Impact of optical fiber-based photo-activation on dental composite polymerization.

OBJECTIVES: The study aimed to introduce a novel two-step optical fiber-based photo-activation of dental resin-based composites (RBCs) for reducing polymerization shrinkage stress (PSS). METHODS: Proposed protocol design - in the first step, two flexible plastic optical fibers connected to a dental light curing unit (LCU), were used as light guides inserted into the filling to initiate low-irradiance polymerization from within; in the second step, fibers were extracted and remaining voids were filled with RBC, followed by conventional high-irradiance curing to finalize polymerization. Three bulk-fill RBCs were tested (Beautifil-Bulk Restorative, Filtek Bulk-fill Posterior, Tetric PowerFill) using tooth cavity models. Three non-invasive examination techniques were employed: Digital Holographic Interferometry, Infrared Thermography, and Raman spectroscopy for monitoring model deformation, RBC temperature change, and degree of conversion (DC), respectively. A control group (for each examined RBC) underwent conventional photo-activation. RESULTS: The experimental protocol significantly reduced model deformation by 15 - 35 %, accompanied by an 18 - 54 % reduction in RBC temperature change, emphasizing the impact of thermal shrinkage on PSS. Real-time measurements of deformation and temperature provided indirect insights into reaction dynamics and illuminated potential mechanisms underlying PSS reduction. After a 24-hour dark-storage period, DC outcomes comparable to conventional curing were observed, affirming the clinical applicability of the method. CONCLUSIONS: Protocol involving the use of two 1.5 mm fibers in the first step (300 mW/cm2 x 10 s), followed by a second conventional curing step (1000 mW/cm2 x 10 s), is recommended to achieve the desired PSS reduction, while maintaining adequate DC and ensuring efficient clinical application. CLINICAL SIGNIFICANCE: Obtained PSS reduction offers promise in potentially improving the performance of composite restorations. Additionally, leveraging the flexibility of optical fibers improves light guide approach for restorations on posterior teeth. Meanwhile, implementation in clinical practice is easily achievable by coupling the fibers with commercial dental LCUs using the provided plastic adapter.

Thermography and conversion of fast-cure composite photocured with quad-wave and laser curing lights compared to a conventional curing light.

OBJECTIVES: This study investigated effects of the different emittance-mode protocols from three light curing units (LCUs): (i) a Laser (Monet); (ii) a quad-wave (PinkWave); (iii) a conventional LED (Elipar S10) on the temperature rise (ΔT) and degree of conversion (DC) when photo-curing fast or conventional bulk-fill resin-based composites (RBC). The aim was to correlate ΔT and DC, and the radiant exposure delivered to RBC specimens. METHODS: A 3D-printed resin mold of 4 mm depth was filled with two bulk-fill RBCs: Tetric PowerFill® (fast photo-polymerised composite) (TPF) or Tetric EvoCeram® Bulk-Fill (EVO). Three LCUs were used: (i) Monet laser for 1 s and 3 s (MONET-1 s, MONET-3 s); (ii) PinkWave quad-wave used for 3 s in Boost mode (PW-3 s) and for 20 s in standard mode (PW-20 s); (iii) Elipar S10 for 5 s (S10-5 s) and for 20 s in standard mode (S10-20 s). 2-dimensional temperature maps were obtained before, during and for 60 s after the LCU had turned off using a thermal imaging camera. Thermal changes were analysed at five depths: (0, 1, 2, 3, and 4 mm from the top surface of the RBC). The maximum temperature rise (Tmax) and the mean temperature rise (ΔT) were determined. Cylindrical-shaped specimens were prepared from each material using a stainless-steel split mold (4 × 4 mm) and light-cured with the same protocols. The DC was measured for 120 s and at 1 h after LCU had turned off using Fourier Transform Infrared Spectroscopy (FTIR). Data were analysed using Three-way ANOVA, One-way ANOVA, independent t-tests, and Tukey post-hoc tests (p < 0.05). RESULTS: Radiant exposures delivered by the various irradiation protocols were between 4.5-30.3 J/cm2. Short exposure times from MONET-1 s and PW-3 s delivered the lowest radiant exposures (4.5 and 5.2 J/cm2, respectively) and produced the lowest ΔT and DC. The longer exposure times in the standard modes of PW-20 s, S10-20 s, and MONET-3 s produced the highest Tmax, ΔT, and DC for both composites. The ΔT range among composites at different depths varied significantly (31.7-49.9 °C). DC of TPF ranged between 30-65% and in EVO between 15.3-56%. TPF had higher Tmax, ΔT for all depths and DC compared to EVO, across the LCU protocols (p < 0.05), except for PW-20 s and MONET-3 s. The coronal part of the restorations (1-2 mm) had the highest ΔT. There was a positive correlation between ΔT and DC at 4-mm depth after 120 s SIGNIFICANCE: Longer, or standard, exposure times of the LCUs delivered greater radiant exposures and had higher DC and ΔT compared to shorter or high-irradiance protocols. The fast photo-polymerised RBC had comparatively superior thermal and conversion outcomes when it received a high irradiance for a short time (1-5 s) compared to the conventional Bulk-Fill RBC.

Polymerization efficiency of different bulk-fill resin composites cured by monowave and polywave light-curing units: a comparative study.

OBJECTIVES: The objective was to evaluate the polymerization efficiency of different bulk-fill resin-based composites cured by monowave and polywave light-curing units, by assessment of the degree of conversion and Vickers microhardness at different depths. METHOD AND MATERIALS: Two commercially available bulk-fill resin-based composites were used: Filtek One Bulk Fill Restorative (3M ESPE) and Tetric N-Ceram Bulk Fill (Ivoclar Vivadent). The light-curing units utilized were two LED light-curing units: a monowave LED light-curing unit (BlueLEX LD-105, Monitex) and a polywave LED light-curing unit (Twin Wave GT-2000, Monitex). For each test, 20 cylindrical specimens (4 mm diameter, 4 mm thickness) were prepared from each bulk-fill resin-based composite using a split Teflon mold. Ten specimens were light-cured by the monowave light-curing unit and the other ten were light-cured by the polywave light-curing unit according to the manufacturer's recommendations. Attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR) was used to assess the degree of conversion, and a Vickers microhardness tester was used to assess Vickers microhardness. Statistical analysis was performed using three-way ANOVA and Tukey post-hoc tests (P < .05). RESULTS: The degree of conversion and Vickers microhardness in bulk-fill resin-based composites containing only camphorquinone as photoinitiator were similar when cured with either monowave or polywave light-curing units. However, bulk-fill resin-based composites containing a combination of photoinitiators exhibited significantly higher degree of conversion and Vickers microhardness when cured with a polywave light-curing unit. Although all groups showed statistically significant differences between the top and bottom surfaces regarding degree of conversion and Vickers microhardness, all of them showed bottom/top ratios > 80% regarding degree of conversion and Vickers microhardness. CONCLUSION: The polywave light-curing unit enhanced the polymerization efficiency of bulk-fill resin-based composites especially when the latter contained a combination of photoinitiators, but does not prevent the use of a monowave light-curing unit.

Light transmittance through resin-matrix composite onlays adhered to resin-matrix cements or flowable composites.

OBJECTIVE: The aim of this study was to evaluate the influence of the thickness of resin-matrix composite blocks manufactured by CAD-CAM on the light transmittance towards different resin-matrix cements or flowable composites. METHODS: Sixty specimens of resin-matrix composite CAD-CAM blocks reinforced with 89 wt% inorganic fillers were cross-sectioned with 2 or 3 mm thicknesses. The specimens were conditioned with adhesive system and divided in groups according to the luting material, namely: two dual-cured resin-matrix cements, two traditional flowable resin-matrix composites, and one thermal-induced flowable resin-matrix composite. Specimens were light-cured at 900 mW/cm2 for 40s. Light transmittance assays were preformed using a spectrophotometer with an integrated monochromator before and after light-curing. Microstructural analysis was performed by optical and scanning electron microscopy (SEM). Nanoindentation tests were performed to evaluate mechanical properties for indirect evaluation of degree of monomers conversion. RESULTS: Optical and SEM images revealed low thickness values for the cementation interfaces for the traditional flowable resin-matrix composite. The cement thickness increased with the size and content of inorganic fillers. The highest light transmittance was recorded for the onlay blocks cemented with the traditional flowable resin-matrix composites while a group cemented with the dual-cured resin-matrix cement revealed the lowest light transmittance. The elastic modulus and hardness increased for specimens with high content of inorganic fillers as well as it increased in function of the light transmittance. CONCLUSIONS: The light transmittance of flowable resin-matrix composites was higher than that for resin-matrix cement after cementation to resin-matrix composites blocks. The type, size, and content of inorganic fillers of the luting material affected the thickness of the cement layer and light transmittance through the materials. CLINICAL RELEVANCE: On chair-side light curing, the transmission of visible light can be interfered by the chemical composition and viscosity of the luting materials. The increase in size and content of inorganic fillers of resin-matrix composites and luting materials can decrease the light transmittance leading to inefficient polymerization.

Evaluation of microhardness of short fiber-reinforced composites inside the root canal after different light curing methods - An in vitro study.

OBJECTIVES: Short fiber-reinforced composite (SFRC) materials make it possible to reinforce root canal treated teeth with individualized, directly layered intraradicular posts (the Bioblock technique). The question arises, however, as to whether the photopolymerization of the material is sufficient deep within the root canal space and if it can be improved through different light-conducting options. Our study aimed to investigate the hardness of intraradicular SFRC material applied using the Bioblock technique and cured with various illumination methods, as measured through nanoindentation. MATERIALS AND METHODS: For this investigation, thirty plastic artificial teeth that had undergone root canal treatment were selected. These teeth were randomly divided into six study groups (Group 1-6; each group consisting of 5 teeth). The restoration procedures involved the use of SFRC or conventional composite materials, placed 6 mm apically from the root canal orifice. In Group 1 and 2, a conventional composite was used, whereas in Group 3-6, SFRC was employed for interradicular reinforcement (with a layered technique in Group 3 and 4 and a bulk-fill technique in Group 5 and 6). A modified light source was utilized for photopolymerization in Group 2, 4, and 6, whereas in Group 3 and 5, the polymerization light was directed through a prefabricated glass fiber posts. The control group (Group 1) utilized conventional composite material with a standard light-curing method. Following embedding and sectioning, the hardness of the composite materials was measured at 2 mm intervals within the root canal (1st, 2nd, 3rd measurements, in the coronal to apical direction). RESULTS: During the 1st measurement, light curing conducted through the glass fiber posts (Group 3 and 5) led to markedly higher hardness levels compared to the groups restored with conventional composite (control group with p = 0.002, p = 0.001, and Group 2 with p = 0.043, p = 0.034, respectively). In the 2nd measurement, only Group 5 demonstrated significantly greater hardness in comparison to the control group (p = 0.003) and Group 2 (p = 0.015). However, in the 3rd measurement, no statistically significant differences were observed among the groups. CONCLUSION: light curing through the glass fiber post provides outstanding hardness for the SFRC material in the apical layer in the root canal.

Polymerization shrinkage of light-cured conventional and bulk-fill composites -The effect of cavity depth and post-curing.

Volumetric shrinkage (VS) of conventional, bulk-fill, and core build-up resin-based composites (RBCs) of various thickness (1-5 mm) was measured using the modified bonded-disk method with confocal laser scanning microscopy. Additionally, the bottom-to-top ratio of Vickers hardness (%VH) was measured. Conventional RBCs exhibited significantly higher VS than bulk-fill and core build-up RBCs (p<0.05). As specimen thickness increased, VS relative to volume (%VS) and difference in VS at each depth (VSdepth) decreased. For conventional RBCs, there was a significant drop in VSdepth between 1 mm and 2 mm (p<0.05), and another drop was observed between 3 mm and 4 mm (p<0.05) where %VH decreased below 90%. For bulk-fill and core build-up RBCs, VSdepth decreased significantly between 2 mm and 3 mm (p<0.05), but %VH exceeded 90% even in 5 mm deep cavities. These results indicated that post-curing contributed to lower shrinkage in deeper layers, and that conventional RBCs were not adequately polymerized at the depth of over 3 mm.

Effect of Using Manufacturer-recommended Exposure Times to Photo-activate Bulk-fill and Conventional Resin-based Composites.

OBJECTIVES: To analyze the effect of using the resin-based composite manufacturer's recommended exposure time on the degree of conversion (DC), Knoop hardness (KH), and elastic modulus (E) of conventional and bulk-fill resin-based composites (RBCs). METHODS: Three resin-based composites (RBCs) were tested: Tetric EvoCeram Bulk Fill (TET), Opus Bulk Fill APS (OPU), and RBC Vittra APS (VIT). They were photo-activated in 2 mm deep, 6 mm diameter molds for their recommended exposure times of 10 seconds, 20 seconds, or 40 seconds from four light-curing units (LCUs). Two delivered a single emission peak in the blue light region (Optilight Max and Radii-Cal) and two delivered multiple emission peaks in the violet and blue region (VALO Cordless and Bluephase G2). After 24 hours of dry storage at 37°C in the dark, the KH (Kgf/mm2), E (MPa) and DC (%) at the top and bottom surfaces of specimens (n=5) were measured and the results analyzed by 2-way analysis of variance (ANOVA) followed by a Tukey test (α=0.05). RESULTS: The irradiance (mW/cm2) and spectral irradiance (mW/cm2/nm) from the LCUs were reduced significantly (8-35%) after passing through 2.0 mm of RBC (p<0.001). The DC at the bottom of VIT and TET was less than at the top surface (p<0.001). OPU had the same DC at the top and bottom surface (p=0.341). The KH and E values at the top surface of VIT and TET were substantially higher than at the bottom (p<0.001). OPU exposed for 40 seconds achieved higher mechanical properties than TET that was photo-activated for 10 seconds (p<0.001). The opacity of different bulk-fill RBCs changed differently during the polymerization; OPU became more opaque, whereas TET became more transparent. When exposed for their recommended times, the 2 mm thick RBCs that used Ivocerin or the APS photoinitiator system were adequately photo-activated using either the single or multiple emission peak LCUs (p=0.341). CONCLUSION: After 24 hours' storage, all the 2 mm thick RBCs photo-cured in 6 mm diameter molds achieved a bottom-to-top hardness ratio of at least 80% when their recommended exposure times were used. TET, when photo-activated for 10 seconds, achieved lower mechanical properties than OPU that had been photo-activated for 40 seconds. The change in opacity of the RBCs was different during photo-activation.

Fast Curing with High-power Curing Lights Affects Depth of Cure and Post-gel Shrinkage and Increases Temperature in Bulk-fill Composites.

OBJECTIVES: High-power LED curing lights and bulk-fill resin composites are intended to reduce chair time. This study investigated depth of cure, post-gel shrinkage (responsible for shrinkage stress), and heat generation in bulk-fill composites when cured according to minimum curing times recommended by manufacturers of curing lights and composites. METHODS: A regular LED curing light (Demi Ultra, 1350 mW/cm2, Kerr Dental) and two LED curing lights with high-power modes (VALO Grand, 3117 mW/cm2 Xtra Power, Ultradent; and Bluephase PowerCure, 2435 mW/cm2 Turbo and 3344 mW/cm2 3sCure, Ivoclar Vivadent) were tested on three bulk-fill composites (Filtek One Bulk Fill, 3M Oral Care Solutions; Tetric EvoCeram Bulk Fill, Ivoclar Vivadent; Tetric Powerfill, Ivoclar Vivadent). Using minimum times recommended by manufacturers (3, 5, 6, 10, or 20 seconds), depth of cure was determined by Vickers hardness of specimens cured in a slot (n=10). Post-gel polymerization shrinkage was measured using a strain gauge (n=10) and temperature with a thermocouple (n=5). Results were analyzed using two- and one-way analysis of variance (ANOVA) followed by pairwise comparisons or Student-Newman-Keuls post hoc tests (α=0.05). RESULTS: Curing lights and curing protocols significantly affected depth of cure, post-gel shrinkage, and temperature rise (p<0.001). Cure decreased with depth whereby best overall curing performance was achieved by the 20 second exposure at lowest irradiance (Demi Ultra). Fast curing (3-5 seconds) at high irradiance resulted in lesser depth-of-cure performance, except for the BluePhase-Tetric PowerFill combination. Post-gel shrinkage was higher in all composites when cured at high irradiance (p<0.001), while heat generated also tended to be higher. CONCLUSIONS: Although the high-power LED curing lights advertise time savings, not all manufacturer recommended minimum curing times cured bulk-fill materials to the same extent. Moreover, these time savings came at a cost of higher post-gel shrinkage and generated more heat in the bulk-fill composites than the lower irradiance curing protocol.

Effect of Two Different Ultrafast Curing Exposure Durations on the Surface Hardness of Bulk Fill Composite - An In-Vitro Study.

AIM: The aim of the present study is to assess the microhardness of resin-based composites (RBCs) cured with ultrafast curing mode at two different exposure durations. STUDY DESIGN: This is an experimental in-vitro study. Forty-five cylindrical composite specimens were prepared to a dimension of 5 mm height and 4 mm diameter. Curing was done using three different exposure modes and duration with dual mode LED curing light as follows: Group I: Ultrafast curing mode for 1 second at 2300 mW/cm2 (n = 15); Group II: Ultrafast curing mode for 3 second at 2300 mW/cm2 (n = 15) and Group III: Standard exposure mode for 20 second at 1000 mW/cm2 (n = 15). Vicker's microhardness measurement was done on both the curing and non-curing sides of the specimen using a motorised diamond-faced micro-indenter (Wilson Wolpwert, Germany) using a load of 50 gram and a dwell time of 30 second. STATISTICAL ANALYSIS: Kruskal Wallis ANOVA was used to test for difference between the three groups followed by Mann-Whitney U test for post-hoc analysis. RESULTS: The microhardness values of the composite cured with a conventional curing unit were significantly higher than the ultrafast cured specimens. CONCLUSION: Low-intensity conventional curing lights were found to perform better than the high-intensity ultrafast curing units.

How does indirect air-cooling influence pulp chamber temperature in different volume teeth and absence/presence of resin-based composite during light curing?

BACKGROUND: Light-curing of materials during restorative dental procedures poses a risk for pulp tissue overheating. Therefore, the aim of this study was to investigate the effect of indirect air-cooling on pulp chamber temperatures during light-curing of varying volume teeth and absence/presence of resin-based composite (RBC) at different exposure time. METHODS: The volume of 11 human teeth was measured by micro computed tomograph. An experimental rig controlled the thermal environment of the teeth and a thermocouple inserted retrograde into the root canal measured temperature changes. Pulp chamber temperature was measured with and without air-cooling on teeth without and with RBC at 15 s, 30 s and 60 s intervals. Generalized estimating equations were used for statistical analysis. RESULTS: The temperature increase with air-cooling (versus no air-cooling) was lower in teeth despite absence/presence of RBC (ß = - 4.26, 95%CI - 5.33 and ß = - 4.47, 95%CI - 5.60, respectively). With air-cooling, the temperature increase in teeth with RBC was lower compared to teeth without RBC (ß = - 0.42, 95%CI -0.79; - 0.05). Higher teeth volume resulted in lower temperature increase with air-cooling than without air-cooling (ß = - 0.04, 95%CI -0.07; - 0.01 and ß = - 0.17, 95%CI -0.30; - 0.05, respectively). CONCLUSIONS: Air-cooling resulted in lower pulp chamber temperature increase. Using air-cooling, the temperature increase was lower in teeth with RBC compared to teeth without RBC. Lower volume teeth resulted in higher temperature increase, thus they seemed to benefit more from air-cooling compared to higher volume teeth. Air-cooling could be an effective tool in controlling pulp temperature increase during light-curing, especially when the tooth volume is small.

The Effect of Different Light-curing Units and Tip Distances on the Polymerization Efficiency of Bulk-fill Materials.

PROBLEM STATEMENT: In an average class II posterior preparation, the curing light tip is placed at a distance from the restoration surface that far exceeds the 1-mm manufacturer's recommendation. This distance can have potentially detrimental effects on the curing efficiency of the light-curing unit as well as the properties of the resin-based composite restoration, especially at the bottom of the cavity preparation. PURPOSE: The purpose of this study was to evaluate the effects of various types of light-curing units (LCUs) and the different curing distances on the degree of conversion (DC) and the surface hardness of bulk-fill composite materials. METHODS AND MATERIALS: A total of 390 specimens of three resin-based composites (RBCs) were fabricated. Two bulk-fill RBCs, including Filtek Bulk Fill Posterior (3M ESPE GmbH, Seefeld, Germany) and Tetric N-Ceram Bulk Fill (Ivoclar Vivadent AG, Schaan, Liechtenstein), as well as a Filtek Z350 XT nano-filled composite (3M ESPE GmbH, Seefeld, Germany), were utilized. In this study, the Vickers microhardness number (VMN) and the DC were evaluated at 2 and 4 mm thicknesses. Polymerization for 20 seconds was performed using two high-power light-curing units, namely the polywave Bluephase G2 light-emitting diode (LED) LCU (Ivoclar Vivadent AG, Schaan, Liechtenstein) and the monowave Elipar Deep Cure S LED LCU (3M Oral Care, St Paul, MN, USA) at 0, 2, and 4 mm distance between the curing tip and the RBC surface. The results were analyzed using the two-way analysis of variance method. Scheffe's post-hoc multiple comparison tests were used to determine significant differences between the materials, the LCU, and the tip distances. RESULTS: The highest DC (70.17) was shown by Filtek Bulk Fill Posterior at a distance of 0 mm, whereas the lowest DC (45.99) was measured for the conventional Filtek Z350 XT at a 4 mm distance. Moreover, higher VMNs were shown by Filtek Bulk Fill and Filtek Z350 composites at 0 mm distance than by the Tetric N-Ceram Bulk Fill composite material when cured with a Bluephase G2 LCU. For all materials, a significant decrease in the DC and mean VMN values was observed at a 4 mm distance in comparison with 0 and 2 mm distances. CONCLUSIONS: The DC and VMN values among the studied bulk fill materials were more significantly affected by the material composition and curing protocols. The increased distance from the light tip has a detrimental effect on the mechanical properties of composite resin materials. Significant differences were observed in the curing efficiency of the two LCUs investigated.

Effect of light-curing time and direction on microhardness of a light-cured resin composite to cement CAD-CAM restorations.

PURPOSE: To evaluate the effect of light-curing exposure time and location on polymerization of a restorative bulk-fill resin composite to lute endocrowns. METHODS: A light-cured restorative bulk-fill resin composite (Filtek One Bulk Fill) was submitted to direct light-curing by a high-power LED light-curing unit for 20 seconds as the positive control group (n= 10). Five more groups (n= 10) were light-cured in a natural tooth mold from two sites (labial and lingual) through a nanohybrid resin composite CAD-CAM restoration (Lava Ultimate A2 LT), for different irradiation times: 90 seconds per site, 40 seconds per site, 30 seconds per site, 20 seconds per site and 10 seconds per site. Vickers microhardness measurements were made at two different depths and test/control ratios were calculated. Ratios of 0.8 were considered as an adequate level of curing. A quantile regression was run to identify the minimally sufficient time of light-curing, and a two-way ANOVA was used to compare the results to previous findings and evaluate the effect of curing location. RESULTS: Analysis showed that 40 seconds x 2 is the minimal irradiation time that presents a test/control ratio above 0.8. Quantile regressions showed that the required irradiation time to reach a test/control ratio of 0.8 at a confidence level of 95% is 41.5 seconds and 39.2 seconds at 200 µm and 500 µm depths in the luting agent, respectively. There was no statistically significant difference between microhardness of the two depths except for the irradiation time of 10 seconds. The two-site to three-site light curing comparison showed no statistically significant difference except for the 90-second time. CLINICAL SIGNIFICANCE: Systematic light-curing through the labial, lingual and occlusal surfaces of thick indirect restorations is not always required for sufficient polymerization and can even waste valuable clinical time especially in the case of multiple restorations luted with resin composites.

Influence of Primer Pre-curing and Co-curing on Shear Bond Strength of Orthodontic Brackets Using Three Light-cure Adhesive Systems: An In Vitro Study.

AIM: This study aimed to evaluate the shear bond strength (SBS) of orthodontic brackets with primer pre-curing and co-curing using three light cure adhesive systems. MATERIALS AND METHODS: In this in vitro study, 102 extracted premolar teeth mounted on self-cure acrylic resin blocks were separated into six groups based on primer pre-curing and co-curing with each group receiving stainless steel orthodontic premolar brackets bonded to the buccal surfaces. The following adhesives were used: Transbond XT (3M Unitek, CA, USA), Orthofix (Anabond Stedman, India), and Enlight (Ormco, India). In the groups with pre-curing, the primer was pre-cured for 20 seconds while in the groups with co-curing, the primer and adhesive were cured together. Shear bond strength tests and Adhesive Remnant Index (ARI) were assessed followed by an scanning electron microscope (SEM) view (×3000) of the enamel surface after debonding. Statistical analysis was done using a one-way analysis of variance (ANOVA) test. RESULTS: The descriptive statistics in the pre-cured groups showed a statistically significant difference. The highest mean SBS was observed for group I, i.e., Transbond XT with primer pre-curing (20.56 ± 3.22 MPa). The lowest mean SBS was for group IV, i.e., Orthofix with primer co-curing (7.57 + 0.49 MPa). The results of ANOVA revealed a significant difference among the groups. The ARI scoring and the SEM analysis also confirmed this finding. CONCLUSION: Shear bond strength of orthodontic brackets with primer pre-curing showed a better bond strength than brackets with co-curing. The ARI data suggested that the majority of bracket failure happened at the resin-bracket interface. Scanning electron microscope analysis also confirmed the ARI and SBS findings. CLINICAL SIGNIFICANCE: During the bonding of orthodontic brackets, the primer can be co-cured where the primer and adhesive resin are cured simultaneously or pre-cured where the primer is cured separately. Most orthodontic clinicians to save time co-cure primer. Both these methods affect the SBS of brackets.

Analysis of Cosmetic Effect of Nanocomposite Resin on Anterior Teeth.

The problems of anterior teeth include dental plaque, dental caries, and fracture, which are usually treated with common composite resin clinically. Although good repair effect can be achieved, patients are prone to anterior tooth sensitivity after surgery. Therefore, the purpose of this study is to analyze the cosmetic effect of nanocomposite resin on anterior teeth. Up to 176 patients (176 teeth) undergoing anterior dental cosmetic restoration in our hospital were selected and assigned to the LR group (n = 88) and the NR group (n = 88) according to patients' voluntary choice of prosthetic materials. The LR group was cured with light-cured composite resin, while the NR group was cured with nanocomposite resin. By comparing the related indexes of patients in the two groups, it was discovered that in the NR group, the excellent and good rate and patients' evaluation of the repair effect were higher, while the periodontal attachment, gingival index, dental plaque index, VAS score, and the incidence of tooth sensitivity were lower, all P < 0.05. The results indicated that the nanocomposite resin had significant cosmetic effect on anterior teeth and had application value.

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

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

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

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

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

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

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

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

Impact of adhesive system generation and light curing units on orthodontic bonding: In vitro study.

OBJECTIVE: We aimed to compare adhesive performance of fourth, fifth and seventh generation adhesive systems (GASs) and the effect of two different light curing units on shear bond strength (SBS). MATERIALS AND METHODS: One hundred and twenty extracted human upper premolars were divided in four groups. Bonds were assessed as following: group 1 using 4th GAS, group 2 using 5th GAS, group 3 and 4 using 7th GAS with two different light curing units (1500 and 800mw/cm2). Adhesive remnant index (ARI) scores were counted. RESULTS: Group 1 and 2 showed similar SBSs (P=0.7) which were significantly higher than group 3 (P=0.0002). Group 4 exhibited significantly the weakest SBS with mean=2.15±0.25. Applying shear forces less than 15MPa on group 3 bonds led to the release of almost all of the of brackets. Whereas, applying the same forces on group 2 bonds leads to the release of 66.7% of brackets. Notably, only 40% of brackets in group 1 were debonded. Group 4 brackets were totally debonded when applying shear forces less than 10MPa. While ARI=0 was the most frequent in group 1, ARI=3 was the most frequent in group 3. CONCLUSION: Fourth and fifth GASs showed similar SBS higher than seventh GAS. Fourth GAS bonds were able to resist longer against traction forces than those set up by fifth generation. Seventh GAS bonds offered the least efficient resistance. ARI=0 was the highest in group 1. However, Group 4 showed the highest ARI=1 and ARI=2 revealing cohesive failure. We also found that the adhesive power is proportional to the power of the lamp used. In fact, we concluded that 1500 mw/cm2 units light curing during 30seconds generated an ideal energy to enhance orthodontic bracket adhesion.

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

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

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

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

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