Marginal Adaptation of Class II Composite

Fiilings: Guided Polymerization vs

Reduced Light intensity
Gtz M. Lsche^

Purpose: To improve the marginal adaptation ot Ciass II composite fillings, a three-sited light-cjring technique was proposed by Lutz et al in 1986 and has preven to be effective in several studies. This study investigated whether this effect, attributed to guided poiymerization towards the cavity margins, might aisc
be due to the decreased polymerization stress resulting from reduced curing light intensity caused by
transdental curing.
Materials and Methods: Forty extracted human molars were mounted in casts and 40 Class II slot-type
cavities were cut (cervical margins 0.5 mm above the CEJ). To measure the light being transmitted from a
haiogen curing light onto a composite layer within a cavity, miniature photodetectors were used and irradiance measured for a three-layer technique (1st: oen/ical-horizontai: 2nd and 3rd: lateral-diagonal] with occiusai or three-sited curing. To evaluate the infiuence of iight intensity on marginai adaptation, the
prepared cavities were treated as toiiows: after base placement and acid etching, the cavities were fiiied
with Herculite XR (Kerr, Romulus, Ml, USA) in three increments. Aii cavities were fiiied with the iayering
technique described above. In two groups (n=10|, curing was carried out only from ODclusal. in the remaining groups, the cervical composite layer was cured through a iight-trahsmitting, iaterai reflective wedge.
and the foiiowing iayers transdentally with a proximal wand positioning. Using the photodetectors, the output power of an argon iaser was adjusted so that the composite was cured with the equivaient irradiance
calculated for occlusal (high-mtensity groups) and three-sited curing occlusal (low-intensity groups). Replicas were produced after storing in water for 2 1 days and thermocycling (2000>;, 50 to S^C). The margins cf the filiings were quantitatively assessed using a SEM at 20X. The results were statistically
analyzed (ANOVA, Bonferroni/Dunn; p < 0.05).
Results: The summed values for the criteria "restoration margin fracture", "enamel margin fracture," and
"marginal opening" at the cervical margins were 11.3 11.5 (three-sited curing, iow intensity), 14.1 15.7
(occiusai curing, low intensity). 25.4 21,2 (three-sited curing, high intensity), and 27.8 30,6 (occlusai
curing, high intensity).
Conclusion: No significant difference was found between curing techniques at equal energy levels; the effect of the three-sited light curing technique should therefore not be attributed to guided polymerization
but to the reduction of light intensity.
J Mtiesive Dent 1999:1:31-39.
Submitted for publication: 03.11,98; accepted for publication: 16.11.98.

olymerization shrinkage is probably the greatest

problem associated with composite resins if
' Associate Professor, Department of Operative Dentistry, Preventive
used as filling materials in large cavities. The rea-

Dentistry, and Endodontics, School of Dental Medicine, Humboldt

university BeriiniCharit), Berlin, Germany.

s o n f o r S h r i n k a g e is t h e d e c r e a s i n g b i n d i n g d i s ^^^^^ between monomer molecules and the

growing polymer chain. The amount of shrinkage at

Z!::^r^o^o^:

MeS%ro?S^;;^tS

Preventive Dentistry, and Endodontics, Fhrer Strasse 15, 1335.3

Berlin, Germany. E-mail: ioe5che@charite.de

- y ti-^ is related to the degree of polymerization.

j e, t h e c o n v e r s i o n Of C = C bonds tO C-0 bondS.
j^^^^^ f^^ g gj^g,,, material. Shrinkage must be correlated to t h e degree of conversion. Depending on

31

Figl

Three-sited light curing technique as escriQed by Lutz etal

the selection and combination of resin monomers

and the type and amount of filler used, currently
available composite fiiling materiais show a free
voiumetric shrinkage of 2.6 to 4.8 vol.-%.9
Compared to chemioaliy cured composites, the
setting reaction of iight-cured materials takes piace
very rapidiy and stress reiief by fiow is restricted.^i
High curing-light intensity, whioh is desirabie for optimal polymerization, results in a faster polymerization reaction^^, 24 thereby further restricting stress
relief. The benefioisi effect of lower curing-iight intensity on marginai adaptation has been demonstrated for cavities with restricted bonding areas,
I e, Class V oomposite fillings in dentin,12.34,35 Class
|3o or V22 fillings in enamei without circular beveis,
or restoration margins of Class ill fiiiings close to
the CEJ.20
The iarge volume and the often clinicaiiy restricted area for safe bonding cervically^^ are problems associated with ciass II composite fillings. To

32

overcome the problem of shrinkage, a multitude of

filling techniques has been developed in the attempt to reduce shrinkage-espeoiaily cervicaliy-by
placing the composite in increments, ailowing the
utmost unrestricted shrinkage of the filling materiai,
Probabiy the most sophistioated technique was
introduced in 1986 by Lutz et ai.^s based on the
idea of guiding polymerization shrinkage vectors towards the cavity margins using a iaterai light refiective wedge at the cervioal margin and transdentai
poiymerization at the axial waiis of the proximal box
(Fig 1). This so-called three-sited light-curing technique has proven to be effective not oniy by the deveioper but aiso by other authors,5.i9 A substantiai
decrease of curing light intensity, however, has to
be taken into account with this technique, as the
light intensity being transmitted through the wedge
was found to be less than 8%,6 Reflection of light
on the tooth surface^' and reduction of curing light

jve Dentistry

Fig 2

Position of miniature photodetectors and resuits of intracavity irradiance measurements.

intensity by transdental polymerization^e may be

other important factors.

PURPOSE OF THE STUDY

The purpose of this study was to investigate
whether the good resuits achieved with the threesited polymerization technique are attributable
solely to the effect of directed polymerization or if
the reduction of curing light intensity also plays an
important role.

tions, Vestogum (Espe, Seefeld, Germany), a pink

polyether, was used, Oiass II siot-type cavities
(n=10) were cut so that the vertical cavity margins
extended on the buccai and iingual sides to within
0.5 mm of the neighboring tooth. The cervical margins were piaced 0,5 mm above the OEJ. After cavity preparation, the casts were stored in water for
24 h prior to measurement of irradiance.

MATERIALS AND METHODS

Before matrix placement, the cavities were biown

dry. For evaluation of the three-sited iight-curing
technique, a myiar matrix was adapted with a Luciwedge'- (Hawe Neos Dental, Bioggio, Switzerland);
for the Gcclusai curing technique, a metal matrix
with a sycamore wedge (Hawe Neos Dentai) was applied.

To determine the amount of light reaching the surface of the uncured composite in a Oiass il cavity,
extracted human moiars were mounted in casts
with neighboring teeth. To reproduce gingival condi-

The sensitive area (1 x 2,5 mm) of miniature silicon photodeteotors (OSD 5-5T, Oentronic, Oroyden,
Great Britain) was covered with a piece of No. 45
plus No, 47 B geiatin fiiter (Kodak Wratten Geiatin
Fiiter. Eastman Kodak, Rochester, NY, USA), The

Vol 1, No l_1222_

33

Fig 3

Exprimentai set-up for iow and high cunng iight intensity.

photodetectors were calibrated with a precision radiometer and irradiance detector (iL 1700 + SED
033, International Light, Newburyport, MA, USA).
The irradiance of a standard halogen light source
(Kerr, Romuius, Mi, USA) was controiied with the
same equipment prior to irradiance measurement
within each cavity (612+17 mW/cm').
For each curing technique, the detectors were
positioned at those locations where light wouid be
expected to hit the composite surface first. For occlusal curing, the sensitive area pointed upwards;
for three-sited curing, two detectors were used for
eaoh location, one sensitive area pointing towards
the transparent matrix, one towards the oervioai or
axiai cavity walls. Both curing techniques were evaluated in eaoh cavity. The measurements were repeated five times after intermittent water storage
for 24 h. The positions of the detectors within the
cavities are illustrated and the results given in Fig

34

For evaiuation of marginal adaptation, 40 extracted human moiars, which were randomly assigned to four groups (n=10), were mounted in
casts as described above. Untii cavity preparation
and filling of the cavities, the casts were stored in
water at room temperature.
All following steps, from preparation to completion ofthe restoration, were done under 4.5x magnification (Zeiss, Oberkochen, Germany). After
initial preparation for proper extension of the verticai margins (0.5 mm distance to neighboring tooth),
the adjacent typodont tooth was removed for optimal access during extension of the cervical margin
to 0.5 mm above the CEJ. The axial depth of the
cavity at the Ievei of the cervicai floor was 1.5 mm.
Occlusal and vertical margins were beveied with a
fine-grit diamond (Composhape H 40, Intensiv, Viganelio-Lugano, Switzerland). Only a short bevel
was prepared at the cervioal enamel. Ail exposed
dentin was covered with a glass ionomer base

TheJournai of Adhesiva Dentistry

Lsche

Fig 4
Resuits at occlusal margins (the bars represent the summed vaiues ofthe criteria restoration margin fracture, enamei
margin fracture and marginal opening; nonsignificant differences are underiined; p < 0,05),

(Ketac Bond, Espe, Germany). The enamel margins

were acid etched with a 35% phosphoric etching
gei. After 60 s, the cavity was rinsed for 60 s and
thoroughly dried.
After remounting and fixing the adjacent typodont t o o t h , mylar matrices with Luciwedge'(groups 1 and 4) or steel matrices in combination
with a sycamore wedge {groups 2 and 3) were applied. An experimental argon ion laser (Model 2010
with fiberoptic 316. Spectra Physics, Mountain
View, CA, USA) was used which had been adjusted
in wavelength and curing area to the halogen curing
light. Before composite piacement, the power output of the iaser was adjusted for each cavity with
help of the photodetectors mentioned above: when
the low intensity for the three-sited curing technique
(50 mW/cm2 at the cervicai and 150 mW/cm^ at
the vertical walls) was used as a standard, the laser
was adjusted for occlusal curingtothe same values
[group 2). When the values measured for occlusai

curing {cervicai 2 5 0 m W / c m ^ ; middle 4 0 0

mW/cm^, and occiusal 500 mW/cm^) were used as
a standard, the values of the three-sited curing
(group 4) were adjusted to the same high-intensity
values (Fig 3).
A bonding agent (Bondiite; Kerr, Romulus, Ml,
USA] was applied, biown thin, and cured from occiusai for 20 s (intensity at occiusal margin = 500
mW/cm2). Curing time for each increment of composite (Herculite LY, Kerr) was 60 s. After poiymerization, the teeth were removed from the casts and
the fillings finished and polished under direct vision
with fine grit diamonds (Composhape H 40 and H
15, Intensiv) and aluminum-oxide-coated fiexible
discs (SoFlex, 3M, St Paul, MN, USA),
The teeth were stored in water for 2 1 days at
room temperature and thereafter thermocycled
(2000x, 5C to 550), Repiicas were produced after
water storage and thermocyoling, A quantitative
marginai anaiysis in the SEM3i at a magnification of
35

Vol 1, No 1 , 1 9 9 9

vertical margins

3-sited - standard Q occlusal - low intensity

occlusal - standard |R| 3-sited - high intensity

vertical margin before TC

intensity p > 11.05

vertical margin after TC

liiyerin}; ifcliriiqut

p > 11.115

li;ht inl,- iiiv.k'ch. p > 11.1)5

Fig 5
Results at verticai margins (the bars represent the summed vaiues of the cntena restoration margin fracture, enamel
margin fracture and marginai opening: nonsignificant differences are underlined; p < 0.05).

200x was performed. The criteria for evaluation

were: excellent margin, marginal irregularities, submargination, overhangs, restoration margin fract u r e , enamel margin f r a c t u r e , and marginal
opening. The values of the criteria restoration margin fracture, enamel margin fracture, and marginal
openingbeing regarded as indicators for stress development-were summed and the results statistically analyzed at a significance level of p = 0.05
(ANOVA, Bonferroni/Dunn, Stat View 4.02, Abacus
Concept, Berkeley, CA, USA).

very good and no significant differences were found

between groups (Figs 4 and 5). In the cervical area
(Fig 6) before thermocycling, low summed marginal
criteria values were found for both curing techniques with low-light intensities, while the values for
both high-intensity groups were significantly higher.
After thermocycling, the increase in these summed
values for the low-intensity groups was more pronounced than for the high-intensity groups, again
showing significantly worse marginal adaptation
compared to the low-intensity groups. Curing light
intensity was found to be a significant factor, while
layerihg technique had no significant influence.

RESULTS
DISCUSSION
The results found for the three margin locations are
shown in Figs 4 to 6. Non-significant differences
(p > 0.05] are underlined.
At occlusal and vertical margins, adaptation was
36

The influence of curing light intensity on the polymerization of composite resins has been shown ih
many studies, and up to a certain limit, a linear corThe Journal of Adhesive Dentistry

cervical margins

3-sited - standard

ocolusal - low intensity \J

occiusal - standard

cervical margin before TC

lii;hl inten.sity p < ().()5

3-siled - high intensity

cervical margin after TC

liivfring ttcliiiicjiie p > 0.05

liijht int.

Fig G
Results at cervical margins (the bars represent the summed values ofthe criteria restoration margin fracture, enamel
margin fracture and marginal opening: nonsignificant differences are underlined; p < 0.05|.

relation of curing light intensity and polymerization

is found.26 The maximal absorption wavelength of
campheroquinone used as a photoinitiator in most
composites is 468 nm,^^ but waveiengths of 410 to
500 nm, 454 to 495 nm,38 and 440 to 500 nmi"
are regarded as effective for polymerization as well.
To predict polymerization from light intensity measurements, only the relevant spectrum should be
assessed.S36,37 AS proposed by McCabe and Carrick,26 Kodak gelatin filters No. 45 (435 to 550 nm)
and No. 47 B (370 to 500 nm) were used to limit
the sensitivity of the silicon photodetectors to 435
to 500 nm. Because they were thin, they were preferred over a more specific narrow bandpass filter
(ideally 468 nm), which was too thick and couid not
be reduced to the size of the photodetectors.
For the occiusai and middie detector position,
the values found for occiusal curing are in agreement with the results of Hansen and Asmussen, indicating that curing from ocolusal is efficient, and
Vol 1, No 1 , 1 9 9 9

iittle iight reduction has to be taken into account.^^

The low vaiues found for the cervical iayer if cured
from the occiusal can be attributed to the narrow
configuration of a slot-type cavity, which restricts
the access of iight. The irradiance measured is,
however, still sufficient, as minimai curing energy
shouid be 233 mW/cmV60 s.32
The vaiues found for the three-sited curing technique can be attributed to severai factors. A considerabie decrease of irradiance occurred: the
maximai iight intensity transmitted through the
wedge was found to be less than 8%.^ Due to the
dimensions and rigidity of the Luciwedge'-, it can
seldom be compietely inserted into the proximal
space, thus increasing the exit distance of the light
wand to the tooth. This results in poor and inhomogeneous polymerization of the composite in the
proximal box.3.29 Cutting off the excess length of
the wedge wouid improve the resuits,^^ but for adequate curing, additional polymerization from oc37

clusal is necessary,^^ The reflection of light from

the surface of the tooth, matrix, or restorative materiai 37 is sureiy one major factor infiuencing the measurement at the verticai waiis. The thickness of the
tooth structure^^ and the rapidly increasing opacity
of enamel due to dehydration^ are other clinicaiiy
important factors, ail together resuiting in values
too low to ensure complete poiymerization.
Class li slot-type cavities were cut, and where
sufficient enamei was available, a bevel was prepared to provide optimal prerequisites for adhesive
bonding to enamei.^^ The enamei thickness ciose to
the CEJ does not allow a bevei of sufficient width.i^
Nevertheless, a short bevel was prepared to reduce
the amount of enamel marginal fractures found
with butt joint preparations in that area," Although
rather effective dentin bonding agents are currently
avaiiabie which aliow augmentation of the adhesion
area in the critical cervicai region, aii exposed
dentin was covered with a giass ionomer base to
limit the bonding area and reveal the maximal infiuence of stress during shrinkage and thermocyciing.

bevel of sufficient width could be prepared and a

hybrid composite was placed and cured in increments.i9 Since occiusal and vertical enamel thickness allowed the preparation of an adequate bevel,
similar results were found in this study and neither
curing iight intensity nor iayering technique had a
significant impact on marginal adaptation.
The results at the cervicai margins showed the
infiuence of increased and faster polymerization
shrinkage with higher intensities,12.24 jf^g fast development of the polymerization reaction of lightcuring composites impairs stress reiief by flow,i" resulting in signifioantly worse results for restorations
cured with higher iight intensities. The more pronounced increase of marginal deficiencies after
thermocyciing for the two groups cured with low intensity can be explained by postcuring contraction,^
This is lower in the high-intensity groups, because
the composite is more completely polymerized by
the first curing. Although post-irradiation poiymerization is obvious in both groups cured with iow intensity, complete polymerization is questionable.

To aliow adjustment of intensity without wavelength shifts and to achieve the high irradiance values measured for occiusai curing as well as for
transdental poiymerization, an experimental argon
ion iaser was used for polymerization, Waveiengths
were limited to 457 to 501 nm,3S The beam of the
laser was widened and applied through a standard
light rod combined with the dichroic fiiter used in
the halogen curing unit, making the curing characteristics simiiar to those of the light source used
during irradiance measurements, Intracavity measurements revealed equivalent results to the Optiiux 400,
Thermocyoiing is the common procedure to induce stress, based on the difference in coefficients
of thermal expansion of composite and tooth structure,^ Together with the quantitative margin analysis of cavity margins of adhesive restorations, it
allows prediction of the success of adhesive
restoration techniques to a certain degree,3i [n previous studies, the criteria restoration margin fraoture, enamel margin fracture, and marginal
openingespecially for cavity margins ciose to the
CEJwere found to be indicators for stress deveiopment and faiiure of the restoration.1618.20,21 jf^gy
were therefore summed for better statistical comparison of the exprimentai groups.

The procedure proposed by Radke^^ to cure the

cervical layer not only through the Luciwedge but
additionaily from occiusal would in effect be similar
to the soft-start polymerization described by Mehl
et aP'^ for Class V cavities. This technique has not
yet been finaiiy evaiuated for Ciass il cavities with
restricted bonding area, but preliminary results
show that at equal energy levels, marginai discrepancies are significantly reduced by step-wise polymerization (unpublished data).

CONCLUSION
The good results achieved with the three-sited lightcuring technique should not be attributed to the effect of guided polymerization, but to polymerization
with iower light intensity. The following steps might
ensure good marginal adaptation and adequate
cure: 1) increasing the cervical bonding area by use
of efficient dentin bonding agents; 2) iayering of
several smaii increments at the cervicai floor (eg,
using iow- viscosity resins); or 3) using different curing techniques, such as precuring through the lateral refiective wedge and postcuring from occiusal
or using soft-start polymerization in combination
with occiusai curing.

In a previous study, good marginal adaptation

and no statisticaiiy significant difference was found
between occiusal and three-sited curing, because a
38

The Journal of Adhesive Dentistry

ACKNOWLEDGMENTS
This study was supported by the University Research Fund / Charit/ HU Berlin, Project No. 98-181.

REFERENCES
1. Ben-Amar A. Metzger Z, Gontar G, Cavity design for Class II
composite restorations. J Prosthet Dent 1987:58:5-8.
2. Brodbelt RHW, O'Brien WF, Fan JG, Frazier-Dib JG, Yu R.
Translucency of human dental enamei. J Dent Res 1981-601749-1753,
3. Ciamponi AL, Dei Portillo Lujan VA, Ferreira Santos JF. Effectiveness of reflective wedges on the polymerizaticn of composite resins. Quintessence Int 1994:25:599-602.
4. Cook WD. Spectral distributions of dentai photopoiymerization sources. J Dent Res 1982:61:1436-1438.
5. Cvitko E. Denehy G, Boyer DB. Effect of matrix systems and
polymenzation techniques en micrcleakage of Class il resin
ccmposite restorations. Am J Dent 1992:5:321-323.
6. De Goes MF, Rubbi E. Baffa 0, Panzeri H, Optical transmittance of reflecting wedges. Am J Dent 1992:5:73-80.
7. Frnst C-P, Kijrschner R, Wiliershausen B, Polymerisationsspannung in Kompositmaterialien bei Verwendung eines
zweistufigen Lichtpoiymerisaticnsgerates. Acta Met Dent
Helv 1997:2:208-215.
8. Fan PL, Wozniak WT, Reyes WD, Stanford JW. irradiance of
visible iight-curing units on voltage variation effects. J Am
Dent Assoc 1987:115:442^45.
9. Feilzer A, De Gee A. Davidson C, Curing contraction of composites and giass-ionomer cements. J Prosthet Dent 1988:
59:297-300.
10. Feiizer AJ. Polymerisation shrinkage stress in dentai composite resin restorations. Amsterdam: Academisch Proefschrift,
1989.
11. Feilzer AJ, De Gee AJ, Davidscn CL. Setting stresses in composites for two different curing modes. Dent Mater 1993;9:25.
12. Feilzer AJ, Dooren LH, De Gee AJ, Davidson CL. Influence of
light intensity on polymerization shrinkage and integrity of
restoration-cavity interface. Eur J Orai Sci 1995:103:322326.
13. Hansen Ek, Asmussen E. Visible-light cunng units: correiation
between depth of cure and distance between exit window
and resin surface. Acta Odontoi Scand 1997:55:162-166.
14. Harrington E. Wilson IHJ. Determination of radiation energy
emitted by iight activation units. J Oral Rehabil 1995:22:377385.
15. Jargensen KD, Ono T. Gingival enamel thickness vs. bevel
preparation. Tandl Bladet 1984:88:297-300.
16. Lsche AC, Lsche GM. Rouiet J-F. The effect of prolonged
water storage on marginai adaptation of Class II fillings (abstract 3013]. J Dent Res 1996:75:394,
17. Lsche GM, Hilbig WH, Rouiet J-F. The margin quality of direct
pcsterior composite restorations close to the CEJ (abstract
1889]. J Dent Res 1992:71:752.
18. Lsche GM, Lsche AC, Rouiet J-F. The effect of light scattering inserts on the marginai adaptaticn of compcsite fillings
[abstract 957]. J Dent Res 1993:72:223.

Voi 1, No 1 , 1 9 9 9

19. Lsche GM, Neuerburg OM, Rouiet J-F. Die adhesive Versorgung konsen/ativer Klasse ii Kavitaten. Deutsch Zahnrztl
Z 1993:48:26-30.
20. Lsche GM, Rosansky J. Rouiet J-F. The influence of curing
light intensity on marginal adaptation of Class III composite
fillings [abstract 184). J Dent Res 1996:75:40.
21. Lsche GM, Schiffer I, Rouiet J-F. Der EinfiuS seitlich reflektierender Leuchtkeiie auf das Randverhalten an Klasse III
Kompositfllungen. Deutsch Zahnarzti 2 1994:49:449-453.
22. Lsche GM, SchCirg C, Rcuiet J-F. The influence of curing Iight
intensity on marginal adaptation cf composite fiiiings (abstract 1284]. J Dent Res 1993:72:264.
23. Lutz F, Krejci I, Luescher B, Oidenburg TR. improved proximai
margin adaptation of Class li composite resin restorations by
use of light-refiecting wedges. Quintessence Int 1986;17:
659-664.
24. Masutani S, Arai S, Hinoura K, Takigawa T, Onose H. influence of Ar-iaser curing technique on resin hardness and
shrinkage (abstract 1604], J Dent Res 1990:69:309.
25. Mayer R, sthetisch-adhsive Filungstherapie im Seitenzahngebiet-eine Iliusian? Deutsch Zahnrztl Z 1991:46:468470.
26. McCabe JF, Carrick TE. Output from visible-light activation
units and depth cf cure of light-activated composites. J Dent
Res 1989:68:1534 1539.
27. Mehi A, i-iickel R, Kunzelmann KH. Physical properties and
gap formation of light-cured composites with and without
'softstart-polymerization'. J Dent 1997:25:321-330,
28. 0iio G, Jergensen KD. Effect cf beveiiing on the occurrence of
fractures in the enamel surrounding composite resin fiiiings.
J Oral Rehabil 1977:4:305-309.
29. Radtke R. Einflu des Lichtkeils auf die Polymerisation von
zwei lichthrtenden Seitenzahncomposites. Zahnmed Diss,
Berlin. 1991.
30. Reinhardt K-J. Der Einflu der Lichtqueile auf die Randstndigkeit vcn Kompositfiiungen. Deutsch Zahnrztl Z
1991;46:132-134.
31. Rouiet J-F, Reich T, Biunck U, Noack MJ. Quantitative margin
anaiysis in the scanning eiectron microscope. Scanning Microscopy 1989;3:147-159.
32. Rueggeberg FA, Caughman WF, Curtis JW, Jr. Effect of light intensity and exposure duration on cure of resin composite.
Oper Dent 1994;19:26-32.
33. Severin C. Maquin M, Husson R. Argon ion laser beam as
restorative resin photocuring agent: clinical requirement,
power output specification [abstract 73]. J Dent Res
1986:65:123.
34. Uno S, Asmussen E. Marginal adaptaticn of a restorative
resin polymerized at reduced rate. Scand J Dent Res 1991:
99:440-444.
35. tJnterbnnk GL, Muessner R, Infiuence of light intensity on two
restorative systems. J Dent 1995:23:183-189,
36. Vogel K, Saiz U, Infiuence of trans-tooth curing on physicai
properties of composite [abstract 137|. J Dent Res 1997:
76:1111.
37. Watts DC, Cash AJ. Anaiysis of optical transmission by 400500 nm visibie iight into aesthetic dental biomaterials. J
Dent 1994:22:112-117.
38. Yearn JA. Factors affecting cure of visibie iight activated composites. Int Dent J 1985:35:218-225.

39