Curing techniques

Historically, dentists have

restored teeth by using
conventional curing lights to cure
layers of composites, typically at
time intervals of 40 seconds per
layer.

Over the past few years, the
industry has focused on reducing
the resin curing time by using
stronger curing lights or altering
resin composition.

The goal is to achieve
restorations more quickly.
2
2

Curing of dental composites with
blue light was introduced in the
1970s. The source of blue light is
normally a halogen bulb with a filter
which produces blue light in the
range of 410 nm 500 nm of the
visible spectrum.

Although halogen bulb based light
curing units are most commonly
used to cure dental composites but
recent development in curing light
technology has shaken the
compliance of many practitioners
and brought to light the aspects of
the polymerization process which
were either ignored or not realized.
3
One of the major problems with resin composite
restorations is the effect of polymerization shrinkage
and the resulting stress at the interface between
restoration and tooth tissue.

This leads to poor marginal seal, marginal staining and
recurrent caries.

4
Composite polymerization can
be divided into PRE AND
POST GEL PHASES.

In the pre-gel phase, the
reactive species present
enough mobility to rearrange
and compensate for the
volumetric shrinkage without
generating significant amount
of internal and interfacial
stresses.

5
Pre-gel Phase
No Stress, No Translation
(Compensation from Free Surface)
In the post gel phase

When the degree of
conversion approaches 10-
20%, the network is extensive
enough to create a gel.
As a consequence, the
continued polymerization is
associated with elastic
modulus development, stress
generation within the material,
at the tooth/restoration
interface and in the tooth
structure.
Beyong the gel point,
polymerization shrinkage
creates strain on the network
and the attachment area to the
bonding system.
This facilitates gap formation,
affecting the longitivity of the
restoration.


Post-gel Phase
Distortion
If bond strength exceeds stress
Gap Formation
If stress exceeds bond strength
To reduce the shrinkage and the
following stress, different kinds of
curing modes have been
proposed.

A review of standard visible light-
curing techniques helps to lay the
groundwork for understanding
where each type of curing unit fits
into a dentist's armamentarium.

7
8


The continuous cure refers to a light cure sequence in
which the light is on continuously.

There are four types of continuous curing:
Uniform continuous cure
Step cure
Ramp cure
High-energy pulse

Continuous curing is conducted with halogen, arc, and
laser lamps.
9
In the uniform
continuous cure
technique, a light of
constant intensity is
applied to a
composite for a
specific period of
time.

This is the most
familiar method of
curing currently used.
10
In the step cure
technique, the
composite is first
cured at low energy,
then stepped up to
high energy, each for
a set duration.
11

The approach allows
for a slow initial rate of
polymerization and a
high initial level of
stress relaxation during
the early stages, and it
ends at the maximum
intensity once the gel
point has been
reached.

This drives the curing
reaction to the highest
possible conversion
only after much of the
stress has been
relieved

12

Theoretically, this practice
reduces the overall
polymerization shrinkage at
the margin of the final
restoration.
The reduction in shrinkage,
however, is small and
results in less composite
polymerization because the
lower intensity light yields
lower energy levels.

In addition, this technique
results in an uneven cure,
since the top layer is more
saturated with light and thus
more highly cured.
Step curing is possible only
with halogen lamps; arc
lamps and lasers cannot be
used because they work by
applying large amounts of
energy over short periods of
time.


13
J Can Dent Assoc 2001; 67(10):588-92
14

Light is initially applied at low
intensity and gradually
increased over time to high
intensity.
Intensity is increased with time
(30 secs) either by bringing the
light toward the tooth from a
distance, curing through a
cusp, or using a curing light
designed to increase in
intensity.
This sequential curing low to
high intensity significantly
reduces polymerization
shrinkage without
compromising the depth of
cure.

15
Ramped curing allows the light-cured
material to have a longer gel phase in
which polymerization contraction stresses
are dissipated more readily.

Ramp curing is an attempt to pass through
all of the different intensities in hopes of
optimizing a composites polymerization.

Ramping consists of either stepwise,
linear, or exponential modes.

16
Some studies indicate ramp
curing causes
polymerization with longer
chains, resulting in a more
stable composite.
In theory, very high energy
applied over a short period
tends to cause
dimethacrylate monomers
to attach to themselves,
resulting in shorter polymer
chains and a more brittle
material with higher
polymerization shrinkage
and more marginal gaps.
Ramp curing, with its
dependence on low
intensity, is possible only
with halogen lamps; arc and
laser lamps can generate
only large, non-variable
amounts of energy.
It is possible to ramp cure
manually by holding a
conventional curing lamp at
a distance from a tooth and
slowly bringing it closer to
increase intensity.


17


Uses a brief (10 second) pulse of
extremely high energy {1000-
2800 mw per cm), which is three
to six times the normal power
density.
High-intensity curing allows for
shorter exposure times for a
given depth of cure.
A depth of 2 mm can be cured in
10 secs with a PAC light and 5
secs with an Argon laser-curing
light as compared with 40 secs
by a OTH lamp.
18

A high-intensity curing initiates a multitude of growth centers
during an initial irradiation period along with a final polymer with
higher cross-link density.

Because the relationship between energy density and post-gel
shrinkage strain is considered to be linear, high-energy densities
may translate into increased stress levels but do not result
necessarily in high degrees of conversion or superior mechanical
properties.

Therefore, although high-intensity curing may lead to the same
conversion rate, degree of polymerization shrinkage, and
mechanical properties, it likely leads to greater shrinkage
stresses.
19

Disadvantages:


1. Short exposure times cause accelerated rates of
curing and insufficient time for stress relaxation.
This leads to greater shrinkage stresses and a
poorer interface.
2. High-intensity light curing has a narrowed
wavelength range for the output. Therefore, the
wavelength range of the light source must be
coincident with the photoinitiator.
3. Heat is a significant problem.
4. It may not produce the same type of polymer
network during curing.
5. Using a higher intensity of light for shorter exposure
time is reported to result in more cytotoxicity than a
longer curing time with lower intensity
20
21
The influence of different light-curing modes on
microleakage of posterior resin composites

This investigation evaluated the effect of various curing modes on the extent of microleakage of differently resin-
based posterior composites.

The cavities were restored by posterior composites (Filtek P90, Filtek Z250, and Filtek P60). The composite
was placed in horizontal layers and irradiated at three modes of continuous intensities (conventional, high intensity
power, and pulse-soft start).

The KruskalWallis revealed high significant differences between microleakage medians of the posterior
composites examined (p<0.05).

However, no significant differences were noted between microleakage medians at different modes of curing
intensities occlusally (p=0.076) and there were significant differences gingivally (p=0.015).

MannWhitney U-test showed a significant difference in microleakage for cavities restored by Z250 between high
power and pulse modes of cure (p=0.006).

The highest microleakage score was identified in the cavities restored with P60, while the lowest microleakage
score was found in cavities restored by P90 specifically at conventional and pulse mode of cure.

The light intensity modes have no significant effect on the microleakage, while the difference in composition of
posterior resin composites investigated was the main factor for such a significant difference.
Journal of Adhesion Science and Technology Volume 28, Issue 2, 2014
22

The restoration is initially
cured at low intensity to
contour and shape the
restoration in occlusion,
followed by a second
exposure to completely cure
the restoration.
This allows substantial
relaxation of polymerization
stresses.
The longer the period
available for relaxation, the
lower the generation of
residual stresses.

This method also aids in the
finishing of composite
restorationsa partially
cured composite material
can be easily finished as
compared with fully cured
material.
By filtering the light during
an initial cure, obtaining a
soft, easily finished material
is possible.
Thereafter, the filter is
removed and the composite
is cured completely.

23

Also called as soft-cure technique.

A low intensity or soft light is used to initiate a slow polymerization
that allows a composite resin to flow from the free (unbound)
restoration surface toward the (bound) tooth structure.

This reduces polymerization stress at the margins and could reduce
"white line" or other marginal openings or defects.

To complete the polymerization process, the intensity of the next
curing cycle is greatly increased, to produce the needed energy for
optimal polymerization.
24
Proposed by Kanca and
Suh.

Single pulse of light is
applied to a restoration,
followed by a pause and
then by a second pulse
cure of greater intensity
and longer duration.

It is best thought of as an
interrupted step increase.
An initial exposure of up to 1
j/cm is considered to be most
efficient in reducing shrinkage
stresses.

The lower-intensity light slows
the rate of polymerization, which
allows shrinkage to occur until
the material becomes rigid, and
is reported to result in fewer
problems at the margins.

The second, more intense pulse
brings the composite to the final
state of polymerization.
25
Another important parameter is delay time between irradiances.

During the dark period, polymerization reaction occurs at a
reduced rate.

Thus, longer delays lead to a greater amount of chain relaxation.

Significant reductions in shrinkage stress and microleakage and
increased microhardness have been reported for pulse-delay
methods, with dark periods from 1 min to 5 mins.

For pulse-delay curing, the greatest reduction of polymerization
shrinkage is achieved with a delay of 3 mins to 5 mins.
26
This type of polymerization has not yet been adequately
examined, and there are three areas of potential concern:

(1) The rapid application of energy might result in a
Weaker resin restoration owing to the formation of
Shorter polymers;
(2) It is possible that rapid applications of energy could reduce
Diametral tensile strength;
(3) There may be a threshold level at which a resin has good
Properties, and thus, higher energies would result in more
Brittle resins

Pulse curing is usually done with halogen lamps.


27
Composite depth of cure using four
polymerization techniques
OBJECTIVE: To evaluate in vitro the effect of four light-curing techniques
on depth of cure of a composite resin.

MATERIAL AND METHODS: Four photoactivation methods were
investigated: stepped, ramped, pulse-delay and traditional.

RESULTS: The effect of factors studied (curing method and distance
from the surface) and the interaction of these factors was statistically
significant (p<0.05). The traditional method of cure provided higher
microhardness values (69.6 2.5) than the stepped (63.5 3.1) and
pulsed (63.9 3.2) methods at all depths evaluated, but it did not differ
from the ramped method (66.7 4.4) at 0.1 and 1.0 mm of depth.

CONCLUSION: All techniques employed provided satisfactory cure of
the composite resin up to the depth of 2.0 mm from the irradiated
surface.
J. Appl. Oral Sci. vol.17 no.5 Bauru Sept./Oct. 2009
28
INTERMITTENT LIGHT-CURING
The composite is polymerized during short
periods of light-on and light-off.

Similar to the other techniques, the aim of this
approach is to reduce the polymerization-
induced stress by using light-off periods.

Alonso et al., observed improved marginal
adaptation in conjunction with this method.
29

TRANS ENAMEL POLYMERIZATION
TECHNIQUE / BULK FILL TECHNIQUE :

There are many methods
of placing and curing
composite resin that
attempt to control the
effects of polymerization
shrinkage.

One of these techniques
is called trans enamel
polymerization.

Advocated by Belvedere.

Adhesive, a flowable
composite, and a
composite resin are
placed into the tooth in
bulk and then
polymerized by curing
through the tooth from the
buccal and lingual
through the enamel.

A final cure is then
applied from the occlusal.

30

3-SIDED LIGHT CURING TECHNIQUE / SLOW
POLYMERIZATION TECHNIQUE :

In this technique, an increment of
composite resin is applied at the
gingival margin and cured using a
light reflecting wedge.

Then an increment is used to fill the
facial two thirds of the box, which is
cured from the facial.

Another increment fills the bow and
is cured from the lingual.

Other increments complete the
occlusal portion of the restoration.

This 3 sided light curing technique
was evaluated by Losche.
31

Usually, extra-oral curing is used for the fabrication of indirect
RBC (resin based composite) restorations (inlays, veneers,
metal-free bridges, etc) that are processed in the laboratory.

These laboratory photocuring units (LPUs) work with various
combinations of light, heat, pressure, and vacuum to increase
the degree of polymerization and wear resistance of RBCs.

Hardness and depth of cure of an indirect RBC can be
influenced by the LPUs employed.

It is reported that LPUs, which provide light curing in
conjunction with heat and nitrogen pressure, result in a
significant increase in hardness and tensile strength of RBCs.
32

Various light-curing units belonging to different
generations are available commercially.

Usually, they are hand-held devices with a light
source and light guide of fused optical fibers.

A curing unit with a minimal light output of 550 lux
is considered appropriate for dental use
33
QTH - Quartz
Tungsten
Halogen
Curing Lights
PAC
Plasma Arc
Curing Lights
LED Light
Emitting
Diodes
Curing Light
Laser Curing
Lights
34
Most widely used light-curing units

Contain a quartz bulb with a tungsten
filament in a halogen environment.

The units irradiate both uv and white
light that must be filtered to remove
heat and transmit light only in the
violet-blue region of the spectrum.

They are available in continuous,
step-cure, or ramp-cure modes.

QTH-curing lights work at wavelengths of
400 nm to 500 nm with output ranging
from 400 mW/cm to 800 mW/cm

Less than 0.5% of the total light
produced in a QTH is suitable for
curing, and most is converted to heat.
35

Many halogen curing lamps use a 50- to 100-
watt bulb to produce 500 mw of light that peaks
at 468 nm.

This approach yields an efficiency rate of only
0.5%; the other 99.5% of the energy is simply
given off as heat.

To minimize heating, uv and infrared band-pass
filters are inserted just before the fiber optic
system is used.

Orange filters are widely used because they are
complementary to blue spectrum and absorb
blue radiation.

A small fan is employed to dissipate unwanted
heat from the filters and reflector.

36
Disadvantages:

They have a slower
cure time (about 15
sec to 20 sec).
The units are
relatively large and
cumbersome.
The lights (bulbs)
decrease in output
with time and thus
need frequent
replacement.
They have low-
energy
performance and
generate high
temperatures.
They require a filter
and ventilating fan.
37
Initially, low-power blue LEDs using
silicon carbide (first generation
LEDs) having a power output of 7
W per LED were introduced.

Blue LEDs, or second-generation
LEDs, were built on gallium nitride
technology and had a power output
of 3 mW (400-fold increase).

The second generation LEDs are
considered to be more effective in
curing composites than their
predecessors.

These units are cordless, small,
lightweight, and battery powered.
38

They do not require filters because they emit light at a
specific wavelength within the 400-nm to 500-nm
photoabsorption range and have an efficiency of about 16%.

Thus, all the emitted light is useful, resulting in high energy
performance of the curing light.

The spectral output falls between 410 nm and 490 nm or
between 450 nm and 490 nm.

These units show a constant effectiveness without any drop
in intensity with time because the diodes do not require
frequent replacement.

Because no heat generation occurs during curing, a cooling
fan is not needed.

39
The batteries
must be
recharged.
They cost more
than
conventional
halogen lights.
The curing time is
slower than that of
plasma-arc curing
lights and some
enhanced halogen
lights.
Disadvantages
40

A literature review suggests LED
devices and conventional QTH-curing
lights have no significant differences.

LED units are considered similar or
better compared with QTH units
regarding the degree of
polymerization, microleakage at
enamel and dentin margins, shrinkage
strain behavior, wear rate of RBCs,
flexural properties of cured RBCs, and
hardness of cured RBCs.

Also, bond strength values for dual-
cure resin cements used in
cementation of indirect RBC
restorations is found to be equivalent
for LED- and QTH curing lights.


However, depth of curing with LED units
is higher than QTH devices, and QTH-
curing lights tend to show more
yellowing of RBCs than LEDs.

Few authors consider conventional
QTH-curing lights to be better than
LEDs.

LEDs have been shown to take longer
for complete curing of microfilled and
hybrid RBCs

41
Evaluation of the Influence of Three Types of Light Curing
Systems On Temperature Rise, Depth of Cure and Degree of
Conversion of Three Resin Based Composites
Aim of study: The purpose of this study was to evaluate the effect
of Quartz tungsten halogen, Light emitted diode & soft start light
curing units on temperature rise, depth of cure & degree of
conversion of different types of dental composites (Spectrum,
Esthet X & Z250).
Result and Conclusion:
QTH light curing showed the highest temperature rise value, while
the soft start gave the lowest values.
Soft start light curing revealed the highest depth of cure values,
while the QTH showed the lowest values among three curing
modes.
Soft start light curing system showed the highest degree of
conversion and QTH had the lowest values.
Esthet X dental composite gave the highest results of the degree of
conversion while Z250 showed the lowest values.
J Interdiscipl Med Dent Sci 2:110.
42
Effectiveness of light emitting diode and halogen
light curing units for curing microhybrid and
nanocomposites
J Conserv Dent 2013;16:233-7
43
Plasma Arc
Plasma-arc curing (PAC) lights are high-
intensity light curing units.

Used for pulse energy curing

They have more intense light sources
(fluorescent bulb-containing plasma), allowing
for shorter exposure times.

Light is obtained from an electrically conductive
gas (xenon) called plasma that forms between
two tungsten electrodes under pressure.

The light spectrum provided by plasma is
limited.

The wavelength of high-intensity light emitted is
determined by the bulb-coating material and
filtered out to minimize transmission of infrared
and UV energy and to allow emission of blue
light (400 nm to 500 nm).
44

These units have a high energy output and short curing time.

An exposure of 10 secs from a PAC light is equivalent to 40
secs from a QTH light.

They yield a power density up to 2500 mW/cm.

These units have been shown to have higher conversion rates
and depths of cure for RBCs as compared with QTH units.

These systems work at wavelengths between 370 nm and
450 nm or between 430 nm and 500 nm.
45
The heat
production
must be
controlled.
They are
expensive.
The lamp
(bulb)
replacement is
costly.
Most devices
are large,
heavy, and
bulky.
They have
low-energy
performance.
Filters and
ventilating fan
are required.
Disadvantages:

46

The results obtained from the QTH
units are better than those acquired
from PAC units.

RBCs cured with a PAC unit have
shown more polymerization shrinkage
than with QTH units.

The hardness values of RBC
specimens cured by the PAC units
have been shown to be significantly
lower than LED and QTH units.

The recommended time of 3 secs for
PAC units is inadequate and should be
doubled to obtain optimal mechanical
properties of RBCs.

An incremental technique of 2 mm
should be followed.

These units, when used in
combination with QTH units, have
been shown to provide higher
bond strength values for dentin
bonding agents.

The devices are best suited for
cementation of orthodontic bands
and brackets.

47
48

Laser lamps are high-intensity
lamps based on the laser
principle.

The emitted wavelength depends
on the material used (argon
produces blue light).

Argon laser lamps have the
highest intensity.

These lamps work within a limited
range of wavelengths, do not
require filters, and require shorter
exposure times for curing RBCs.

The devices generate little infrared
output, so not much heat is
produced.

They work at specific bandwidths
of light in the ranges of 454 nm to
466 nm, 472 nm to 497 nm, and
514 nm.

Because a laser is a narrow beam
of coherent light, no loss of power
over distance occurs as in seen in
QTH units.

Therefore, argon laser curing lights
are the units of choice for
inaccessible areas.

49
The curing depth
is limited to 1.5
mm to 2 mm.
The curing tip
is small, so
more time is
needed to cure
the RBCs.
They are
expensive.
They have a
narrow light
guide {or spot
size)
Disadvantages:

50
Studies have reported similar results for both laser and
QTH units.

No difference in bond strength is seen between the
argon laser and standard QTH units.

Laser devices have been shown to produce an
increased degree and depth of cure for RBCs.

The laser systems have also demonstrated greater
material wear, more polymerization shrinkage, and
increased marginal leakage.
51

1. Exposure time,
2. Intensity,
3. Temperature,
4. Light distance,
5. Resin
thickness,
6. Air inhibition,
7. Tooth structure,
8. Composite
shade,
9. Filler type,
10. Accelerator
11.Quantity,
12.Heat,
13.Room light

52
52
Light-cured composites polymerize
both during and after visible light
activation.

These two curing reactions are known
as the light and dark reactions.

The Light reaction occurs while light
from the curing unit penetrates the
composite.


53
53
The Dark reaction, also called Post-irradiation
polymerization, begins immediately after the
curing light goes off and continues for upto 24
hours, even in total darkness, but most of it
occurs within 10 to 15 minutes post cure.

The minimum curing time for a light reaction for
most composites under a continuous curing
mode is 20 to 40 seconds (using curing units
with the normal 400 mW/cm
2
output).
54
54


The curing intensity of a 468
20 nm blue light has been
about 400 mW/cm
2
.

This is the output of most
curing units and is referred
to as the Power Density.

Problems occur when the
minimum intensity is not
achieved.


55
55
There are four common causes of
decreased intensity:

I. As the bulbs in curing lamps age, the intensity
of blue light can decrease
II. Voltage drops can affect blue light production
III. Sterilization of curing tips can reduce light
transmission
IV. Filters to increase blue light transmission can
degrade

56
56


Light-cured composites cure less effectively if they are cold
during application (e.g., just taken out of the refrigerator).

Composites at room temperature cure more completely and
rapidly.

Composites should be held at room temperature at least 1
hour prior to use.

Most curing lamps produce heat, which speeds the curing
process.

However, excess heat can result in pulpitis and pulp death.

57
57

Distance and angle between
light and resin

The ideal distance of the light source from the composite
is 1 mm, with the light source positioned 90 degrees
from the composite surface.

Light intensity drops off rapidly as the distance from the
light rod to the composite increases.

Distance can still be a problem if the lamp is placed
against the tooth, since a deep box increases the
distance the light must penetrate.



58
58
With many curing lamps, a higher power density (of
about 600 mW/cm
2
) is required to ensure that 400
mW/cm
2
reaches the first increment of composite in
a posterior box.

To compensate for the loss of intensity, cure for
longer periods of time the layers of composite that
are at a greater distance from the light rod.

Further polymerization can be achieved by curing
from the proximal surfaces after finishing.


59
59







Fig. In deep restorations and those with poor access, the distance between the light guide and the composite can increase, which generally
reduces the power density at the surface by over 70%.


























Fig. Schematic representation of a 50% reduction in light intensity in deeper areas of a preparation


60
60


As the angle diverges from 90 degrees to the
composite surface, the light energy is reflected
away and penetration is greatly reduced.

This can be demonstrated by angling the light
rod against a radiometer and watching the
intensity values shown on the meter drop.

In molar preparations, the marginal ridge of the
adjacent tooth blocks light when placed at an
angle.


61
61


Resin thickness greatly affects resin curing.

Optimum polymerization occurs at depths of just 0.5 to
1.0 mm, because of the inhibition of air at the surface
and the difficulty with which light penetrates a resin.

One classic study showed that 7 days after a 40- second
curing cycle, a 1-mm deep composite (of light shade) is
cured to 68 to 84% of optimum hardness, as measured
by surface hardness.

62
62
At 2 mm, this same composite has only 40
to 60% of the desired hardness.

At 3 mm, it has only 34% of the hardness.

Thus, composites should be cured in
increments of not more than 1 to 2 mm.

63
63



Oxygen in the air competes with polymerization
and inhibits setting of the resin.

The extent of surface inhibition is inversely related
to filler loading.

The under-cured layer can vary from 50 to 500 m
(or more), depending on the reactivity of the
photoinitiators used.



64
64
Unfilled resins should be cured, then covered
with an air-inhibiting gel, such as a thin layer of
petroleum jelly, glycerin, or commercial products,
such as Oxyguard, and then re-cured.

In addition, curing through a matrix increases
surface polymerization because the matrix
reduces air inhibition.

65
65



It is possible to light-cure resin through enamel,
but this technique is just one- to two-thirds as
effective as direct curing and is appropriate only
when there is no alternative.

Such curing is possible through up to 3 mm of
enamel or 0.5 mm of dentin, but the clinician
should double or triple exposure times.

When light-curing through tooth structure,
porcelain veneers, and other barriers, it is
advisable to use a high-intensity light.

66
66

Darker composite shades cure more slowly
and less deeply than lighter shades.

At a depth of 1 mm, a dark composite shade
achieves just two- thirds of optimum depth of
cure achieved in translucent shades.

A brighter light reduces the amount of time it
takes to cure darker shades.

Hence, when esthetics is not critical, the
lightest shade should be used.


67
67



Microfilled composites are more difficult to
cure than macrofilled composites, which have
larger quartz and glass fillers.

Generally, the more heavily loaded a
composite is with larger inorganic fillers, the
more easily the resin cures.

However, extremely high loading can make a
composite opaque, which actually increases
the required duration of exposure.


68
68


All photoinitiators deteriorate over time.

However, light-cured composites are more stable than
chemically cured composites.

Some light- cured composites lose about 10% of their
physical properties when stored for 2 years at room
temperature.

The maximum usable life span of a light- cured composite is
generally 3 to 4 years or more from the date of manufacture, if
stored at room temperature.

If contained in a sealed tube, they last much longer.


69
69
The major cause of decreased shelf life for light-cured
composite is evaporation of critical monomers from
unidose containers.

Auto- cured materials have shelf life of 6 to 36 months.

There are large variations in the shelf life of various
auto- and dual-cured composites.

Most autocured composites have an extended shelf
life if kept under refrigeration.
70
70
The heat given off by a curing light increases the rate of
photochemical initiation and polymerization reaction and
increases the amount of resin cured.

Excessive curing heat is thought to cause no photochemical
damage to either the tooth or the composite.

However, the heat generated in the tooth during light-curing
results in higher intrapulpal temperatures, which could be
harmful.

Deep layers of resin should be cured thoroughly; cooling with a
dry air syringe may be helpful.

71
71


The working time of light-cured composites depends on the
operatory light and the ambient room light to which the
composites are exposed.

Differences in these light sources can dramatically affect working
time. Newer, faster-setting composites are even more sensitive.

1. Operatory lighting:

Most operatory lights operate at high temperature that
produce spectrums in the blue range.

This spectrum is included to improve the color selection of
dental restoratives, but it initiates curing.

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2. Incandescent lighting:

Incandescent lights are low in blue light and
provide the longest composite working time.

3. Fluorescent lighting:

In general, fluorescent lighting has the shortest
working time for light-cured composites,
because it emits a large amount of blue light.


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Clinical Evaluation of the Soft-Start (Pulse-delay)
Polymerization Technique in Class I and II Composite
Restorations
A double blind, randomized clinical trial was carried out to compare
two curing techniquesSoft-Start (SS) and the plasma arc curing
light (PAC).

The hypothesis that, delaying the gel point (with SS) improves
marginal seal, was tested.

Protocols: PAC (Control)incremental curing <2.0 mm, 2000
mW/cm2 for 10 seconds for all layers, SS (Treatment)incremental
curing <2.0 mm, 600 mW/cm2 for 20 seconds, except the final layer
or enamel replacement increment, which was cured as follows
(mW/cm2/time) 200/3 seconds, wait 3 minutes; 200/3 seconds, wait 5
minutes; 600/20 seconds from multiple angles.

Conclusion: Within the limitations of this study, Class I and II
restorations placed with a SS technique did not show significant
changes in post-op sensitivity or decreased signs of marginal
stress.
Operative Dentistry, 2008, 33-3, 265-271
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Class I and Class V composite restorations: Influence
of light-curing techniques on microleakage
Purpose: To evaluate the effect of light-curing techniques on in vitro
microleakage of class I and class V composite restorations.

A resin composite (TPH 3 Dentsply) was inserted in two layers and
light-cured using two protocols (n=15 each): conventional curing (500
mW/cm2, 30 s each increment) and pulse delay technique (first
increment similar to the conventional technique and the last increment
initially cured with 200 mW/cm2 for 3 s and after 5 min light-cured again
with 500 mW/cm2 for 30 s)

Results: In class I cavities the pulse delay light-curing technique showed
statistically significant better sealing than the conventional technique. In
class V restorations no difference was detected between the two
techniques in enamel and dentin.

Conclusion: Light-curing technique affected the microleakage in class I
composite restorations but not in class V.
Rev. odonto cinc. 2009;24(3):299-304
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Postoperative sensitivity in Class V composite
restorations: Comparing soft start vs. constant curing
modes of LED
Journal of Conservative Dentistry | Jan-Mar 2011 | Vol 14 | Issue 1
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The cytotoxicity of resin composites cured with
three light curing units at different curing
distances
Objective: The purpose of this study was to compare the effect of light
curing distance on the cytotoxicity of five resin composites cured with
three high-power light curing units.

For curing, soft-up mode of quartz-tungsten-halogen, exponential mode
of light emitting diode for 20 s, and ramp-curing mode of plasma arc light
curing units for 6 s were used.

The curing tip distances were determined as 2 and 9 mm.

Conclusions: The results of this study suggest that the light curing units
and resin composites should be harmonized to one another and the
curing distance between the tip of the light curing unit and the
restoration surface should be as close as possible in order to achieve
maximal biocompatibility.
Med Oral Patol Oral Cir Bucal. 2011 Mar 1;16 (2):e252-9.
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