beam homogeneity, reduced the total emitted power, and reduced the optical tip area by 60%. CONCLUSIONS: Using different light guides on the same LCU significantly affected the power output, irradiance values, and beam homogeneity. For all LCUs, irradiance values calculated using conventional methods (I(CM)) did not represent the irradiance distribution across the tip end of the LCU. CLINICAL SIGNIFICANCE Irradiance values calculated using conventional methods assume power uniformity within the beam and do not validly characterize the distribution of the irradiance delivered from dental light curing units.