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Introduction

INTRODUCTION
With the advent of light curing technology composite resin restorations are
playing an ever increasing role as routine restorative materials in day to day clinical
practice. They enable immediate direct and highly esthetic results with minimal loss
of patients time and minimal chair side time. In short, they have set a revolution
many contemporary clinicians have lived through. Gone are the days of chemically
cured composites where in hurried placement and curde shaping with a confined
distorted matrix band were done. Available now are materials offering setting on
command, with prolonged placement time to sculpt, adapt and contour the restoration.
There are many advantages of these dental composites over the traditional
restorative materials, like the amount of tooth preparation can be as minimal as
possible. Also, since they are tooth colored restorative materials, they also improve
the esthetics. ut these composites also carry with them some of the disadvantages
like polymeri!ation shrinkage, which is one of the ma"or drawbacks of composite,
which leads to postoperative sensitivity of the tooth.
#actors such as polymeri!ation shrinkage, depth of cure, surface hardness of
composite which are clinically relevant depend upon many factors in that one of the
factor is the curing unit employed.
$uring of dental composites with blue light was introduced in the %&'()s. The
source of blue light is normally a halogen bulb with a filter which produces blue light
in the range of *%( nm + ,(( nm of the visible spectrum. -ight in this range of
wavelength is the most effectively absorbed by the camphoro.uinone, which in
combination with an amine produces free radicals. This results in polymeri!ation of
resin monomers at the molecular scale, macroscopically the dental composite hardens.
%
Introduction
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
polymeri!ation process which were either ignored or not reali!ed. With advent of
high speed curing and soft start polymeri!ation, the clinician is faced with the
dilemma of "umping on the band wagon to minimi!e precious chair side time, while
attempting to provide restorations of high .uality and long clinical durability.
/ecently various light curing sources have entered the market with their own
advantages and disadvantages. -ight sources like conventional .uart! tungsten
halogen sources 01T23, high intensity 1T2 /amped, pulse delay methods, argon ion
lasers, plasma arc units and the new light emitting diodes 0-45)s3. All these recent
devices claim advantages of reduced curing time. 5evices have complex construction
and are costlier compared to halogen sources. 6ut of all these curing lights, -45)s
have created a revolution in curing technology. -45)s have a life time of over %(,(((
hours and undergo little degradation of light out put over time. -45)s have relatively
low power consumption, which makes them suitable for portable use. ased on these
developments blue light emitting diodes act as a source of promise to the dentist.
2owever long term clinical results and their effects on some of the properties of the
materials remain .uestionable.
6ver the past few decades, we have seen the strong emergence of light curing
technology in the field of dentistry, light cured resin based composites are the most
important parts of restorative and esthetic dentistry. These light cured resins have
become a state of art since 7, years.
7
Curing of Resins
CURING OF RESINS
$uring of resin is basically done under the following ways 8
%3 2eat curing
73 $hemical activation
93 -ight
a. -ight activation
b. :hotocuring with visible 0lue3 light
Chemical Activation :
4arlier or the first composites were cured by chemically activation
polymeri!ation process. This is also known as $old curing or ;elf curing.
<ost denture base resins are polymeri!ed by heat activation.
A second type of induction system is chemically activated at ambient oral
temperature. ;uch a system consist of at least two reactants these when mixed
together, undergo a chemical reaction that generates free radicals. 5uring storage,
these components must be separated from each other= hence chemically induced
systems always consist of two or more parts. An example of such a system is the
tertiary amine 0the activator3 and ben!oyl peroxide 0the initiator3, which are mixed
together to initiate the polymeri!ation of so>called ?self>cured@ dental resins at room
temperature.
This chemically activated polymeri!ation is initiated by mixing of two pastes
"ust before use. As during mixing it was impossible to avoid incorporation of air into
the mix, which could lead to formation of pores that will weaken the structure and
trap oxygen which further inhibits polymeri!ation during curing.

9
Curing of Resins
Incorporation of air
<ixing of two pastes :ore formation
Weak structure
In chemical activation the operator has no control over the working time after
two pastes are mixed. Therefore one should go for both insertion and controlling
.uickly after the mixing of pastes.
2) Light Activation :
$hemically activated resins were having some problems and to overcome
these problems of chemical activation, manufacturers developed resins which did not
re.uire mixing. This new procedure included photosensitive initiator system and light
source for activation.
A second type of induction system is light activated. When this system was
first introduced to dentistry, ultraviolet light was used. 2owever, because of concerns
about the effect of ultraviolet light on the retina and nonpigmented oral tissues, its
limited penetration depth, and the loss in intensity of the ultraviolet light source over
time, initiator systems were subse.uently developed that could be activated by visible
light. In the visible light cured dental restorative materials, camphor.uinone and an
organic amine 0e.g. dimethyl>aminoethylmethacrylate3 generate free radicals when
irradiated by light in the blue to violet region. -ight with a wavelength of about *'(
nm is needed to trigger this reaction. ecause no appreciable polymeri!ation takes
place at ambient temperature in the dark, such compositions can be one part systems,
provided that they are stored where they are not exposed to light. 2owever, factors
such as light intensity, angle of illumination, and distance of resin from the light
source can significantly affect the number of free radicals that are formed, thereby
making this system, techni.ue sensitive. In this system, photons from a light source
*
Curing of Resins
activate the initiator to generate free radicals that, in turn, can initiate the
polymeri!ation process.
In case of chemically activated resins, there was limited time for the operator
to work but here in case of light activated or light cured materials operator has the
advantage of contouring the material before its curing.
In case of light curing, once the curing is initiated exposure time of '( seconds
or less is re.uired to cure a 7 mm thick layer. Whereas in chemically cured systems
several minutes were re.uired for chemical curing.
2owever, for light curing there are substantial limitations for example, they
must be placed incrementally, when the bulk exceeds approximately 7>9 mm there
will not be proper curing which is because of limited depth of light penetration.
Thus these light curing composites re.uire more time when producing layer
restorations such as $lass II cavity preparations.
6ther drawbacks are =
> $ost factor + 2igh cost
> ;everal complicating factors
3) hotoc!"ing #ith $i%i&le '(l!e Light)
5entists produce cross>linked resin when a diacrylate monomer containing a
photo initiator system is irradiated with blue light.
A)vantage% o* Light C!"e) Com+o%ite% Ove" Chemicall, C!"e) Com+o%ite% :
%3 <ixing is not re.uired, so they result in less porosity, less staining and
increased strength.
,
Curing of Resins
73 An aliphatic amine can be used instead of aromatic amines re.uired with
chemical curing, thereby enhancing color stability.
93 $ommand polymeri!ation on exposure to blue light, providing control of
working time.
D"a-&ac.% :
%3 -imited curing depth, re.uire build up layers of 7 mm or less.
73 /elatively poor accessibility in certain posterior and interproximal locations.
93 Aariable exposure times because of shade 0hue, value, chroma3, differences,
resulting in longer exposure times for darker shades and or increased opacity.
*3 ;ensitivity to room illumination, which may lead to formation of skin or crust
when an opened tube is exposed too long to room light.
B
Curing Lamps / Curing Units
CURING LA/S 0 CURING UNITS
$uring lamps are hand held devices that contain light source and are e.uipped
with relatively short, rigid light guide which is made of fused optical fibres.
#ew have a power unit connected to a handpiece by a long flexible, li.uid
filled light guide.
At present most widely used curing units are =
%3 2alogen 1uart! tungsten also called as 1T2. i.e. -ight source is 1uart! bulb
with a tungsten filament in a halogen environment, which is similar to those
used in automobiles head light and slide pro"ectors.
73 :lasma arc curing units called as :A$.
93 -ight emitting diodes 0-453 curing units.
*3 -aser curing units.
,3 Cenon curing units
2ere laser lamps offer several advantages over .uart! tungsten halogen but
have higher cost and other offsetting drawbacks. -45 lamps re.uire much less power
than other light sources and they do not produce heat or re.uire filters. They are light
weight and can be battery operated. :A$ and argon laser lamps are high powered,
more intense light sources that allows shorter exposure times for curing given
thickness of composites.
'
Terminology
TER/INOLOG1
C2FACTOR:
The configuration factor or ratio between the bonded surface area of a resin>
based composite restoration to the unbonded or free surface area.
-ow $>factor preparations, such as $lass III preparations, have a ratio of 9
bonded to 9 unbonded surfaces and produce less stress than higher $>factor
preparations, such as the $lass I and $lass A cavity configurations, which have a $>
factor of , 0the highest3. If a light curing techni.ue could produce a difference in
marginal adaptation, it would be shown in the $lass I or $lass A restoration.
2owever, the studies could not show any one curing method for completely
eliminating marginal defects.
O#ER DENSIT1 :
Is power divided by the area of the curing light tip and is expressed as
milliwatts by centimeters s.uared 0mWDcm
7
3.
This is the number read from a radiometer when a reading is taken to measure
the output of the curing light. When a radiometer with a fixed opening is used to
measure power density, the radiometer uses that opening, usually at E mm, to
calculate the area and miscalculates the power density if the light guide varies from
that fixed opening. If the light guide and the orifice for the radiometer coincide, then
it will provide an accurate value.
ENERG1 :
Is the work or power applied per unit of time and is measured in "oules 0F3.
E
Terminology
ENERG1 DENSIT1 :
Is power density applied for a certain time 0FDcm
7
3.
4very composite resin has a certain amount of energy density that must be
applied to the composite resin to cause it to polymeri!e. :ublished values for the
energy density re.uired to cure composite range from 7% FDcm
7
to 7* FDcm
7
.
DET3 OF CURE :
The thickness of a resin that can be converted from a monomer to a polymer
under a specific light curing condition.

DET3 OF CURE
3o- to /ea%!"e De+th o* C!"e :
%3 6lder <ethod
73 Gewer method
&
Terminology
4) Ol)e" /etho) :
The older American 5ental Association 0A5A3 method is a simple, but not
very precise, method of measuring depth of cure. In this method, resin>based
composite samples are light cured in a metal mold. The resin based composite is
removed and the soft, uncured material is scraped away. The sample is measured and
the measurement is divided by 7 to approximate the depth of fully cured resin based
composites 0AG;IDA5A ;pecification H7', 5irect /esin %&&93.
2) Ne-e" /etho) :
Gewer method of measuring depth of cure uses the International 6rgani!ation
for ;tandardi!ation 0I;63 specification, which defines depth of cure as the depth of
composite cured to a hardness of E(I of the top>cured surface. /esin>based
composites light cured for *( seconds with the AI:
T<
curing -ight set at B((
mWDcm
7
. Jsing the I;6 specification, most composites cured resulted in a depth of
cure of about 7 mm.
2igh intensity curing lights will not provide significantly greater curing depths
at e.uivalent energy densities, but will cure 7 mm of composite resin in less time in
the authors laboratory. Three shades 0A>9, >7 and $>73 of 9< 4;:4 :B( composite
resin were cured using 9 curing lights 8 0%3 AI: 01T2 -ight3= 073 Wave -ight, 0:A$
-ight3= and 093 The Airtuoso 0:A$ light3, and determined the depth of cure obtained
with each light. 5epth of cure was defined as the depth of composite with E(I of the
hardness of the top initially cured surface. The depth of cure ranged from 7 mm to *
mm even with the :ac curing lights.
%(
Terminology
GEL OINT :
The gel point is the point at which the resin changes from a viscous paste to an
elastic solid.
When the gel point is reached, stress is transmitted from the composite resin,
which could shrink freely, to the surrounding tooth structures. When composite resin
is a paste, or pre gel state, no stress is conducted to the surrounding tooth structure.
As curing begins, the material flows from unbound surfaces to accommodate for
shrinkage. When the composite changes from a viscous paste to an elastic solid, the
modulus increases until the composite can no longer flow. At that point, stress is
transferred to the tooth. The stress can cause deformation of the cusps, cusp fracture,
enamel fracture, or marginal gaps because of adhesive failure and, ultimately, white
line formation.
%%
Polymerization
OL1/ERI5ATION
De*inition 8 :olymeri!ation + It is defined as, chemical reaction in which monomers
of a low molecular weight are converted into chains of polymers with a high
molecular weight 8
:olymeri!ation
<onomer K <onomer K <onomer K <onomer > <er + <er + <er + <er +
:olymeri!ation occurs through a series of chemical reactions by which the
macromolecule, or the polymer, is formed from large numbers of molecules known as
monomers. ;ynthetic resins are often called plastics. A plastic material is a substance
that, although dimensionally stable in normal use, was plastically reshaped at some
stage of manufacture. /esins are composed of very large molecules. The particular
form and morphology of the molecule determine whether the resin is a fiber, a rigid
material, or a rubber like product. :olymers have had an enormous impact on
dentistry, and they are now used as sealants 0prophylactic material used to seal
fissures against the ingress of cariogenic bacteria3, bonding materials, restorative
materials, veneering materials, denture bases, denture teeth and impression materials.
FUNDA/ENTAL NATURE OF OL1/ERS :
The most significant feature of polymers are that they consist of very large
molecules and that their molecular structure is capable of virtually limitless
configurations and conformations. $hain length, the extent of chain branching and
cross>linking, and the organi!ation of the chains are fundamental features of polymers
that determine the properties of polymeric materials. :olymeri!ation is a repetitive
intermolecular reaction that is functionally capable of proceeding in deficiently.
ecause any chemical compound possessing a molecular weight in excess of ,((( is
%7
Polymerization
considered to be a macromolecule, most polymer molecules can be described as
macromolecules. In some instances, the molecular weight of the polymer molecule
can be as high as ,( million.
In addition to the traditional polymers, macromolecules can consist of
inorganic polymers such as the silicon dioxide network found in several ceramics and
resin composites used in dentistry.
C3E/ISTR1 OF OL1/ERI5ATION :
<onomers maybe "oined via one of two types of reaction
%3 Addition polymeri!ation
73 ;tep>growth or condensation polymeri!ation.
In addition, polymeri!ation monomers are activate done at a time and add
together in se.uence to form a growing chain. In step>growth polymeri!ation the
components are difunctional and all are, or become, reactive simultaneously. $hains
then grow by the stepwise linking of bifunctional monomers that often, but not
always, produces a low molecular weight byproduct such as water or an alcohol.
4) A))ition ol,me"i6ation :
<ost dental resins are polymeri!ed by a mechanism in which monomers add
se.uentially to the end of a growing chain. Addition polymeri!ation starts from an
active center, adding one monomer at a time to rapidly form a chain. In theory, the
chain can grow indefinitely until the entire monomer is exhausted. The process is
simple, but it is not easy to control.
In addition polymeri!ation can readily procedure giant molecules of almost
unlimited si!e. There is no change in composition during addition polymeri!ation.
%9
Polymerization
The macromolecules are formed from smaller units, or monomers, without change in
composition because the monomer and the polymer have the same empirical
formulas. In other words, the structure of the monomer is repeated many times in the
polymer.
Stage% :
;tages in Addition :olymeri!ation 8
%3 Induction
73 :ropogation
93 $hain transfer
*3 Termination
4) In)!ction :
Two processes control the induction stage= activation and initiation. #or an
addition polymeri!ation process to begin, a source of free radicals, /L is re.uired.
#ree radicals can be generated by activation of radical producing molecules using a
second chemical, heat, visible light, ultraviolet light, or energy transfer from another
compound that acts as a free radical. 6f these, chemical agents, heat, and visible light
are most often used in dentistry.
/ + / K 4xternal energy 7 /L 0%3
6ne of the re.uisites of an addition>polymeri!able compound is the presence
of an unsaturated group, that is, a double bond, as well as a source of free radicals.
Theoretically, /L can be almost any free radical. A free radical is an atom or group of
atoms possessing an unpaired electron 0L3. The unpaired electron confers electron>
withdrawal ability to the free radical. When the free radical and its unpaired electron
approach a monomer with its high electron density double bond, an electron is
%*
Polymerization
extracted, and it pairs with the /L electron to form a bond between the radical and the
monomer molecule, leaving the other electron of the double bond unpaired. Thus the
original free radical bonds tone side of the monomer molecule and forms a new free
radical site at the other end. The reaction is now initiated.
4thylene, 2
7
$ M $2
7
, the simplest monomer capable of addition
polymeri!ation, can be used for illustration.
/L K 2
7
$ M$2
7
$ + $2
7
L
The polymeri!ation processes useful for dental resins are commonly activated
by one of three energy sources= heat, chemicals, and light. <ost denture base resins
are polymeri!ed by heat activation. A second type of induction system is chemically
activated at ambient oral temperature. ;uch a system consists of atleast two reactants
that, when mixed together undergo a chemical reaction that generates free radicals.
5uring storage, these components must be separated from each other= hence
chemically induced systems always consist of two or more parts. An example of such
a system is the tertiary amine 0the activator3 and ben!oyl peroxide 0the initiator3,
which are mixed together to initiate the polymeri!ation of so called ?self>cured@
dental resins at room temperature. This process, in fact, is a special case of heat
activation, because the presence of the amine reduces the thermal energy re.uired to
break the initiator into free radicals at ambient temperature 0i.e. room temperature or
mouth temperature3. The amines forms a complex with ben!oyl peroxide, which
reduces the thermal energy 0and thus the temperature3 needed to split it into two free
radicals.
A third type of induction system is light activated. In this system, photons
from a light source activate the imitator to generate free radicals that, in turn, can
initiate the polymeri!ation process.
%,
Polymerization
"o+agation :
The resulting free radical monomer complex then acts as a new free radical
center when it approaches another monomer to form a dimmer, which also becomes a
free radical. This reactive species, in turn, can add successively to a large number of
ethylene molecules so that the polymeri!ation process continues through the
propagation of the reactive center.
ecause little energy is re.uired once change growth begins, the process
continues with evolution of heat and leads to large polymer molecules within seconds.
Theoretically, the chain reactions should continue until all of the monomer has been
converted to a polymer between the initial set and the final set. The process continues
to complete the formation f the desired polymer. 2owever, the polymeri!ation
reaction is never .uite completed.
The growth of the polymer chain ceases when the reactive center is destroyed
by one of a number of possible termination reactions. The entire addition
polymeri!ation process can be pictured as a series of chain reactions. The process
occurs rapidly, almost instantaneously. The reactions are exothermic, and considerable
heat is evolved.
Chain T"an%*e" 8 In this process, the active free radical of a growing chain is
transferred to another molecule and a new free radical for further growth is created.
Te"mination 8 Although chain termination can result from chain transfer, addition
polymeri!ation reactions are most often terminated either by direct coupling two free
radical chain ends or by the exchange of a hydrogen atom from one growing chain to
another.
%B
Polymerization
Inhi&ition o* A))ition ol,me"i6ation :
The polymeri!ation reactions are not likely to result in a complete exhaustion
of the monomer, nor do they always form polymers of high molecular weight.
Impurities in the monomer often inhibit such reactions.
Any impurity in the monomer that can react with free radicals inhibits or
retards the polymeri!ation reaction. An impurity can react with the activated initiator
or with an activated growth in chain to prevent further growth. The presence of such
inhibitors markedly influences the length of the induction period, as well as the degree
of polymeri!ation.
The addition of a small amount of a common inhibitors, such as hydro.uinone,
to the monomer inhibits spontaneous polymeri!ation if no initiator is present and
retards the polymeri!ation in the presence of an initiator. Thus inhibitors affect both
the storage stability and the working time of a dental resin. #or this reason,
commercial dental resins commonly contain a small amount 0approximately (.((BI
or less3 of an inhibitor such as the methyl ether of hydro.uinone to aid in the
prevention of polymeri!ation during storage and in the case of two part 0self>cure3
systems, to provide ade.uate time for mixing and placement.
6xygen reacts rapidly with free radicals, and its presence retards the
polymeri!ation reaction.
Ste+ G"o-th ol,me"i6ation :
The reactions that produce step growth polymeri!ation can progress by any of
the chemical reaction mechanisms that "oin two or more molecules in producing a
simple, no macromolecular structure. The primary compounds react, often with the
%'
Polymerization
formation of by>products such as water, alcohols, halogen acids, and ammonia. The
formation of these by>products is the reason step>growth polymeri!ation often is
called condensation polymeri!ation. This mechanism is the one used in biological
tissues to produce proteins, carbohydrates, deoxyribonucleic acid, and ribonucleic
acid, which re exclusively formed via step growth polymeri!ation reactions.
A polymer science has progressed, the classification of condensation +
polymeri!ed resins has broadened. ecause the goal is to minimi!e classification
uncertainties, the term step>growth polymeri!ation 0rather than condensation
polymeri!ation3 is preferred. ;tep growth polymeri!ed resins are those in which
polymeri!ation is accompanied by repeated elimination of small molecules. The
formation of polymers by step growth is rather slow because the reaction proceeds in
a stepwise fashion from monomer to dimmer to trimmer, and so forth, until large
polymer molecules containing many monomer molecules are eventually formed.
;uch a polymeri!ation process tends to stop before the chain has reached a truly great
si!e, because as the chains grow, they become less mobile and less numerous.
%E
Polymerization Shrinkage
OL1/ERI5ATION S3RIN7AGE
:olymeri!ation is the chemical reaction that converts small individual
monomer molecules into long chain polymer molecules.
A contraction that accompanies the polymeri!ation reaction, often resulting in
a loss of accuracy or a reduced fit.
In the order to restore a tooth in such away that it is leak proof, there must be
no dimensional mismatch at the toothD restoration interface. :erfect adaptation should
be obtained while setting and maintained during thermal and mechanical cycling in
function. Jnfortunately, materials such as resin composites do not meet these
re.uirements. #rom the beginning, the dimensional stability of the restorative
material is compromised by the polymeri!ation reaction of the matrix phase. The
conversion of the monomer molecule into a polymer network is accompanied with a
closer packing of the molecules, which leads to bulk contraction the reduction of
volume is usually denoted as curing contraction or polymeri!ation shrinkage. The
lower the initial viscosity of the material, the more monomer entities must be united
into polymer chains and networks. Although the space occupied by filler particles
does not participate in the curing contraction high filler loads re.uire low molecular
weight monomers to ensure a proper handling viscosity. Within certain limits,
polymeri!ation shrinkage is not dependent on the filler load= if nothing obstructs the
shrinkage, leakage cannot be prevented.
rannstrom and Ao"inovic found that toxins from bacteria that invade and
grow in the space between filling and cavity wall are the main cause of pulpal
irritation in teeth restored with resin composites. The inevitable curing contraction of
resin composites must be guided to the cavity walls, a powerful tool for this is
%&
Polymerization Shrinkage
bonding of the resin composite to the cavity walls. If such bonding can be achieved,
gap formation can be prevented. 2owever, when shrinkage is prevented, contractile
forces are produced in the material, which places a strain on the restored tooth and
endanger the coherence. Therefore, shrinkage interpretation re.uires other factors
other then dimensional instability. In order to prevent damage from stress and
shrinkage stress relieving mechanisms have become an important field of research
within dentistry.
The polymeri!ation of the resin matrix produces a gelation in which the
restorative materials are transformed from a viscous plastic into a rigid elastic phase.
The gel point is defined as the moment at which the material can no longer provide
viscous flow to keep up with the curing contraction.
Therefore, the results of shrinkage determinations are dependent on the flow
ability of the material in the experimental set up.
In a situation, where a curing material is bonded on all sides to rigid structures,
bulk contraction cannot occur and yet unavoidable shrinkage must be compensated by
some kind of volume generation. This can come from a minimal strain on the material
and mainly from dislodgement of the bond, increase in porosity or internal loss of
coherence. In this particular case, the contractile forces come into action when the
reaction is initiated at the very start of the contraction. Therefore, all shrinkage must
be regarded as possible contribution to stress.
In general volumetric curing contraction determinations are basically ?free@
shrinkage measurements and therefore offer the total curing contraction, while the
dimensional changes in linear curing contraction determinations are more or less
?hindered@ and therefore should be regarded as a post gel curing phenomenon. #or
7(
Polymerization Shrinkage
that reason, the various linear shrinkage determinations are hard to compare. A
scheme reasoning holds true for the studies where strain groups are used to determine
the post gel curing contractions.
A number of devices for determining the volumetric curing contraction has
been reported in dental literature, most of which are based on measurements in
mercury dilatometer or a water dilatometer. 5ilatometry is laborious and time
consuming and is also sub"ect to data scattering when used for low viscosity resins.
The curing contraction is usually determined linearly. Watts and $ash used an
indirect method of determination in which they calculated the volumetric contraction
from the post gel linear displacement of a deflecting disk resting on a brass ring in
which a resin composite disk is centrally located. Forgenson et al and <unksgaard et
al measured the wall to wall polymeri!ation contraction of a restoration using a light
microscope.
Although polymeri!ation shrinkage is the cause, shrinkage stress may be seen
as the mechanism, which is responsible for .uite a few of the problems with adhesive
restorations encountered in clinical dentistry. It can cause separation from the cavity
walls or cohesive fractures in one of the structures. ;hrinkage stress occurs when the
contraction is obstructed and the material is rigid to resist sufficient plastic flow to
compensate for the original volume.
Got withstanding the strength of the material involved shrinkage will take
place, for the simple reason that it is physically unavoidable. Jnless the surrounding
structures to which the shrinking material is bonded, such elastic compliance,
something will fracture, in order to compensate for reduce volume and so create open
7%
Polymerization Shrinkage
spaces. The magnitude of the contraction stress is dependent not only on the
compliance of the surrounding structures but also on the nature of the shrinking
material, notably the visco>elastic properties. At a given shrinkage value, the most
rigid material will cause the highest stress. In the dental literature, shrinkage stress
determinations have been studied both .ualitatively and .uantitatively. $linically the
most realistic method is probably the measurement of the shrinkage stress with strain
gauges. 2ere, all variables are included.
In a number of studies the setting stress was determined in a direct manner. In
the most common test set up, a resin composite sample is placed between opposing
adhesive surfaces, which are connected to the frame and load cell of tensilometer.
/elatively large errors in the determination can occur if the effects of the compliance
of the test set up are not taken into account. ecause usually, the amount of linear
shrinkage of the sample which must generate the polymeri!ation contraction stresses
is .uite small in comparison with the compliance of the load cell and the compliance
of the test set upD tensilomer combination. To exclude this influence, a feed back
system, which maintains the original sample length during the measurement, must be
included in the test design. The need for such a system can be illustrated by means of
the following example, if two samples are tested which have the same intrinsic
shrinkage but different sample heights, the absolute shrinkage value will be lower for
the shorter sample. In that case, the influence of the relatively constant compliance of
the test set up is much larger for the shorter sample. This results in a greater stress
relief, which leads to the determination of a stress value, which is too low.
Jnfortunately in many studies this factor is not taken into account or it is under
estimated when the stress is established. 5irect result of this misinterpretation is that
77
Polymerization Shrinkage
a lower stress is recorded for thinner layers, while in studies where compliance is
excluded the opposite in the case.
Another important factor, which influences the test results, is the adhesion of
the sample to the adhesive surface. If the light chemical adhesion is achieved, no
additional flow possibilities can be divided from the adhesive side. 2owever when a
micromechanical adhesion is responsible for the bonding, reducing stresses are
formed due to the increased flow possibilities from that layer. A similar consideration
accounts for the degree of porosity within the resin composite while the volume of a
homogenously dense material cannot expand by force, a person one can, due to
enlargement of the internal voids. It stress determinations are carried out under
condition without compliance, the tensile contraction stresses can reach a level which
surpasses the instant coherence, which leads to spontaneous fractures. In practice,
this will not occur, as the compliance of the surrounding structures is sufficient to
reduce the setting stresses to a level blow the cohesive or adhesive strength.
The remaining stress is maintained by the total elastic deformation of all
materials involve din the restoration of the tooth. This involves a great risk of failure
during the functioning of the tooth than on unstressed structure. All possibilities or
tress reduction should therefore be considered when using restorative materials, which
are sub"ect to shrinkage in adhesive dentistry.
79
ifferent Curing Techni!ues
DIFFERENT CURING TEC3NI8UES AND T3EIR EFFECT ON
OL1/ERI5ATION
$omposite resin shrinkage and final margin integrity are affected by
%3 :reparation si!e and configuration
73 The curing light
93 The clinician)s techni.ue,
*3 The resin>bonded composite.
2owever, the ma"or factor controlling the stress to the surrounding tooth
structure is the shrinkage of the composite resin. After shrinkage, the composite
absorbs water, which helps compensate for some, but not all, of the polymeri!ation
shrinkage.
TRANS ENA/EL OL1/ERI5ATION TEC3NI8UE 0 (UL7 FILL
TEC3NI8UE :
There are many methods of placing and curing composite resin that attempt to
control the effects of polymeri!ation shrinkage. 6ne of these techni.ues is called
trans enamel polymerization, advocated by "el#edere, where the adhesive, a
flowable composite, and a composite resin are placed into the tooth in bulk and then
polymeri!ed by curing through the tooth from the buccal and lingual through the
enamel. A final cure is then applied from the occlusal.
This method of curing composite resin was tested by measuring the leakage in
$lass I restorations. In 7 separate studies, composite resin was used to restore
premolars using * different placement and curing techni.ues. Go difference in
leakage was found from the bulk filling techni.ue vs any of the incremental curing
7*
ifferent Curing Techni!ues
techni.ues, even the pulse delay curing techni.ue. The composite resin was placed
incrementally using different types of increments + hori!ontal, diagonal, and with a
slot down the middle. There was no statistical difference among any group= the bulk
fill had the same leakage as the other placement methods. After the microleakge was
measured, the hardness of the sectioned teeth was measured, beginning from the
occlusal and proceeding toward the pulp. The hardness of the bulk filled teeth was
significantly softer than the incrementally cured restorations, which again
demonstrates the limited depth of cure of composite resin. Increments of composite
resin need to be placed to completely cure the composite. Incompletely cured
composite resins may release components into the oral cavity that may be detrimental.
The reason for the reduced shrinkage with the bulk curing techni.ue, was obvious
uncured composite resin does not shrink as much as completely cured resin. A
significant factor in the reduction of curing effectiveness with this bulk filling
techni.ue is that light attenuates while penetrating through the tooth structure. As
light passes through the tooth structure, it drops dramatically from ,(( mWDcm
7
to E(
mWDcm
7
when curing through 7., mm of tooth. Jsing * different curing lights, only
the 7 :A$ lights + Airtuoso and Wavelength produced enough output to cure through
7 mm of tooth.
32SIDED LIG3T CURING TEC3NI8UE 0 SLO# OL1/ERI5ATION
TEC3NI8UE :
-ight attenuation also explains the reduction in polymeri!ation stresses with
the 9 sided light curing techni.ue. In this techni.ue, 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. 6ther
7,
ifferent Curing Techni!ues
increments complete the occlusal portion of the restoration. This 9 sided light curing
techni.ue was evaluated by -osche, who reported that light attenuation produces the
reduction in shrinkage, not the three sided curing techni.ue.

OCCLUSAL ASECT (UCCO2LINGUAL ASECT
In %&&7, over a * minute period, while controlling the output of the curing unit
with a rheostat, Goracci and coworkers slowly polymeri!ed composite resin, and
showed fewer gaps and marginal defects with this techni.ue. The slow
polymeri!ation techni.ue was verified, but re.uired so much time to polymeri!e
composite resin that it was clinically ineffective. 2owever, they did show that slow
polymeri!ation methods have merit. The commercial development of that techni.ue
increased polymeri!ation rates and shortened the time for polymeri!ation re.uired to
make it clinically useful. This may mean that the ability to produce gap free margins
and improve marginal integrity may have decreased. The 9< 4;:4 2igh light was
the first curing light with a step or soft cure. This unit started at a low output of %E(
m WDcm
7
, which, after %( seconds, increased to ',( mWDcm
7
to complete the *(
second cure. The 9< 4;:4 2ighlight curing light was discontinued and replaced with
the 9< 4;:4 4lipar
N
Tri-ight
N
which had an exponential output mode of which the
output slides from low to high output. In 7 studies, no significant difference could be
found between using this techni.ue and bulk curing.
7B
ifferent Curing Techni!ues
ULSE DELA1 OR ULSE CURE TEC3NI8UE :
Another techni.ue advocating decreasing stress associated with the shrinkage
of composite resin is the pulse delay, or the pulse cure techni.ue. This re.uires
placing increments of composite resin and curing each increment for 7( seconds. The
final enamel replacement increment is cured with a brief burst of energy for 7 to 9
seconds. A 9 minute delay is then allowed to enable the composite time to flow and
shrink while the restoration is finished and polished. After finishing, the restoration is
cured at high intensity to totally polymeri!e the material. <echanical properties are
maintained when these techni.ues are applied.
SOFT START CURING TEC3NI8UE :
;oft start techni.ue begins with a low intensity and finishes with a high
intensity. The approach allows for a slow initial rate of polymeri!ation 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. A number
of studies have shown that varying levels of stress reduction in tooth cavity walls can
be achieved in this way, while not increasing total exposure time or sacrificing either
5$ or depth of cure. $onse.uently, a variety of protocols have been developed and
the necessary lamps made available that automatically provide one or more soft start
exposure se.uences.
RA/ED CURING :
In ramping the intensity is gradually increased or ?ramped up@ during the
exposure. This ramping consists of either stepwise, linear, or exponential modes.
7'
ifferent Curing Techni!ues
DELA1ED CURING :
In delayed curing, the restoration is initially incompletely cured at low
intensity. The clinician then sculpts and contours the resin to the correct occlusion and
later applies a second exposure for the final cure. This delay allows substantial stress
relaxation to take place. The longer the time period available for relaxation, the lower
the residual stress. 5elayed curing and exponential ramp curing appear to provide the
greater reductions in curing stress.
/esearch has shown that soft curing techni.ues do not affect the final
mechanical properties of the composite resin= however, the effectiveness of the soft
cure in decreasing leakage and stress at the margins of $lass II restorations is not clear
and it has not been proven clinically. To accomplish improved marginal integrity, the
composite resin must flow during its change from a viscous paste to an elastic solid to
accommodate the resin shrinkage and yield sealed margins. A composite resin that
does not shrink is necessary to consistently improve marginal integrity. In 7 studies
no clear benefit to the pulse delay techni.ue could be seen. White liens form around
margins during finishing, particularly in $lass I restorations. These white lines result
from gaps between composite resin and the cavity walls. This gap fills with finishing
debris because of improper finishing or polymeri!ation shrinkage or, more probably, a
combination of both. The marginal gap also can occur if the polymeri!ation shrinkage
stress is greater than the adhesive bond. :oor marginal integrity can result from
improper application of the bonding system. $>factor or the cavity configuration is
another significant reason for seeing more white line formation around $lass I
restorations than in anterior $lass III restorations.
7E
Curing Units
LIST OF $ARIA(LES ASSOCIATED #IT3 $ISI(LE LIG3T
CURING UNITS
These variables can be divided into 9 categories.
i) E9!i+ment *acto"%
ii) "oce)!"al *acto"%
iii) Re%to"ation *acto"%
i) E9!i+ment Facto"%
a3 ulb frosting or degradation
b3 -ight reflector degradation
c3 6ptical filter degradation
d3 #ibre optic bundle breakage
e3 -ight guide fracture
f3 $ontamination by resin build up
g3 -ine voltage inconsistencies
h3 ;terili!ation problems
i3 Infection control barriers
ii) "oce)!"al Facto"%
a3 -ight tip direction
b3 Access to restoration
c3 5istance from surface
d3 ;i!e of tip
e3 Tip movement
f3 Time of exposure
7&
Curing Units
iii) Re%to"ation *acto"%
a3 restoration thickness
b3 $avity design
c3 #iller amount and si!e
d3 /estoration shade
e3 <onomer ratio
FACTORS T3AT AFFECT LIG3T CURING OF CO/OSITES :
A review of light curing basics is useful to understanding the pros and cons of
the laser and arc lamps currently available for composite resin curing. The favourable
properties of light cured composites depend on achieving a complete cure of the resin
matrix. Inade.uate polymeri!ation can result in loss of biocompatibility, color shifts,
loss of retention, breakage, and excessive wear and softness.
;ome of the most important factors to consider in using and maintaining a
light curing system are time, intensity, temperature, light distance, resin thickness, air
inhibition, tooth structure, composite shade, filler type, accelerator .uantity, heat, and
room light. #ollowing is a brief review of each of these factors.
E:+o%!"e :
-ight cured composites polymeri!e both during and after visible light
activation. These two curing reactions are known as the ?light; an) <)a".@
reactions. The light reaction occurs while light from the curing unit penetrates the
composite. The dark reaction, also called post>irradiation polymeri!ation, begins
immediately after the curing light goes off and continues for upto 2= hours, even in
total darkness, but most of it occurs within 4> to 4? minutes post cure.
9(
Curing Units
The minimum curing time for a light reaction for most composites under a
continuous curing mode is 2> to => seconds 0using curing units with the normal *((
mWDcm
7
output3. A classic study by -eung shows that traditional light cured
composites must be cured for at least *( seconds to initiate a reaction that ensures the
curing will continue to completion. In all composites, ma:im!m ha")ne%% is
achieved within about 2= hours. ;ome newer composites have shorter light curing
times, but the total time re.uired for the resin to completely set is about the same.
6vercuring 0curing for a longer time3 is not harmful but does not improve a material)s
properties.
/egardless of how a composite is cured, the dark reaction takes time and
greatly contributes to the overall strength of the material. Generally, waiting %( to %,
minutes after curing before finishing a composite improves the hardness by 7( to
9(I. A waiting period prior to finishing can improve wear properties significantly,
because the finishing process damages the margins of a restoration. 5amage to the
margins is greatest when a composite is finished before it is fully polymeri!ed. A
good way to minimi!e finishing damage is to retch and reseal the margins with a gla!e
after finishing.
Inten%it, :
The curing intensity of a =@A 2> nm blue light has been about =>> m #0cm
2
for many years. This is the output of most curing units and is referred to as the ?power
density@. :roblems occur when the minimum intensity is not achieved. There are four
common causes of decreased intensity 8 0%3 as the bulbs in curing lamps ageB the
intensity of blue light can decrease, 073 voltage )"o+% can affect blue light production,
9%
Curing Units
093 %te"ili6ation o* c!"ing ti+% can reduce light transmission, and 0*3 *ilte"% to
increase blue light transmission can )eg"a)eC
-ight rods are available that can concentrate the light into a small spot si!e to
increase the power density. A number of radiometer devices can measure blue light
intensity, generally over *(( to ,(( nm wavelengths 0eg, $uring /adiometer,
5emetron, 5anbury, $onnecticut, and $ure /ite, 4#6; Inc., Williamsville, new
Oork3. $uring units should be checked every month with a radiometer to ensure
production of ade.uate blue light intensity. When the intensity is low, replacing the
bulb, filter, or curing tip usually returns the intensity to acceptable levels. <any
curing lamps have radiometers built in. Gewer curing units with a higher power
density 0B(( to %7(( mWDcm
7
3 maintain acceptable output levels for a longer time.
Tem+e"at!"e :
-ight>cured composites cure less effectively if they are cold during application
0eg, "ust taken out of the refrigerator3. $omposites at room temperature cure more
completely and rapidly. $omposites should be held at room temperature at least %
hour prior to use.
<ost curing lamps produce heat= which speeds the curing process. 2owever,
excess heat can result in pulpitis and pulp death. The effect of heat from a curing
lamp on a tooth is not fully understood, partially because there are so may variables.
Di%tance an) Angle (et-een Light an) Re%in :
The ideal distance of the light source from the composite is 4 mm, with the
light source positioned D> )eg"ee% from the composite surface. -ight intensity drops
off rapidly as the distance from the light rod to the composite increases. I# the base
97
Curing Units

AGG-4 6# &(
(
T6 $6<:6;IT4 ;J/#A$4
of a typical proximal box on a posterior composite is , mm from the tip of the light
guide, ade.uate curing duration for a given intensity can be determined only by using
a radiometer from the same distance. 5istance can still be a problem if the lamp is
placed against the tooth, since a deep box increases the distance the light must
penetrate. This is a good reason to use a lamp that produces more than the minimum
*(( mWDcm
7
power density. With many curing lamps, a higher power density 0of
about B(( mWDcm
7
3 is re.uired to ensure than *(( mWDcm
7
reaches the fist increment
of composite in a posterior box. The 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. #urther polymeri!ation can be achieved by curing from the proximal
surfaces after finishing.
Angle an) ath o* the Light :
As the angel diverges from D> )eg"ee% 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 ad"acent tooth
blocks light when placed at an angel.
99
Curing Units
Thic.ne%% o* Re%in :
/esin thickness greatly affects resin curing. 6ptimum polymeri!ation occurs
at depths of "ust (., to %.( mm, owing to the inhibition of air at the surface and the
difficulty with which light penetrates a resin.
6ne classic study showed that ' days after a *( second curing cycle, a % mm
deep composite 0of light shade3 is cured to BE to E*I of optimum hardness, as
measured by surface hardness. At 7 mm, this same composite has only *( to B(I of
the desired hardness. At 9 mm, it has only 9*I of the hardness. Thus, composites
should be cured in increments of not more than % to 7 mm. This assumes an optimum
light source and a composite that is light in shade. In some studies increasing the
curing time to 7 minutes increased the depth of cure= however, additional curing time
has limited effects on depth of cure. A manufacturer)s statement that a composite has
a B mm depth of cure is misleading. This implies that the composite can be placed in B
mm increments, but doing so results in excessive polymeri!ation shrinkage, open
margins, and increased strain on the tooth.
Ai" Inhi&ition :
6xygen in the air competes with polymeri!ation and inhibits setting of the
resin. The extent of surface inhibition is inversely related to filler loading. The under
cured layer can vary from ,( to ,(( m 0or more3, depending on the reactivity of the
photo initiators used. Jnfilled resins should be cured, then covered with an air
inhibiting gel, such as a thin layer of petroleum "elly, glycerin, or commercial
products, such as 6xyguard 0F. <orita3, and then re>cured. ;ome gla!es have
photoinitiators that are sufficiently reactive to make this unnecessary. In addition,
9*
Curing Units
curing through a matrix increases surface polymeri!ation because the matrix reduces
air inhibition.
C!"ing Th"o!gh Tooth St"!ct!"e :
It is possible to light cure resin through enamel, but this techni.ue is "ust one
to two thirds as effective as direct curing and is appropriate only when there is no
alternative. ;uch curing is possible through upto 3 mm of enamel or >C? 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.
Sha)e o* Re%in:
Da".e" com+o%ite %ha)e% c!"e mo"e %lo-l, and less deeply than lighter
shades. At a depth of % mm, a dark composite shade achieves "ust 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. 2ence, when esthetics is not critical,
the lightest shade should be used.
T,+e o* Fille":
/ic"o*ille) com+o%ite% a"e mo"e )i**ic!lt to c!"e than mac"o*ille)
com+o%ite%B which have larger .uart! and glass fillers. Generally, the more heavily
loaded a composite is with larger inorganic fillers, the more easily the resin cures.
2owever, extremely high loading can make a composite opa.ue, which actually
increases the re.uired duration of exposure. <anufacturers are well aware of this and
load materials accordingly.
9,
Curing Units
Amo!nt o* hotoinitiato" :
$omposites differ in the amount of photoinitiator they contain. ;ome
manufacturers use less than the ideal amount of photoinitiator need for maximum
resin strength to increase the dentist)s working time under the operatory light.
All photoinitiators deteriorate over time. 2owever, light cued composites are
more stable than chemically cured composites. ;ome light cured composites lose
about %(I of their physical properties when stored for 7 years at room temperature.
The maximum usable life span of a light cured composite is generally 9 to * years or
more from the date of manufacture, if stored at room temperature. If contained in a
sealed tube, they last much longer. The ma"or cause of decreased shelf life for light
cured composite is evaporation of critical monomers from unidose containers.
Autocured materials have shelf lives of B to 9B months. The key to longevity is the
catalyst peroxide containing paste= some are stabili!ed better than others. There are
large variations in the shelf lies of various auto and dual cured composites. <ost
autocured composites have an extended shelf life if kept under refrigeration.
6bserving a manufacturer)s product expiration date is important, especially with the
shades used less fre.uently.
3eat gene"ate) &, light c!"ing !nit% :
The heat given off by a curing light increases the rate of photochemical
initiation and polymeri!ation reaction and increases the amount of resin cured.
4xcessive curing heat is thought to cause no photochemical damage to either the tooth
or the composite. 2owever, the heat gene"ate) in the tooth )!"ing light c!"ing
"e%!lt% in highe" int"a+!l+al tem+e"at!"e%B -hich co!l) &e ha"m*!l. 5eep layers
of resin should be cured thoroughly= cooling with a dry air syringe may be helpful.
9B
Curing Units
Room Light ol,me"i6ation :
The working time of light cured composites depends on the operatory light
and the ambient room light to which the composites are exposed. 5ifferences in these
light sources can dramatically affect working time. Gewer, faster>setting composites
are even more sensitive.
O+e"ato", Lighting :
<ost operatory lights operate at high temperatures that produce spectrums in
the blue range. This spectrum is included to improve the color selection of dental
restoratives, but it initiates curing.
Incan)e%cent lighting :
Incandescent lights are low in blue light and provide the longest composite
working time.
Fl!o"e%cent Lighting :
In general, fluorescent lighting has the shortest working time for light cured
composites, because it emits a large amount of blue light. $olor corrected tubes emit
considerably more blue light and often have the shortest working time of all lighting
systems.
Im+"oving #o".ing time :
Working time can be improved in two ways 8
%. :lace the operatory light further from the working field. Generally,
doubling the distance of the operatory light from the patient greatly
9'
Curing Units
increases the working time while still providing ade.uate light for
composite placement.
7. :lace an orange filer over the operatory light. This can be held in place
with Aelcro
N
.
9E
Curing Units
CURING UNITS
Almost all halogen visible light curing units cure all visible light cured
composites. 2owever, curing units differ in depth of cure, diameter of cure, number
of available attachments, and heat generation. <any curing units use halogen bulbs,
such as are found in standard slide pro"ectors, as their light source. This light source
produces many wavelengths of light. A special and complex dichroic filter separates
the wavelengths to a narrow spectrum with a bandwidth of usable wavelengths of
approximately *(( to ,(( nm. #or most composites, *'( nm is the optimal
wavelength for polymeri!ation, but this depends on the photoinitiators used in the
resin. ;ome non halogen curing devices do not polymeri!e some composite resins.
This is particularly true of lasers, because their wavelength spectrum is so narrow it
may not include the optimal wavelength for some resins.
;ome curing units contain better filters and light guides than others. Jnits
with poor filters permit longer wavelength energy to pass through the guide, resulting
in higher temperatures at the curing tip or inade.uate blue light output. The light
from the curing tip should be uniform in intensity and wavelength to reduce internal
stress during the polymeri!ation process and to provide optimal stability to the cured
resin. These factors are responsible for differences in curing ability among units using
a similar light source. ;tudies show these differences can be large upto ,(I in depth
of cure measurements, even between identical units made by the same manufacturer.
There are basically three types of visible light curing units= countertop units,
gun type units, and fiber optic hand piece attachment units.
9&
Curing Units
Co!nte"to+ Unit% :
The countertop unit contains all the functional parts in one box. A fiber optic
or fluid filled cord carries the light from the box to the patient.
;ome of these units have a control switch at the end of the cord so the operator
does not have to leave the operating field to activate the light source.
The advantages of countertop units are that the fan and working parts of the
unit are out of the operating field and that they are generally less expensive that other
designs. The disadvantages are that many units lack a switch at the cord end, and
many models do not have wide diameter curing tips. In addition, many countertop
units have fiber optic cords that need periodic replacement because of fiber optic
bundle break down.
G!n T,+e Unit% :
The second type of visible light curing unit has its light source in a gun handle.
The light passes through a small fiber optic cord or glass rod that forms the barrel of
the gun. Generally, these units are attached to an additional table top or wall mounted
unit that contains the necessary transformers to operate the light.

GJG TO:4 $J/IGG JGIT
*(
Curing Units
This type of unit is activated at the operator site. They typically have large
diameters of cure with good intensity and are generally small and easily made
portable. Gun type units have no fiber optic cords to replace since the gun barrels are
usually inflexible. The disadvantages of gun type units are the fan in the handle,
which an be noisy and become warm with extended use= gun bulk and weight 0more
bulky than fiber optic cord ends3= and higher cost.
3an)+iece C!"ing Attachment% :
The third type, the fiber optic handpiece curing attachment, is generally
adapted to existing fiber optic handpiece light sources. Attachment units have curing
tips that are usually smaller than but similar to those in countertop units. ;ome of
these units generate considerable heating the tooth, owing to inefficient or missing
blue light filters.

2AG5:I4$4 $J/IGG JGIT
These units are less expensive, especially if the fiber optic handpiece is
already in place. They are small and re.uire no additional counter space. Their
drawbacks include, generally, a smaller diameter of cure, less intense light source,
release of excessive heat 0some units3, and periodic need for replacement of fiber
optic cords.
*%
Types of Light Curing Units
T1ES OF LIG3T CURING UNITS
i3 1T2 > 1uart! Tungsten 2alogen + $uring -ight s
ii3 :A$ + :lasma Arc $uring -ights
iii3 -45 + -ight 4mitting 5iodes $uring -ight
iv3 -aser $uring -ights
The spectral output 0intensity versus wavelength3 may vary from one unit to
another but here each attempt to maximi!e the light in the absorption range of the
photoinitiator within composite being cured is made. Gow vast variety of current
composites employ $amphor.uinone as the photoinitiator, and it absorbs photons of
light energy predominantly at *'* nm.
*7
$uartz Tungsten %alogen
8UART5 TUNGSTEN 3ALOGEN CURING LIG3TS
1uart! tungsten halogen 1T2 lights were improvement over earlier ultraviolet
0JA3 $uring units. 4arlier or initially 1T2 lights had low output or power densities,
averaging about 9(( mWDcm
7
compared to today)s higher powered units.
a"t% o* 8T3 :
> -ight pipe
> -ight guard
> and pass filters
> -ight and reflectors
> $ooling fan
> Trigger
> $ircuit board
> Tungsten filament
All 1uart! Tungsten 2alogen lights have similar construction.
a"t% o* 8!a"t6 T!ng%ten 3alogen Light C!"ing Unit :
4) Filament :
These 1T2 curing lights produce blue light by passing a current through the
tungsten filament which is housed in a .uart! bulb filled with halogen.
Gow as the current passes through the filament heat and light energy are
generated.
The White light which is produced contains light of all the wavelengths.
*9
$uartz Tungsten %alogen
2) Re*lecto" :
In 1T2 light curing unit the light from the bulb is collected by reflecting it
from silveri!ed mirror behind the bulb towards the path down the fiber optic chain to
the tip.
> It is extremely important that the mirror surface to be kept clean. This
surface becomes heated during the operation and it should be cooled
down between the uses.
> It often condenses vapours from mercury, bonding system solvents or
moisture in the operatory air onto the surface which leads to dulling or
clouding of the surface.
> ;o one should go for routinely cleaning of this surface with alcohol as
methyl&ethyl ketone sol#ents on cotton swa's to renew the reflection
effecti#eness(
3) Filte"% :
/eflector is parabolic in geometry rather than being hemispherical, this is to
focus the light on the or towards small fiber optic entry.
6f this light produced, less than (.,I is suitable for curing and most is
converted at some point into heat and thus to overcome as to minimi!e any heating
that might occur during curing, two filters are inserted in the path of light "ust before
the fiber optic system.
/eflector located behind the bulb reflects the light and heat sending it through
the two filters.
> and pass filter
> Infra red filter
In the manufacturing process these two filters are often fused together.
**
$uartz Tungsten %alogen
and pass filter narrows the spectra of white light to blue wave length 0)*+
nm , -.+ nm3
7

Infrared filter reduces the infrared spectra and heat passing through to the
tooth.

=) Light G!i)e :
After light passes through the band pass filter, it enters the light guide.
-ight guides are available in many si!es and shapes.
a3 ;tandard parallel sided 0Turbo Tip3
b3 ;plit
This turbo tip is a product of 5emetion /esearch $ompany 5anbuy. And this
turbo tips concentrate light energy by narrowing the beam. They focus the
light in the way the magnifying glass focuses the light, by concentrating the
light in a smaller area, producing higher output compared to standard tips.
:rice and $olleagues have shown that tapered light guides concentrate and
increases power density, compared to a standard parallel sided light guide by
about *9I. 2owever this increase in power density is achieved only when the
curing tip contacts the surface being cured.
When turbo tip light is moved away from the surface being cured, greater
drop in the power density occurs with tur'o tip/ compared to standard light guide(
At 0 mm standard tip has greater power density than turbotip. Thus is the
reason why curing lights are more effective when light guide contacts the surface.
In addition to this as the diameter of turbo tips is small so it may not cover the
entire composite resin being polymeri!ed.
*,
$uartz Tungsten %alogen
Thus to cure entire surface, tip should be placed and the resin cured in
overlapping steps. This increases the time re.uired to cure the resin.
3o-eve" the"e a"e !%e% o* %mall )iamete" ti+% %!ch a% :
a3 $uring adhesive in the proximal boxes so that the guide can be placed
class to the surface being cured.
b3 ;pot>curing veneers in the centre of veneer so that excess cement can
be removed at the margins.
A typical 1T2 bulb is rated for E(>%(( hrs 07 P years of clinical practice3 but
these can last for 7>9 times as long under the ideal conditions.
?) Cooling Fan :
#an 8 ;mall fan is sued to dissipate the heat from the filters and reflections.
Gow light passed through this fiber optic bundle is emitted from the tip of
curing unit. ;ome light intensity is lost through the fiber optic system. The output
characteristics of the tip are generally not uniform with high intensity light observed
in the center of the bundle. /esin contamination on curing tip tends to scatter the
light, reducing the effectiveness of effective output. Therefore the tip should 'e
cleaned of cured resin/ when necessary using an appropriate ru''er wheel or slow
speed hand piece(
/ONITORING OF CURING LIG3T :
The curing light output can be monitored directly with a built in or a portable
radiometer or by trial curing of some composite materials.
2owever radiometer approach is much more sensitive to curing problems.
<ost modern curing lights contain or includes a convenient radiometer as a
part of unit that measures the number of photons per unit of area per unit of time.
*B
$uartz Tungsten %alogen
Jnfortunately it measures all the light energy and does not discriminate the
light energy that is matched to photo initiator. Thus real value of measurement is
limited.
$T% curing units functioning in normal range has output from 1++&*++
m2/cm
.
( 3 good rule of thum' is that the minimum output should ne#er drop
'elow )++ m2/cm(
.
/adiometer is designed to measure the photon level per unit time through a
standard %% mm diameter window. Therefore smaller or larger curing units tips
cannot be effectively tested. -ight energy emitting into a fibre optic bundle is
diffused or concentrated depending on whether the curing unit tip is larger or smaller.
;hifting from standard %% mm diameter tip to short 9 mm diameter has the
effect of increasing the light output eight folds. This increases the chance that the
heat produced in curing procedure will raise the temperature of restoration and
surrounding dentin to much more dangerous levels. Increase in pulpal temperature
of more than -
o
&*
o
C easily causes cell death(
Facto"% A**ecting Light C!"ing Fo" 8!a"t6 T!ng%ten 3alogen Unit :
%. 5istance of the tip from the composite
7. $omposite itself effects the light curing process.
9. Time re.uired for ade.uate curing
*. $uring cycles
,. Jnreacted material
B. /apid polymeri!ation
*'
$uartz Tungsten %alogen
4) Di%tance o* the Ti+ o* c!"ing Unit *"om the Com+o%ite :
-ight coming out of the tip of curing unit does not maintain its intensity but it
is scattered by the molecules in the all on the path to the restoration.
I)eall, 8 #ibre optic should be ad"acent to the surface being cured, but this will most
likely contaminates the tip of the material to be cured. The intensity of light striking
the composite is inversely proportional to distance from tip of fibre optic bundle of
curing light to the composite surface.
Ideally 8 Tip should be within 7 mm of composite to be effective.

$6//4$T 5I;TAG$4 6# 7mm
ut this is not possible in many dental procedures because the anatomy of
tooth as a distance into the preparation extensions creates magnetic interference.
5istances of ,>B mm are often encountered. At distances beyond B mm for
1T2 light, the output may be less than %D9
rd
that at the tip.
3o- to +e"mit clo%e a++"o:imation o* c!"ing light to the com+o%ite%C
i) Light transmitting wedges are there for interproximal curing
ii) Light focusing tips are available for access into proximal boxes.
;maller tips are very useful to overcome the problem but re.uire many more
light curing cycles to cover same amount of cured area.
*E
$uartz Tungsten %alogen
$ertain walls containing bonding systems to be cured within complex
preparation extensions such as $lass II restorations, may not be oriented ideally to the
curing light direction and may still be under cured.
2) Com+o%ite It%el* E**ect% the C!"ing "oce%% :
In composites filler particles tend to scatter the light and darker colorants tends
to absorb the light. Therefore it is generally recommended that no more than %., + 7
mm increments to be light cured at a time.
;maller filler particles in the range of (.% + % um, interfere most with the light
and maximi!e scattering. That particle si!e corresponds to the wavelength range for
photo initiator used for curing.
Within the composites the pattern of curing varies as a function of curing tip
radius and light penetration depth into the material. The integrity of the tip folds off
from the center to the edges. Therefore bulk curing of the composites produces
J--4T ;2A:45 $uring :atterns. This may lead to inade.uate curing in the region
of proximal box line angles of $lass II restorations.
The degree of conversion is related to both intensity of light and duration of
exposure. It decreases considerably with depth into composite material.
/estorative material based on is>G<A like restorative materials generally
can only be converted to B,I this is because of technical problems with steric
hindrance of the reacting molecules. Therefore B,I would be considered good
degree of conversion.
*&
$uartz Tungsten %alogen
A curing light may only produce a ,,I degree of cure at % mm into a
composite and even less at greater depth. $linically it is impossible to distinguish
differences in degree of cure.
The bonding between somewhat cured and uncured material is called 54:T2
6# $J/4 and is often as much as , mm for light Aita A shades 0A
7
or A
9
3 of material
in which tip is closed to composite.
%owe#er in cases of poor or darker shades it is recommended that the
materials 'e placed and cured in increments of 4(-& . mm( 5or still darker shades
increments to 'e limited to 4 mm of thickness(
3) Time Re9!i"e) *o" C!"ing :
<ost light curing re.uires the minimum time of 7( seconds for ade.uate
curing under optical condition of access.
To guarantee ade.uate curing has occurred it has become common practice to
post cure for 7(>B( seconds. There is more evidence that postcuring 0curing after the
completion of recommended curing procedure3 may slightly improve the surface layer
properties such as wear resistance.
=) C!"ing C,cle% :
Typical curing cycles of 7( seconds are laborious and interest in much shorter
ones is strong.
It has been estimated that for a standard restorative practice during the course
of normal year that as may as *( hours 0typical work weak3 ay be consumed solely
with light curing.
,(
$uartz Tungsten %alogen
Therefore to overcome this more intense curing units have been developed.
;uch as :A$ 0:lasma Arc $uring3 and laser curing are advertised with curing times of
9>%( seconds.
?) Un"eacte) /ate"ial% :
In curing the amount of unreacted material that remains is still of concern.
If the degree of conversion is B,I in systems with dysfunctional or
polyfucntional molecules then this well include monomer that has atleast one site
reacted to tie it into the polymer network and some monomer that is totally unreacted.
The unreacted material may diffuse out of the system.
$urrent composites are complex mixtures that generally include two or more
principal monomers and these do not co react e.ually.
4vidence is increasing that T4G5<A constitutes most of unreacted monomer
in the system. This is apparently influenced by activation step as well.
@) Ra+i) ol,me"i6ation :
/apid polymeri!ation also affects the mechanical properties of the polymer
network that is forming As first polymeri!ation occurs only some monomer is
consumed and system is still principally a viscous li.uid. 5uring conversion from
monomer to polymer, the formation of new monomers to mono bonds cause
shrinkage, decreasing the net volume of the systems. As long as the system is li.uid,
it deforms .uickly. 2owever as the degree of conversion approaches %(I to 7(I the
network is extensive enough to create a gel. eyond the gel point, polymeri!ation
shrinkage creates strain on the network and the attachment area to the bonding
system. uilt in stresses are relieved ultimately but are considered deleterious at the
times of curing because of potential effects on restoration marginal walls.
,%
$uartz Tungsten %alogen
To decrease this problem or eliminate this problem, .uite a range of altered
curing cycles 0stage curing3 has been explored.
AD$ANTAGES OF 8UART5 TUNGSTEN 3ALOGEN CURING LIG3T :
;ince the late %&'()s halogen lights such as 0curing light dilemma3 6ptilux
,((, Qerr has been in constant use in dentistry. They have served the profession well,
they are a known entity and they are easy to use, relatively reliable devices.
The advantages can further be divided into 8
$onventional halogen curing lights.
4nhanced halogen lights.
IC A)vantage% o* Conventional 3alogen C!"ing Light%
%. $ost less than other light systems
7. They are based on simple technology
9. They generate little or no heat
*. These technology is well known and non threatening.
,. They have good power intensity
B. they emit a broad spectrum of usable light
'. 2eight intensity 1T2 lights have power densities ranging from B(( mWDcm
7
> %((( mWDcm
7
0Table3.
E. <any 1T2 units have different curing modes an can be switched from
continuous curing to lamp modes.
IIC A)vantage% o* Enhance) 3alogen Light% :
%3 They offer a faster resin cure.
73 They operate via a known proven technology.
,7
$uartz Tungsten %alogen
In the last few years, there has been an emphasis on enhanced conventional
light curing lights to provide greater curing intensity and faster cure. The most
obvious way this has been accomplished is by the use of light guides that diminish in
si!e as they exit from curing light.
The Turbo Tip 0Qecs3 4r emplifies this concept. Gumerous enhanced halogen
curing lights 06ptilux ,(%, Qeu3 are on the market and they have been popular
choices for practitioners.
DISAD$ANTAGES OF 8UART5 TUNGSTEN 3ALOGEN CURING LIG3TS
4) The o!t+!t o* 8T3 c!"ing light )ec"ea%e -ith ageC
ulb output decreases as a result of .uart! bulb becoming whiter 0more
opa.ue3 or darker. 1uart! bulb surrounding the filament gets hotter. Gow fan is
located near the bulb which cools the unit. As it heats and cools, bulb begins to
vitrify, becoming whiter and opa.ue with time, tungsten from the filament planes on
the side of bulb further decreases the light output.
2) Filament (!"no!t :
Another disadvantage of 1T2 is filament burnout.
3) Re*lecto" Degene"ate%
The reflectors surrounding the bulk also degenerates and thus finally reduces
the output.
=) Com+o%ite &!il) !+ on the light g!i)e al%o )ec"ea%e% the o!t+!t -ith timeC
ut this building can be removed with acetone. Abrasive cleaning of the
curing tip of the light should also be avoided because it, too well decrease the output.
2ere disposable plastic can prevent build up.
,9
$uartz Tungsten %alogen
?) F"act!"ing an) Chi++ing o* Light G!i)e% :
-ight guards are also sub"ected to fracturing and chipping. 2ere a .uick
method to verify that the light guide is intact is to place the base of guide on the
newspaper type and read out the curing tip. I# image is clear light guide is intact.
Any of these problems can decrees the output overtime, therefore 1T2 curing
units should be checked periodically with a radiometer to ensure ade.uate output. A
radiometer with a digital output is best because it will allow comparison with previous
measurements and a .uick determination of the status of curing light.
@) C!"ing Time :
They have slower curing time about %, seconds then :A$ lights 0Abst. 9
seconds3 or -45 lights.
'3 <ost devices must be plugged into the house electricity.
E3 The units are relatively large and cumbersome
&3 The lamps must be replaced fre.uently at moderate cost.
FAST 3ALOGEN CURING LIG3TS :
The most common example of this category of lights is 6ptilux ,(% 0Qerr3.
This device increased the intensity of halogen light by focusing it into a large orifice
and through fiber optic bundles of diminishing diameter to a reduced diameter orifice,
much like a no!!le on a water hose.
,*
$uartz Tungsten %alogen

6:TI-JC O Q4//
The result of this is faster curing of resin is allowing cure of typical light
colored resin in about %( seconds. Although the cost of the light is more than that of
standard curing light, its reduction in curing time compensates for its extra cost over a
period. The cost of light is about 641++(
3igh Inten%it, 3alogen C!"ing Light% :
/ecently a ;wiss company introduced the first closed + ;ystem water cooled
halogen light, the ;wiss <aser -ight 04<;>4lectro <edical ;ystem ;.A., Gyon,
;wit!erland3.
This unit produces a light that is several times more intense than the emissions
of the typical halogen curing lights. The heat of the light is dissipated by water
cooling instead of fan cooling. It has a built in radiometer, disposable curing tips and
a fast curing time. The cost is higher than that of other halogen lights 6.7++(
,,
Plasma 3rc Curing Units
LAS/A ARC CURING 'AC)
About B years ago :A$ lights were introduced into the market or into dental
profession. :ractitioners could not believe that how .uickly the light cured restorative
resin. Two main examples of earlier units are power pal and the Rem'randt
Sapphire and inspite of continued enthusiastic acceptance by uses they have created
considerable controversy. ;ome practitioners base reported that the rapid cure
affected by :A$ light causes damage to both resin based composites and the tooth
structure. The cost of :A$ lights was 7>* times that of standard halogen curing light.
It ranges from 6.77-&61/0-+( /eplacement lamps costs from 68++ & 640++(
significant heat generation is inherent with :A$ lights but when used with care and
for the necessary few seconds, the light have not proved to be fatal in clinically
observable problems.
la%ma A"c So!"ce :
:A$ embodies much of the high technical engineering found in lasers 0though
it is not a laser3 to create 9
rd
generation light source which is new to dentistry. 3
plasma arc light source utilizes a high energy/ high pressure ionized gas(
3o- AC #o".% :
:A$ light passes current through 7 electrodes, generating plasma field and
light. -ike 1T2 curing lights significant heat is produced as the current passes
through the electrodes. The light energy produced passes through an infra red filter
and band pass filter before it passes through a light guide to narrow the spectrum of
light to blue light. :A$ produces powerful bursts of energy but re.uire a wait time
between pulses. The power of these units decline with time.
,B
Plasma 3rc Curing Units
C!"ing Time &, la%ma A"c Light C!"ing Unit% :
:lasma arc light curing units take %( seconds for curing composites and they
can also take as low as , seconds. This is because of light energy produced by these
units i.e. between *,( mW and E(( mW of light energy in *,B nm to *&B nm range.
These :A$ provides a minimum of B(( mW of light in the *9( nm + ,(( nm range.
This is the range which precisely matches the adsorption curve of camphoro.uione
photoactivator.
Com+a"i%on o* St"ength o* AC to Conventional C!"ing Unit% :
2alogen light curing units commonly shows light strength leading from 9((
mW + ,(( mw and even or rarely B(( mW. These :A$ units has power density of at
least %%&B mWDcm
7
compared to strongest conventional light at about B(( mWDcm
7
.
This means the conventional curing lights appears to provide light about P as strong
as the :A$. 2owever in reality they only provide about %D*
th
the light which is useful
for curing. $onse.uently halogen light curing units takes *( seconds to get the same
light for curing that the :A$ provides in %( seconds.
E**icienc, o* AC -hen com+a"e) to halogen light c!"ing !nit% :
When properly used the :A$ light curing unit will maintain its %( seconds
curing efficiency for , years or more and then these slowly begins o degrade in
performance. ut halogen light curing units degrades significantly after % year.
:A$ will perform with high efficiency for the life of 7>9 conventional light
curing units.
After ,(,((( + % lac curing cycles and over , years, it is necessary to replace
:A$ light sources. At this time light may be still working, but worst is that there is
,'
Plasma 3rc Curing Units
increase in curing time i.e. from %,>7( seconds. At this time one should change light
source and it costs about RB((.
De+th o* C!"e -ith la%ma A"c Light C!"ing Unit% :
<ost manufacturers of composite materials recommended the maximum depth
of cure of %>7 mm. 2owever type of material is also responsible for depth of cure for
example, some better or good .uality materials such as diamond lite or diamond
crown one can use layers of 9>* mm. the more opaceous the material, the thinner the
layer recommended since light will not penetrate as deep in darker or more opa.ue
shades.
C!"ing Ti+ :
5iameter of curing tip is B., mm, however when the recommended light
shielding cone is used, the :A$ has an effective spot si!e of E mm.

$J/IGG TI: 6# :A$
These curing tips can be autoclaved for thousand of cycles with no significant
degradation in performance.
$uring tips can be cleaned simply by use of .>tips with alcohol or acetone on
them for clearing away the oil or other common residues.
If composite material is stuck to the tip, it must be first and then the surface
may be cleaned to its original clarity.
,E
Plasma 3rc Curing Units
#or :A$ light curing units %% mm curing tips are not available in case of large
<65)s or anterior porcelain veneers.
Co%t o* AC Light C!"ing Unit% :
Its cost ranges from 6.77- & 610-+. These are very costly units, i.e. costlier
than conventional light curing units and -45 light curing units.
AD$ANTAGES OF AC LIG3T CURING UNITS :
%3 E**ective c!"ing o* in)i"ect "e%to"ation% 8
:A$ light curing units are very effective for curing in direct restorations
because light attenuates when passing through composite resin, natural tooth, or
ceramic.
2) Le%% Time *o" C!"ing :
:A$ light curing units takes less time for curing. i.e. they take %( seconds and
some time as low as , seconds. This is because of high energy produced by these
units. $uring time averages 9 second for a typical A7 shade.
3) Dec"ea%e) time *o" +"oce)!"e% :
As there is less curing time taken by :A$ light curing units, it will overall
decrease the time for dental procedures.
=) Le%% Damage to Ti%%!e :
It is not proven that :A$ light curing units produce enough heat to cause a
clinically observable problem.
,&
Plasma 3rc Curing Units
?) De+th o* c!"e 8
;ome :A$ light curing units such as diamond plasma xenon arc curing units
can cure upto 9>* mm.
Di%a)vantage% o* AC Light C!"ing Unit% :
4) 3igh Co%t 8
:A$ light curing units have high cost as compared to conventional halogen
curing units and -45 light curing units. These cost ranges from S7&&, > R*B,(.
2) 3igh Co%t o* Re+ai" 8
These :A$ light curing units has high cost of repair. After ,(,((( + % lack
curing cycles. It is necessary to replace :A- light sources. If still continued to work
this curing unit can take %,>7( second for curing. To change light source on s.uare
RB(( which is too costly as compared to normal as conventional halogen light curing
units.
3) La"ge" 0 3eavie" an) (!l.ie" Unit% :
:A$ light curing units are larger, heavier and bulkier than -45 light curing
units.
=) E:ce%%ive 3eat "o)!ction :
2eat production during curing must be controlled by Accurate timing of cure
or reduction of heat by air cooling.
?) Unit% not %!++lie) &, 44 mm c!"ing ti+% :
:A$ light curing units are not supplied by curing tips with diameter of %% mm.
As %% mm tips are re.uired for the curing of <65s and anterior porcelain veneers.
B(
Plasma 3rc Curing Units
@) 3igh Inten%it, :
2igh intensity of the lamp causes silver to precipitate on the lamp thus causing
decreased output.
B%
Light 9mitting iodes
LIG3T E/ITTING DIODES
-ight curing units for polymeri!ation of oral biomaterials in dentistry using
halogen bulbs are likely to be replaced in the near future of light curing units using
light emitting diodes. ;tudies have shown that power full light emitting diodes light
curing units have potential to replace conventional halogen light curing units.
-ight emitting diodes are known for decades as indicators for consumer
products. -ike lasers light is generated by not only thermal process but by a well
defined /elaxation of 4xited 4lectrons, wavelength of light is generated by this
process 8
%. and gap
7. $hemical composition.
/ed, green and yellow light emitting diodes have been available or many years
and they produce light by electrically passing through a "unction of Gallium Arsinide
or Galium Arsinide phosphide. lue light emitting diodes have been available for
approximately %* years. The first light emitting diode was rather dull, with brightness
of less than %( mcd 0millicendelas3. ut now a days much brighter -45 are
available. /ed -45)s are used for flashing bicycles warning beams and have
brightness greater than %((( mcd. lue -ed)s 8 These are used for high speed color
scanning. 5ata transmission through ligads.
In contrast to halogen lamps, light emitting diodes do not produce visible light
by the heating of metal filament, but by .uantum mechanical effects. In simple terms
-45)s cure a combination of two different semi conductors i.e. the Tn>doped) and Tp>
doped) semiconductors. G>doped semiconductors have an excess of electrons and :
doped semiconductors have a lack of electrons or Tholes) when both types of
B7
Light 9mitting iodes
semiconductor are combined and a voltage is applied, electrons from the n doped and
from the : doped elements connect. As a result a characteristic light with a specific
wavelength range is emitted.
The color of an -45 light, which is its most important characteristic, is
determined by the chemical composition of the semi conductor combination
semiconductor are characteri!ed by a so called band gap. In -45)s this band gap is
directly utili!ed for light production, when electrons in the semiconductor
combination relax from a higher to a lower energy level, the exact energy difference
of the band gap is set free in the form of a photon.
In comparison with conventional lamps, the light produced by -45s has a
narrow spectral distribution. This is the main difference between the light produced
by -45s and halogen lamps, when -45s with suitable band gap energy are used, they
produced only the deserve wavelength range. $onse.uently, this innovative method
of light production is a much more efficient way of converting an electric current into
light.
Today -45)s are a promising alternative in light polymeri!ation of dental
material. The use of -45s in dentistry has been discussed ever since the development
of blue diodes in the %&&(s. Important research in this field was carried out by
researchers in the Jnited Qingdom and Fapan Investigations by #u"i ayashi et al
have demonstrated that at a respective light intensity of %(( mwDcm
7
depth of cure
and monomer conversion of the composite was significantly improved with an -45
as compared with a halogen lamp. The above mentioned study demonstrates that the
.uality of light polymeri!ation is not exclusively due to the light intensity. The
narrow absorption peak of the initiator system must also be taken into account. This
B9
Light 9mitting iodes
makes the emitted spectrum an important determinant of a curing light performance.
The absorption curve of camphor.uinone extends between 9B( and ,7( nm, with its
maximum at *B, nm. It has been shown that within this range, the optimal emission
bandwidth of the light source lies between *,( and *&( nm.
In conventional curing devices, a ma"or portion of the photons is emitted
outside the optimal spectrum range for light curing. These photons cannot or only
with reduced probability be absorbed by camphor.uinone. In contrast &,I of the
emission spectrum of blue -45s is situated between **( and ,(( nm, further the
emission maximum of the blue -45)s is approximately *B, nm. Which is almost
identical to the absorption peak of camphor.uinone.
These facts explain the greater depth of cure and conversion with the -45
lamp versus the halogen lamp as described above. 5espite both lamps operating at an
e.uivalent irradiances modestly greater depth of cure was found when composites
were polymeri!ed with an -ed lamp in comparison with a halogen lamp despite the
former having a measured output approximately '(I of the latter 07'B versus 9EE
mWDcm
7
when measured between *%( and ,(( nm3. This finding also support the
importance of considering the emission spectra of curing lamps relative to the
absorption spectrum of camphor.uinone when assessing the .uality of light
polymeri!ation.
NE#EST A$AILA(LE LIG3T E/ITTING DIODES :
%3 9< 4;:4 4lipar
73 #ree light
93 $>-ight
*3 Aersa -ux
B*
Light 9mitting iodes
,3 $ool lu
B3 Jltra>-ume 7
Co%t o* Light Emitting )io)e% :
These light emitting diodes light curing units cost from R%%,(( to R9,(((
depending upon their features.
3o- LEDE% Light C!"ing #o".% :
-ight emitting diodes curing units use Gallium Gitride ;emiconductors which
when sub"ected to electric current produces lue -ight.
Galium Gitride ;emiconductors
4lectric $urrent
lue -ight
a3 -ight is emitted in narrow band in the visible spectrum.
b3 With gallium nitride semiconductors, blue light is emitted with a peak
wavelength of *'( nm.
c3 The semiconductors are aligned in assays as group of light emitting diodes,
depending upon whether the -45s are narrow light emitting semiconductors
or wide light emitting semiconductor.
d3 In some -45 light curing units the -45 alloys are located at the end of the
light guide. 6thers such as 4>light has the -45 array located before existing
the light guide.
e3 It is difficult to align the -45 arrays 8
%3 <ost of the manufacturer)s have positioned the arrays as close as
possible to the surface being cured to maintain as much power as
possible from the light emitting diodes.
B,
Light 9mitting iodes
73 The farther away the arrays are placed from the curing surface -ower
is the 6utput.
TEC3NICAL DESIGN :
In the -45 curing unit, light is produced by means of %& -45s, which are
aligned on three consecutive planes. The distance between the planes, the angles of
emission of the light cones and the angels at which the -45s are placed are chosen to
allow the light rays to enter the end face of the light guide as directly as possible. The
rays of the first and second planes are hardly shadowed at all by the -45s installed in
front of them. Therefore a narrow angle of emission is needed for the -45s situated at
a greater distance from the light guide. The prismatic disc does not bend the optical
path of the rays of the first two -45 planes as they pass through the disc)s planar
area.
Wide angle -45s were chosen for the third plane because the largest portion
of these rays emitted by these -45s is utili!able due to their sort distance from the
light guide. 2owever some of the outer rays would if Jnhindered by pass the light
guide due to the wide angle of emission. The prismatic disc prevents this from
happening since its geometrical design directs these rays back into the optical fiber.
The rays primarily directed into the light guide pass through the planar area of the
prismatic disc like the rays of the first and second planes and are therefore collected
without hindrance.
Another favorable property of the prismatic disk is that it protects the -45
curing from contamination. To further enhance light power, and in order to minimi!e
loss of light intensity due to reflection the diffuser is coated on both sides.
BB
Light 9mitting iodes
The -45 array described above has the benefit that the optical properties of
the -45s themselves 0i.e. their angles of emission3 are utili!ed for light concentration.
A complex arrangement of light collectors 0less systems, reflectors, focused optical
fibers etc( is therefore not needed. This of advantage, since these complex optical
systems can only collects a fraction of each -45)s emission, leading to a significant
loss of light intensity. #urthermore they are more difficult and expensive to
manufacture and re.uire more space than the array described above.
#OR7ING OF SO/E NE#EST LED LIG3T CURING UNITS :
#ree light 7 and ultra lume 7 have significantly grater output than all the other
-45 light curing units. 2ere these -45 light curing units are not arranged in arrays
but they rely on A$ :ower to produce higher output.
Jltra -ume 7 8 2as light output of ,(( mwDcm
7
.
#ree -ight + 78 2as light output of E(E mwDcm
7
.
As compared to other -45)s where they has output between %,7 + *7,
mwDcm
7
.
These light weight -ed light curing units also have excellent depth of cure
when compared to other -ed light curing units.
S+ect"al2O!t+!t *o" Light Emitting Dio)e Light C!"ing Unit% :
The spectral output of the -ed curing lights is a narrow band with a peak
emission of *B( nm + *&( nm. This narrow band does not include I/ 0Infra red3
spectrum which reduces the heat output, but does include JA 0Jltraviolet3
wavelength with adverse biological effects.
B'
Light 9mitting iodes
Time Re9!i"e) &, Le) Light C!"ing Unit% *o" A)e9!ate C!"ing :
With most -45 light curing units, the depth of cure is ade.uate in a 7( second
+ *( second curing time to polymeri!e a 7 mm depth of composite restoration if the
photoinitiator is campro.uinone.
AD$ANTAGES OF LIG3T E/ITTING DIODES LIG3T CURING UNITS :
There are various advantages of -45 light curing units over 1uart! Tungsten
2alogen 01T23 and :A$ 0:lasma Arc $uring3 Jnits.
#h, Denti%t #antE% Le) C!"ing Unit% F
4) I)eal #avelength :
-45 Jnits produces light within a relatively narrow spectral range. The
diodes uses gallium nitride as a semiconductor and produce light with wavelength of
*,(>*&( nm and a peak at *B( nm. And this wavelength is nearly ideal for activating
materials that employ camporo.uinone as photo initiator, but it means these lights will
not properly polymeri!e materials that use some of the new photo initiators that are
sensitive to wavelength of *((>*,( nm.
2) Le%% o-e" 8
-ight 4mitting diode units re.uire less power to operate, because they only
produce light of narrow spectral range. As a result they can be powered with
rechargeable batteries. This makes them possible for them to be cordless portable and
relatively light weight.
3) /o"e com+ati&le an) long li*e :
-ed light curing units can last for about thousands of hours as compared to
1T2 whole halogen bulb tastes for %(( hours. They do not degrade over time.
BE
Light 9mitting iodes
=) Le%% 3eat :
These -45 curing units produces less heat so they are less responsible for
pulpal and gingival irritation.
?) /o)e"ate C!"ing :
They offer a moderate curing time of about %(>7( seconds.
@) Ac!te in O+e"ation :
They are .uite an operation.
G) Long La%ting Dio)e% :
-45 curing units have diodes which are long lasting without the need for
fre.uent replacement.
E3 They use lithium batteries which are 9(I to ,(I smaller than nickel cadmium and
nickel metal hydride batteries.
DISAD$ANTAGES OF LED LIG3T CURING UNITS :
4) Ne-e" Conce+t :
Their concept is new to dentistry and the T$oncept is still) evolving.
2) Slo-e" c!"ing time :
They curing time is slower than that of :A$ light and some enhanced halogen
lights.
93 They batteries must be recharged.
*3 They cost more than do conventional halogen lights.
,3 They offer relatively low intensity.
B3 They uses lithium batteries and there are most expensive rechargeable batteries.
B&
Laser Curing
LASER CURING
5ental lasers were introduced and recogni!ed as a tool for better patient care
in the early %&&(s. In the ensuing years, clinicians have found that practicing cosmetic
dentistry can be more exciting and rewarding by using laser technology for
accomplishing general and cosmetic tasks. $linicians in this speciali!ed area seek to
provide the highest caliber of care, while enhancing the esthetics of the smile. When
considering a smileUs components, cosmetic dentists focus on improvements related to
the color, shape, alignment, and function of the teeth as well as the .uality of the
gingival architecture.
ARGON LASERS
The *EE>nm wavelength of the argon laser has been used effectively to
polymeri!e composite resins because it enhances the physical properties of the
restorative material compared with conventional visible light curing. Argon curing of
dentin bonding also has improved adhesion compared with conventional visible light
curing. Argon curing of sealants improves the attachment to the enamel surface and
reduces microleakage significantly compared with conventional light curing. The
benefits of this procedure allow for enhanced physical properties, improved adhesion,
and reduced microleakage, all accomplished in less curing time with argon lasers in
%(>second cycles compared with a conventional curing light administered in *(>
second cycles. The *EE>nm argon laser is an essential tool for a cosmetic or
restorative dentist continually working with composite resins 0the selection of the
composites should be compatible with specific wavelengths3.
'(
Laser Curing
A"gon La%e" Inte"action -ith Re%to"ative /ate"ial%:
$urrently, photoactivated dental resins employ a diketone, such as camphoro>
.uinone, and a tertiary amine reducing agent to initiate polymeri!ation 0American
5ental Association, %&E,= $raig, %&E*3. This photoinitiator system is sensitive to light
in the blue region of the visible spectrum with broad peak activity in the *E(>nm
region 0$ook, %&E73. When exposed to light of this wavelength, free radicals are
formed that induce the polymeri!ation reaction. $urrent visible light units use a
tungsten>halogen bulb as the light source and a filter to reduce the output of undesired
wavelengths. The argon laserUs monochromatic wavelengths of *EE nm and ,%*., nm
have been shown to be effective in the initiation of polymeri!ation of dental resins.
;tudies by lankenau et al have demonstrated that the argon laser can be used to
polymeri!e both hybrid and microfilled composite resins with an enhancement of the
physical properties of the polymeri!ed restorative material following argon laser
exposure compared to conventional visible light curing. This tendency was more
pronounced for the microfilled materials and appeared to be related to the fact that the
argon laser was associated with a greater degree of resin polymeri!ation 0lankenau
et al, %&E&3. Additional research has shown that when argon laser energy is used with
dentin bonding materials, adhesion to dentin will rival or exceed that which is
obtainable with conventional visible light sources 0lankenau et al, %&E&b3. The
attachment of pit and fissure sealants to the enamel of teeth was also significantly
improved with argon laser polymeri!ation compared to visible light curing and the
microleakage associated with these sealants was significantly reduced. It has also
been demonstrated that the enhanced physical properties, the improved adhesion, and
the reduced microleakage can be achieved with significantly reduced exposure time.
Argon laser polymeri!ation re.uires a %(>second cure cycle while visible light acti>
'%
Laser Curing
vation usually takes approximately *( seconds 0lankenau et al, %&&(a, %&&(=
lankenau et al, %&&7, %&&73.
An examination of the physical and mechanical properties of a restorative
material can be useful in predicting how that material will endure in the oral
environment. $ompressive strength is a measure of a materialUs resistance to fracture
or failure when compressive loads, such as mastication, are applied. It, therefore, can
provide an indication of how a restorative material will perform during function.
Argon laser polymeri!ation of microfilled and small particle resins resulted in slightly
greater, but not statistically significant, compressive strength values when compared
to those with visible light activation.
At the very least, this demonstrates that argon laser activation of resin
polymeri!ation does not impair the attainment of current clinically acceptable
compressive strength values. Interestingly enough, the attainment of these comparable
compressive strength values was achieved with one fourth the polymeri!ation time
re.uired by visible light activation.
#unctional stresses in the oral cavity typically are not solely compressive in
nature. -ateral forces that tend to elongate or stretch a restorative material are also
present. 5iametral tensile strength values should provide an indication of a materialUs
resistance to these forces. Argon laser polymeri!ation resulted in greater diametral
tensile strength values for both micro>filled and small particle resin>restorative
materials, and these differences were statistically significant. It may be inferred that
argon laser>polymeri!ed restorations should be better able to resist these lateral,
tensile forces generated during function. #unctional stresses can also result in the
distortion or deformation of a restoration.
'7
Laser Curing
Transverse flexural strength is a measure of a materialUs resistance to dis>
tortion. When results with argon laser polymeri!ation were compared to those with
visible light activation, the transverse flexural strength of a microfilled resin and a
small particle resin were both improved with the difference being statistically sig>
nificant for the microfilled material. /elated to this concept of restoration deformation
is the flexural modulus, which is a measure of a restorative materialUs stiffness or
rigidity. This can be important clinically because if a large discrepancy exists between
the flexural modulus of a resin restorative material and the surrounding tooth structure
to which it is. attached, shear forces could develop at that point of attachment 0ie, the
enamel or dentin bond3. This would be most likely to occur when the less rigid resin
restorative material bends as occlusal loads are applied and the more rigid or stiffer
tooth structure does not. This could ultimately lead to margin failures of the
restoration and the subse.uent problems of interfacial staining, microleakage, and
secondary caries. As observed with the transverse flexural strength, argon laser
polymeri!ation yielded flexural modulus values for both microfilled and small particle
resins that indicated these materials would be more resistant to deformation than when
conventional visible light activation was used, and these differences were statistically
significant for the microfilled material.
<icrofilled materials tend to have a greater resin content and a lower filler
particle loading than their small particle counterparts. ;ince the microfilled materials
have a greater resin content, it would appear that they have a greater relative
component that is affected by the polymeri!ation process. ;ince the argon laser
represents a more effective means of polymeri!ation, its results should be most
apparent in those materials that have the greatest component in need of
polymeri!ation, in other words, the resin matrix. This could possibly explain the
'9
Laser Curing
differences encountered between microfilled and small particle composite resin
materials as well as account for the improvements noted with resin rich materials such
as pit and fissure sealants 0lankenau et al, %&&73.
A"gon La%e" hoto+ol,me"i6ation o* Com+o%ite Re%in% :
5uring the %&E(s, scientific studies demonstrated the ability of visible light to
penetrate both composite material and tooth structure to photopolymeri!e
camphor.uinone>activated resins 0;wart! et al, %&E9= #orsten, %&E*= Weaver et al,
%&EE3. <ore recent studies have indicated that argon laser light is effective in
photopolymeri!ation of these systems and improves the physical properties of the
restorations 0Qelsey et al, %&E&= :owell et al, %&E&= ;everin, %&E&= lankenau et al,
%&&%, %&&%3. When used to photopolymeri!e camphor.uinone>activated composite
resins, the argon laser increases the depth of cure, increases the diametral tensile
strength, increases the adhesive bond strength, increases the degree of polymeri!ation
of the material, reduces the acid solubility of the surrounding enamel, and decreases
the time of activation significantly. 6ne weak link of light>activated composite resins,
directional photopolymeri!ation shrinkage, has not yet been reported with the argon
laser in the scientific literature. With the growing demand for cosmetic dentistry and
bonded restorations, the argon laser has a bright future in dentistry.
To cure composite resins, the power output of the argon laser should be set at
7,( to ,(( mW. 5epending on the type of composite selected. The pulse parameters
should be set for a single pulse, with duration of %( sec. Any si!e fiber can be used=
we prefer the 9(( m diameter bare fiber, but many clinicians use the B(( m fiber.
The key is to create approximately a ,>mm spot si!e on the target material. This will
produce a power density of approximately %.7, to 7.,( WDcm
7
throughout the ,>mm
'*
Laser Curing
spot. The laser will ade.uately cure to a depth of 7 mm on most materials in %(>sec.
Incrementally cure the restoration with maximum 7>mm increments %(>sec each. 5o
not exceed B(( W for *( sec on a given increment.
Ca%e 4C Cla%% III Com+o%ite Re%to"ation o* Late"al Inci%o":
A ,9>year>old white man with an unremarkable medical history sought
treatment. 2is maxillary right lateral incisor had a distal incipient carious lesion. After
local anesthesia and isolation with a rubber dam, the lesion was exposed and debrided
with a high>speed handpiece and carbide bur. The composite restoration was then
placed with standard procedures. The argon laser was used to photopolymeri!e the
material with ,(( mW, , mm spot si!e, and %( sec pulse. The material may be cured
from one position if the restoration does not exceed 7 mm in depth from the buccal to
lingual aspects, or may be cured about %( sec each from the buccal and lingual
surfaces. This restoration was polymeri!ed for a total of %( sec. When
photopolymeri!ing anterior porcelain veneer restorations, expose the restoration
incrementally with , mm spots at ,(( mW, %(>sec duration, until the entire restoration
has been covered.
Ca%e 2C Cla%% $ Com+o%ite Re%in Re%to"ation% in a Ge"iat"ic atient:
#ig shows a segment of the mandibular dentition of a geriatric patient who
had serious cardiac problems, the complications of which contributed to a significant
amount of recurrent decay. <ost of the oral changes occurred within a B>month
period. An argon laser was used to polymeri!e conventional light>cured composite
resin restorations. In addition to improving the physical properties of the restorative
material, this method of curing may be beneficial to the older patient, because it has
',
Laser Curing
the potential to create a more acid resistant surrounding tooth surface, which will
enable the teeth to better resist the illness>related changes in the oral environment.
Ca%e 3C Con%e"vative Cla%% II /ola" Re%to"ation:
A %B>year>old white male with an unremarkable medical history underwent an
examination. The maxillary left first molar was diagnosed with a carious lesion on the
mesial and occlusal surfaces. After local anesthesia and isolation with a rubber dam,
the lesion was exposed and debrided with a high speed handpiece and carbide burs.
The enamel and dentin were etched in preparation for the placement of a posterior
composite restoration. After the application of the adhesive, the unfilled resin was
cured with the argon laser at (.,( W for , sec. With a matrix retainer, the posterior
composite filling material was placed according to the manufacturerUs directions. The
composite was then cured at 9 mm deep increments at (.,( W, , mm spot si!e, and
single pulse of %( sec for each increment. At 7E days after placement of the
composite, the posterior restoration demonstrated an excellent clinical appearance.
While the restoration may be cured with the fiber stationary, alternative techni.ues
suggest moving the fiber continuously to assure even distribution of the laser energy
within the restoration.
Ca%e = : E%thetic Denti%t", :
A patient sought treatment for the repair of an incisal edge defect on the
central incisor and the diastema between the incisors. The argon laser was used at
79% mW of power for a %( second cure cycle to polymeri!e each increment of
composite resin. $omposite resin was placed according to the manufacturer)s
directions. Gormal placement, finishing, and polishing techni.ues were used.
'B
Laser Curing
ecause of the numerous increments re.uired to properly restore this case, laser
polymeri!ation resulted in a considerable reduction of time to complete the treatment.
Ca%e ? : hoto +ol,me"i6ation o* Gla%% Ionome" (a%e /ate"ial :
The polymeri!ation of light activated bases andDor liners can also be
accomplished with the argon laser. An argon laser was used at 79% mW of power for
%( sec to polymeri!e a typical light activated base, with an excellent result.
<a"or problems associated with the use of light activated bases and liners is
the time re.uired to polymeri!e them and gaining access in deep areas of preparations
to bring the conventional light to these areas. The argon laser with a wide variety of
fiber si!es provides access to all locations of a cavity preparation. The reduction in
polymeri!ation time is a benefit in each case.
The argon laser can be used to photopolymeri!e any light activated restorative
material with a campho.uinone activated resin. The feature will most certainly make
the argon laser a primary instrument for the general practitioner.
(AC7GROUND:
The argon laser is a versatile multiwavelength laser with many proven and
potential clinical applications in dentistry. Its seven wavelengths range from *,'.& run
to ,%* nm, emitting a blue>green visible light with *'B nm, *EE nm, and ,%* nm
being the strongest wavelengths, allowing it to be used for polymeri!ing of light>
activated materials as well as cutting soft tissue. In %&E&, :owell et al showed that ,
seconds of argon laser exposure created a composite with higher compressive
strengths than 7( seconds of visible curing light. They showed that with ',I less
time the argon laser could produce e.ual or better results than the conventional
halogen light.
''
Laser Curing
;evrin and <a.uin reported the ability of the argon laser to increase the
hardness of composite resin as compared with samples that had been cured with the
halogen light. They also predicted the use of the argon laser for clinical applications if
a minimum of 9(( mW could be produced. Qelsey et al showed improved physical
properties of %(>second cured argon samples versus visible curing light at *( seconds.
These properties included diametral tensile strengths, transverse flexural strengths,
and compressive strengths. They reported significantly increased physical properties
with less curing time.
At the %&E& International Association for 5ental /esearch 0IA5/3 meeting,
Arai et al likewise showed the beneficial effects of the argon laser on the Qnoop
hardness number of composite resin, and at the %&&% IA5/ meeting, urtscher
reported on the positive effects of the argon laser on curing depth of composites.
lankenau et al showed that laser curing converted a greater amount of monomer to
polymeri!ed resin, leaving less unreactive monomer than that cured with a visible
light, and -osche reported a greater conversion rate of camphoro.uinone with the
argon laser.
The camphoro.uinone photoactivated resins have their peak activity for
conversion between *'( and *E( nm. The argon laser is effective and beneficial in
polymeri!ing these resins because the argon laserUs wavelengths of *'B nm and *EE
nm are in this peak activity range. The argon laser emits a blue colored light that is
visible and, as published data have indicated, highly effective in polymeri!ing light>
activated restorative materials.
In Fune %&&%, the J.;. #ood and 5rug Administration 0#5A3 cleared for
marketing and clinical use the first argon laser for polymeri!ing of light>activated
'E
Laser Curing
materials and soft tissue surgery. ;ince that time, the argon laser has received
clearance in other countries as well, leading to expanded clinical use of the argon
laser. The laser can be used in con"unction with all clinical aspects of composite resin
curing at approximately 7,( mW of power. After acid etching, the laser is used to cure
the bonding materials in 7 to , seconds before polymeri!ing and bonding the
composite resin to the tooth, using a %(>second cure time. This approach provides a
clinical result that is e.uivalent to visible light>cured resins cured with *(> to B(>
second exposure but is accomplished in
less time.
CLINICAL ALICATION
The argon laser is useful in class 7 composite restorations, not only because of
the decreased curing time needed, but also the small fiber si!e allows for easy access
of the curing light to the interproximal box area and provides a highly satisfactory
result for the completed restoration. Qelsey et al published data showing that optimal
results can be accomplished with only 7,( to 9,( mW of argon laser power, and
likewise, optimal results are achieved with only %( to %7 seconds of curing time.
;tudies continue to support the ability of the argon laser to cure composite fast and
effectively with Aargas et al reporting ade.uately polymeri!ed composite resin in 9(I
to ,(I less time and $hristensen and $hristensen reporting polymeri!ation in %(
seconds or less for five different resins. ;pot si!e of the argon laser has little or no
bearing on the strength of the material. Aw and Gicholls showed there was no
significant difference in shrinkage of composites cured with an argon laser or halogen
light, and $hristensen and $hristensenV confirmed that short curing times with the
laser did not affect shrinkage. ;everin and <a.uinUs predictions seem to have been
substantiated through research.
'&
Laser Curing
:ulpal histologies from in vivo testing confirm that the argon laser at energy
levels used in restorative dentistry creates neither short>term nor long>term pulpal
pathology.
Tests by the authors research group have shown the effectiveness of the argon
laser in polymeri!ing restorative materials other than composite. -ight>activated
cavity liners, such as Timeline 05entsplyD$aulk, <elford, 543,show significantly
improved diametral tensile strengths with shorter cure times than the same material
cured with halogen light. -ikewise, all light>activated glass ionomers tested by
lankenau et al showed significantly better diametral tensile strengths when cured
with the argon laser. Additionally, the argon laser is effective clinically for applying
pit>and>fissure sealants. With a curing time of only , to %( seconds, it is easier for the
patient to remain still as well as to control salivary contamination, providing a good
clinical result. -aboratory tests have shown less microleakage of sealants cured with
the argon laser versus those cured by the visible light source, in addition to only %(
seconds of curing time being needed. 5iametral tensile strengths of the sealants cured
with the laser were also greatly improved. The laser seems to provide a significantly
improved pit>and>fissure sealant.
;tudies with the argon laser have shown that by replacing the visible cure
halogen light with an argon laser, improved bond strengths could be achieved. :owell
et al reported that enamel bond strengths using ;cotch ond 7 09< 5ental :roducts,
;t. :aul, <G3 were e.ual to or slightly better than those achieved with the visible
light but re.uired only , seconds of curing time instead of 7( seconds. lankenau et al
also reported on significantly improved dentin bond strengths using the argon laser
E(
Laser Curing
instead of the visible light. ;hanthala and <unshi showed a %BI to 7,I increase in
enamel bond strengths through the use of argon laser for curing.
ecause of the multiple wavelengths in the argon laser, it also can be used for
soft tissue surgery, such as removing fibromas, hyperplastic gingiva, and excess tissue
around restorations and controlling bleeding around crown preparations as well as
many other soft tissue surgical procedures. Its advantages are similar to other lasers8
little or no bleeding, little swelling after surgery, and minimal postoperative
discomfort.
Clinical Ca%e
A %&>year>old female student re.uested cosmetic correction of the large spaces
between her lower anterior teeth. The teeth were radiographically and clinically
sound. Jsing cotton roll isolation, the teeth were cleaned with flour of pumice and
water using a slow>speed handpiece on a rubber cup. After cleaning, the teeth were
rinsed with water and dried. Jsing a phosphoric acid gel, the interproximal surfaces
were etched for %( seconds and rinsed with water. After rinsing, the excess water was
removed using pledgets of cotton, but the teeth were not desiccated. Jsing a wet
bonding agent 0:rime and ond 7.%, -.5. $aulk, $o3, the bonding agent was applied
to the acid conditioned surface ad left on the tooth for 7( seconds. 4xcess bonding
agent was removed with a gentle stream of air, then laser cured for , seconds. T:2
05entsply D $aulk, <elford, 543 was used as the restorative composite to achieve the
desired shape. The material was light activated with the argon laser light at 79( mW
of energy for %( seconds per increment. After all areas were polymeri!ed, the
restorations were shaped and polished using conventional polishing techni.ues.
6cclusion was ad"usted and home care instructions were given. :ostoperative
photographs are immediately post insertion.
E%
:enon Curing
HENON CURING
INTRODUCTION
#lash curing is inherently different from other methods of curing such as
mercury vapor or microwave generated ultraviolet sources. #lash curing is
particularly useful in applications where other curing methods have proven
inade.uate. The advantages of flash curing include8 faster free radical generation,
increased surface penetration, less dependence on photoinitiators, greater safety,
lower heat transferred to substrate, curing of opa.ue systems, ease of meeting
special lamp configuration re.uirements.
LA/ LIFE
A ma"or obstacle to the growth of this technology was lamp life. In the past,
xenon lamps for curing applications have lasted only from *( to B( hours. This
problem was overcome with a novel 0patent pending3 approach to long life without
sacrificing power density. The new lamps are guaranteed for %((( hours and prorated
for 9((( hours. This new development has opened the door to the commercial
exploitation of this exciting technology.

C4G6G -A<:;
E7
:enon Curing
(AC7GROUND
The relative differences between flash energy and continuous wave 0$W3
radiation in terms of pulse amplitude and controlled spaced pulses. The peak power
levels with flash energy can be as high as %( x %(B watts with pulsed widths in the
microsecond region. The flashlamp spectrum is directly dependent on the
characteristics of the electrical operating conditions. The optimum wavelength can be
generated by shifting the current density to a reading that will yield the desired
spectrum for a particular application be it in the JA, visible, or I/ region. The spectral
shift in relation to lamp current densities. The broad spectrum can be VtunedV to peak
at different spectral ranges. The basic electronic circuit, represents a typical design for
flash radiation. The power supply provides the current for charging the main storage
capacitor. Then the lamp is triggered, the stored energy is released from the capacitor
in the form of a current pulse which is shaped by the pulse forming network. The
controlled, short duration current pulses are converted to spaced light by the
flashlamp, yielding distinct light pulses of very high peak power. The two key
e.uipment parameters that affect cure are pulsed recurrence fre.uency and spectrum.
These parameters can be VtunedV to a specific chemical system.
AD$ANTAGES OF FLAS3 CURING
Why should anyone use this method of curing instead of several of the other
alternativesW The most common responses from customers when asked this .uestion
are=
-ow heat
;pecial lamp configuration
2igh radiation deliverable in a short period of time less dependence on
photoinitiators penetration of thick and opa.ue systems
E9
:enon Curing
AC Lo- 3eat
The lower heat associated with xenon flash curing is a real advantage in curing
coatings, inks or adhesives on heat sensitive substrates, especially :A$ 0polyvinyl
chloride3 and #4 0polyethylene3 films. The lower heat is attributed to three
characteristics of the xenon flash lamps8 %3 pulse separation, 73 conversion to useful
radiation without heating to vapor levels as re.uired with mercury lamps, 93 minimum
I/ generation. In addition, the air around the lamp can be cooled to a lower
temperature without effecting radiation efficiency. The maximum temperature of the
material being cured is between %(( and %,(U#, depending on the formulation.
(C S+ecial Lam+ Con*ig!"ation
The nature of the flash lamp is such that it will work in any configuration a
glass blower can shape as long as the operating parameters are properly matched for
the efficient generation of useful radiation.
CC 3igh Ra)iation Delive"a&le In A Sho"t e"io) O* Time
It is clearly demonstrated in figure % that a single pulse of light can deliver as
much energy as a continuous system in a fraction of the time. The pulsed system can
deliver ,(( Foules in one millisecond as opposed to the one second re.uired by the
continuous system. y simply delivering %( pulses per second, ten times the energy
can be delivered to the chemical system for curing.
DC Le%% De+en)ence On hotoinitiato"%
The broad band spectral output allows for the consideration of reducing the
photoinitiator percentage as well as the use of combinations of photoinitiators and
E*
:enon Curing
photo accelerators taking advantage of the effective characteristics of each by
obtaining synergistic results.
EC 3igh ea. o-e"%
In addition to delivering more energy faster, the high peak pulses and longer
wavelengths have an advantage in penetrating thick and opa.ue materials. Gigh
performance materials are claimed to be obtained with the combination of these
curing methods. The production of new photochemical reactions has also been
attributed to the high peak powers.
6ther useful advantages of pulsed light curing include8 instant onDoff
operation, low space re.uirement, and significant output in the visible region of the
spectrum. The latter has opened the door to a safer visible light curing technology.
<uch work remains to be done in the development of visible light curable formulated
products.
E8UI/ENT
There are two standard xenon flash curing units currently available8 a portable
%7( watt unit for curing areas up to %V x %V, and a , kilowatt production unit for larger
areas. A % kilowatt unit is also under development.
AC 42> #att o"ta&le Henon Fla%h C!"ing Unit
As can be seen in figure B, this unit consists of a desk top cabinet with a hand
held lamp connected to the cabinet by a flexible hose. It was designed for high speed
curing of coatings and adhesives In small areas, that is less than or e.ual to %V x %V.
The fast cures are achieved with a high fre.uency pulse train delivered In>a burst
mode. This unit may be run continuously if desired.
E,
:enon Curing
(C ? 7ilo-att Henon Fla%h C!"ing Unit
This unit is illustrated in figures ' and ;. It contains a novel lamp design
0patents pending3 that finally makes it possible to obtain long lamp life without
sacrificing power density. This is accomplished with an alternating lamp. The linear
section of the I;V conveyor received 7E( wattsDinch but the lamp itself is operated at
,( wattsDinch because it is actually &,V long coiled into five parallel %,V sections.
<any attempts were made in the past to duplicate the mercury vapor lamp powerDinch
rating with xenon linear flashlamps but at 7((>9(( wattsDinch, the flashlamp life was
extremely short. 6ther advantages of this design include the capability of varying
lamp configuration to suit particular applications and the ability to, operate at lower
temperatures than is possible with other lamps.
ALICATIONS
The applications have been categori!ed into two groups based on the standard
xenon flash curing e.uipment available. The first group is called small area and refers
to curing areas less than %V x %UX, using the %7( watt unit. The second group, large
area, refers to any area or geometry larger than %V x %V, using the , kilowatt unit.K
AC Small A"ea A++lication%
A common small area application is retouching or repairing of JA cured
coatings. The portable unit with the curing head connected by a flexible hose makes a
handy touch up tool. 6riginal curing of small areas include8 fiber optic connections,
lens alignment, wire tacking, coil termination, and general purpose connectors and
switches. The key advantages of the xenon flash curing in these applications are speed
of cure and delivery of light from a locali!ed source.
(C La"ge A"ea A++lication%
EB
:enon Curing
The large area applications include8 fast cure of clear and pigmented coatings,
curing laminating adhesives through one transparent substrate, curing composites, and
catalysis of photochemical reactions. ;everal other current applications are
confidential.
4C Coating%
5ue to the broad spectrum available, both radiation curable and heat curable
formulations have been cured by the flash method. The xenon source is an efficient
free radical generator. 5epending on the formulation, systems containing
photoinitiators or heat activated peroxides, and some containing neither have been
cured faster with xenon flash than by alternative methods. 6ne of the first costing
applications was the rapid curing of unsaturated polyester by xenon flash for a motor
overcoating. $ure time was reduced from the conventional heat curing for *>; hours
to a 7 minute flash curing.
Another coating application for flash curing is on heat sensitive substrates. As
more products are designed with plastics of low heat tolerance, conventional heat
curing methods can no longer be utili!ed. The xenon source has been found to
generate much less heat than the mercury vapor 5A sources.
2C Laminating A)he%ive%
#lash curing is especially attractive in curing laminating adhesives through a
transparent substrate because of its deep penetration characteristic. Geat sensitive
substrates such as :A$ 0polyvinyl chloride3 and :/ 0polyethylene3 are laminated to
film, foil or paper and the adhesive is rapidly cured with the xenon flash.
3C Com+o%ite%
Glass epoxy prepregs of %D%B and %D, inch thickness have been cured by xenon
flash. The AG</$ 0Army <aterials S <echanics /esearch $enter3 in Watertown,
E'
:enon Curing
<assachusetts, has an ongoing pro"ect evaluating flash cured prepregs in comparison
to conventional autoclaved prepregs. <ilitary and commercial use of glass reinforced
plastics has been extensive because of the strength to weight ratio and cost advantages
offered by these materials over other structural materials.
=C hotochemical Reaction%
There are numerous pro"ects underway to initiate chemical reactions with the
xenon flash source. There is a great potential for increasing chemical reaction rate,
thereby reducing processing costs.
EE
Selection and ;aintenance

LIG3T CURING UNIT SELECTION AND /AINTENANCE
Selection :
There is no one best visible light curing unit, since different units work better
for specific applications. The diameter of cure, for example, is not critical in the
placing of only $lass III, $lass A, and $lass IA restorations= whereas, a unit with a
larger diameter of cure saves chair time by curing larger portions of composites and
veneers during each curing cycle. 5entists placing indirect veneers should have both
a wide curing tip and a high intensity light 0as measured by a radiometer3. The
minimum intensity for light cured cementing of lucent indirect veneers is usually *((
mWDcm
7
over the entire diameter of the curing tip.
To summari!e, there are several factors that must be valuated before
purchasing a visible light curing unit 8
%. :ower density
7. <aximum diameter of curing tip
9. Jniformity of power over the diameter of the curing tip.
*. -ongevity of ade.uate light spectrum once the unit is turned on
,. 2eat generation within the tooth
B. 4ase of use of controls and timer
'. 5urability of curing tips to sterili!ation
E. 5ependability of unit
&. ;i!e and portability of unit
%(. Aoltage regulation
%%. :rice 8 performance ratio
E&
Selection and ;aintenance
A light curing unit should be considered a long term investment, like a
handpiece that is used daily for many years. 6wning more than one unit is
recommended so that if one becomes inoperative, the other is available to complete
procedures in progress.
/aintenance :
A number of features must be checked to ensure that a visible light curing unit
is operating at full capacity
.
C!"ing Ti+ :
$omposite buildup on the curing tip can greatly reduce light intensity.
$omposite buildup occurs when the curing tip touches the composite during curing.
Gote 8 The ideal curing distance is % mm. At least one manufacturer, 5emetron, offers
a cleaning kit to eliminate buildup.
Fi&e" O+tic Co")% :
The fibers of fiber optic bundles are brittle and break down if repeatedly bent.
:rocedures and storage that bends the cords unnecessarily should be avoided.
Light G!i)e% :
-ight guide tips should be shiny and free of materials. Autoclaving can be
used for cleaning most light guides but may eventually cause some degradation,
observed as cloudiness at the ends of the fibers. ?oiler scale@ results from repeated
autoclaving of rigid light guides.
&(
Selection and ;aintenance
Filte"% :
<ost curing units have a filter that selects out the appropriate wavelength to
block glare, heat, light, and any energy not used in the curing process. This filter is
usually located between the curing bulb and the cord tip or gun rod. ecause the
filters can pit, crack, or peel, they must be checked regularly and replaced as needed.
Fan% :
The fan should be kept clean by vacuuming the exhaust port where it is
mounted. It is not necessary to take the curing unit apart todo this. $lean fans run
cooler and reduce the chance of heat damage to the housings or other electrical
components. The smaller fans used in many gun type units may need periodic
replacement because of wearon the bearings. Worn bearings are noisy= noise is a
warning of potential fan failure. A noisy fan should be repaired immediately by the
manufacturer. 5o not operate a nit if its fan stops working.
RO(LE/S #IT3 CURING (UL(S :
(!l& F"o%ting :
ulbs become frosted when the glass enclosing the filament becomes cloudy
or white. This occurs as a result of either deposition of metal oxides, which vapori!e
and form a film on the glass bulb 0which is called the envelope3, or a process known
as devitrification in which impurities in the glass .uart! envelope crystalli!e. #rosting
can result in a *,I drop in curing light output.
&%
Selection and ;aintenance
(!l& (lac.ening :
The deposition of silver and other metal oxides on the internal glass portion of
a bulb causes black discoloration. Although the filament is still emitting light, the
black oxide can result in a '*I drop in curing light output.
Filament (!"no!t :
When the filament is broken, there is a complete loss of light output.
Re*lecto" Deg"a)ation :
/eflector degradation occurs when there is a loss of the reflector film or a
white or yellow coating of oxides develops over the reflector surface. This can result
in a BBI drop in curing light output.
ecause of these problems, curing lights gradually lose intensity. A dentist
should have on hand two new replacement bulbs for each curing light operated, one
for immediate replacement and a second in the event the primary back up bulb does
not function. This is a small investment considering the considerable inconvenience
of curing lamp failure.
-ight emitting diodes have fewer maintenance problems than halogen bulbs
generally but must be checked for decreased power density owing to heat
accumulation during long curing times. 2eat also an result in -45 degeneration over
time.
&7
Selection and ;aintenance
Ra)iomete"% :
A radiometer is a speciali!ed light meter that .uantifies blue light output= a
radiometer determines the effectiveness of a curing unit by measuring the intensity of
*BE nm light coming out of the tip of the light guide. /adiometers are sold as small
handheld devices or may be built into curing units.

It is important to test a curing light when it is new to obtain a baseline for
future reference. <ost radiometers measure light in the *(( to ,(( mm bandwidth.
This is broader than is re.uired by most photoinitiators and makes these units less
reliable in evaluating curing units with narrower spectral outputs 0i.e. -45s and
lasers3. This means the typical radiometer cannot be sued to compare the efficiencies
of -45s and halogen curing units. A speciali!ed radiometer capable of measuring a
narrower band width around *BE nm would give a more precise measurement of any
unit)s spectral bandwidth.
6ngoing testing of curing units is important, especially as the bulb approaches
,( hours of use. 5isregard for light intensity could lead to restorations that discolor,
leak, break, and prematurely wear away. Gote that some radiometers 0eg, the 2eat
/adiometer from 5emetron3 measure glare and heat at ,7( to %%(( nm. This is useful
&9
Selection and ;aintenance
in comparing units to ensure that the curing light is properly filtering out unwanted
light wavelengths that can unnecessarily heat a tooth.
(!l& Aging :
Aging causes the light to change from a short wavelength blue to a longer
wavelength yellow and reduces the available amount of *BE nm light. These changes
are gradual and occur in all high intensity lamps, including those used or operatory
lights. Although the output of -45s drops over time, the wavelengths of that output
remain more consistent.
Im+"ove) O!t+!t (!l&% :
When visible light curing units were developed, the slide pro"ector lamp was
chosen as the light source because of its availability and small si!e. <ost curing
lights still use these bulbs. Jnfortunately, their design fre.uently results in a spot of
high intensity at the center of the light guide and less intensity at the outer edges.
This drop off in intensity is more severe with large diameter light guides. :ro"ector
lamps also have a silver reflective coating that reflects all visible light for correct
color duplication. 6nly *BE nm light is useful in curing= the unnecessary wavelengths
of light produce unwanted hat that stresses the filters. $urrently, most curing lamps
can accommodate speciali!ed bulbs to improve their performance. In addition, curing
tips that collimate the light down to a smaller spot si!e 0eg, turbo tip, 5ementron3 can
be used to further increase power density.
$ustomi!ed bulbs have been developed 0eg, the 6ptiulb, 5emetron3 that
offer the following important improvements over conventional bulbs 8
%. The lamp distributes light uniformly for light guides of all diameters. The
reflector has a deep dish design, with a larger surface area, that collects more
&*
Selection and ;aintenance
light than standard lamps. This results in higher efficiency and greater light
output.
7. The reflector coating is optimi!ed to reflect only the blue light energy that is
useful for curing composite materials. Wavelengths of light other than *BE nm
pass through the reflector and are removed.
&,
<cular %azards of Curing Lights
OCULAR 3A5ARDS OF CURING LIG3TS
OCULAR 3A5ARDS OF CURING LIG3TS :
Jltraviolet light>curing units preceded those using visible light. ecause JA
light is harmful to human skin and eye tissues, the JA curing units included shielding,
and manufacturers warned about the dangers of light exposure. <any dentists were
concerned about using the lamps near patients and staff.
The introduction of the visible light>curing unit prompted great excitement. To
many, the name implied that the light was harmless. 2ow could visible light be
harmfulW The human eye is adapted to the diffuse light found in the forests where
early man lived. <ost of this light was in the yellow and green range= that is still the
wavelength of light most suited for the human eye. The blue light used to polymeri!e
composite is not well tolerated by the human eye. All light>cured polymeri!ation
systems use light that is harmful to vision. The human eye transmits *(( to %*(( nm
of light to the retina. The visual range is *(( to '(( nm. As a lens ages it yellows and
absorbs wavelengths between 97( and *(( nm.
The high>energy blue light emitted from a composite curing unit initiates the
curing process by splitting the double bonds of the camphoro.uinone accelerators,
thus forming free radicals that start resin polymeri!ation. 6f all visible light
wavelengths, blue light is the least essential to vision. The macula lutea provides a
yellow filter in the central area of the retina and absorbs short wavelengths of light.
Aision is most acute in this central area, because the yellow filter enhances acuity.
<arksmen, for example, wear yellow>tinted glasses to reduce blue blur and sharpen
contrast. The eyeUs focal distance varies with the visible wavelengths because the lens
refracts blue light differently than other wavelengths of visible light. Generally, blue
&B
<cular %azards of Curing Lights
light is not focused on the retina, since the eye needs to focus on the longer
wavelength light reflected off ob"ects. In addition, blue and other short wavelengths of
light are sub"ect to a phenomenon known as scattering. lue light is scattered by the
li.uid media of the eye through which light is transmitted. This scattering reduces the
acuity of vision. In older patients, who have a higher incidence of floating particles in
the eye, blue light causes a blurring of vision.
A number of studies show that blue light is damaging to the retina of monkeys.
It has been shown that blue light forms free radicals in the eye, "ust as it does in
composite resins.

2owever, in the retina, these free radicals react with the water>
content of cells, causing peroxides to form in the visual cells. These peroxides are
reactive and denature the delicate photoreceptors of the eye. The results are harmful to
vision. /esearchers estimate that blue light is 99 times more damaging to the
photoreceptors of the retina than is JA light.
4ven small doses of blue light are thought to be damaging. -ike the chemistry
of composite curing, the biochemical mechanism of vision uses carbon>carbon double
bonds. The active photo>receptors of the human eye are thought to depend on the
rotation of a carbon>carbon double bond from a vitamin A molecule. A photoen!yme
maintains vitamin A in an unstable, high>energy cis position. When a photon of light
strikes this double bond, the vitamin A shifts to a low>energy trans position and
triggers the process of vision. Adenosine triphosphate 0AT:3 energy is used to
reposition the vitamin A back to the unstable, high>energy cis position so that it can
again react to light. 4ven small amounts of blue light can damage or destroy these
delicate photoreceptors, by splitting the high>energy double bonds of photoreceptors
into free radicals.
&'
<cular %azards of Curing Lights
3ISTOR1 OF E1E DA/AGE RESEARC3 :
It took researchers in the dental profession a few years to reali!e that the light
emitted from visible light>curing units is the blue light known to be harmful to human
vision. /hesus monkeys haveY been the sub"ect of a lot of research in this field. They
are excellent experimental models because their eyes are similar to human eyes.
The first researchers to study eye damage from blue light were Zigman and
Aaugh. They exposed mice to near>JA radiation and reported a thinning of
photoreceptors after %( weeks. After %B weeks, this photoreceptor loss was
accentuated. The destruction continued until all photoreceptors were lost after E'
weeks.
In %&'E, Zuclick and Taboada exposed rhesus monkeys to blue light of 97, nm
radiation and found that retinal damage occurred at exposures below those re.uired to
in"ure the cornea or lens. -ater, this work was expanded into the *(( to ,(( nm
range. 2am discovered that the damage caused from this light was photochemical
rather than thermal or structural
The *BE to *E( nm wavelength of light that light most damaging to the eyes.
The study by 2am showed chat blue light causes retinal burns in monkeys after
exposures of less than % second. As exposure duration increased, the burns became
more severe. This damage has been named Vsolar retinitis.V /etinal burns appeared *E
hours after light exposure and healing occurred in 7( to 9( days. The healed areas
showed permanently degenerative tissues. These damaged tissues historically have the
appearance of senile macular degeneration. In other words, the light exposure rapidly
aged the visual cells of the retina. 2am and <ueller showed that this damage to the
&E
<cular %azards of Curing Lights
retina is irreparable= the damaged rod and cone photo receptors cannot regenerate.
;ome laboratory studies indicate that exposures of under 7 minutes to visible light>
curing units 0total daily dose from 7, cm3 may be safe.
/esearcher 2am considers ,%( nm the minimal cutoff point for severe eye
damage 02am WT. :ersonal communication3. ;horter wavelengths, those **% nm.
which is the most damaging wavelength, is 7., times more damaging than *EE nm.
Griess and lankenstein have shown that repeated exposure to low levels of blue light
produces cumulative retinal in"ury in rhesus monkeys.

They found that the additive
effect of retinal damage from multiple exposures was &% I greater than single
exposures when the interval between exposures was % day. Thus, repeated exposures
to even low levels of blue light can be extremely damaging.
Oounger eyes are more susceptible to blue light damage. It is important to
educate staff about this so they can ensure that children are prevented from staring at
curing lamps during treatment. the resulting damage could be profound and life long.
E1E ROTECTION :
In most clinical situations, the blue light in contact with the eyes is reflected
light. <any scientists believe that reflected blue light is less harmful to the eye, but
"ust how much safer it may be has not been established by research. In any case,
scientists or shields when working with visible light>curing lamps. Any protective
eyewear should transmit less than %I of wavelengths below ,(( nm.
The best eye protection is to completely avoid looking at the curing light
source. $overing die curing site with a dark ob"ect would be ideal. ;ome clinicians
cover the curing site with their hand. This may prove an unsafe practice. In cell
&&
<cular %azards of Curing Lights
research, blue light is used to induce cancer growth= therefore, skin exposure is
highly discouraged.
A simple yet effective way to provide shielding from curing lights is to cover
the curing field with the reflective side of a mouth mirror. This prevents excess blue
light from reflecting back against the restorative and improves curing. If the mirror is
not large enough, a folded patient napkin easily covers most fields. A slight amount of
brightness will show through die napkin and shows if the light is on or off.
If it is necessary to look at the light source for placement, eye protection is
warranted. Jnfortunately, most optical glasses and plastic contact lenses transmit blue
light and near>JA light radiation with little attenuation. A number of colored plastic
glasses and handheld shields are available. ;ome of these plastics 0usually red and
orange3 can block blue light. They can be cut and made into custom shields. 6ver
time, they may need to be replaced, since the organic dyes used to color plastic fade
with use. $olored protective lenses in glasses are another option. The drawback is that
they re.uire a 7> to B>minute recovery period before normal color perception returns.
This temporary distortion can interfere with the ability to "udge shades.
It is easy to test the effectiveness of a light shield. The wavelengths that harm
the eye are the same ones that cure composite. To test a shield 0or pair of protective
glasses3, try to cure composite by shining the curing light through the shield onto
composite. If the composite can be .cured, the shield is ineffective for eye protection.
%((
Re#iew of Literature
RE$IE# OF LITERATURE
F"ei&e"g RSB Fe""acane IL '4DDA) 4valuated the degree of conversion 05$3
and the physical properties of a new dental composite, Artglass 0Qul!er3, designed
primarily as a replacement material for porcelain in :#<s= and compared the efficacy
of two different curing units for two dissimilar composites 0Artglass and
$harisma3.And concluded that Artglass showed a greater 5$ and fracture toughness
#T but a lower 4, Q2G and wear resistance compared to $harisma when similar
curing methods were used.
D"CLein*el)e" an) D"CCha+el 3ill '4DDD) studied about the best intensity in
length curing units and concluded that light intensity for the first lower level should
be around 7,( mWDcm
7
and second higher level should range from B,( + E,(
mWDcm
7
.
Ro- /ill et al '4DDD) hypothesi!ed that a blue light emitting diode light
curing unit can produce an e.ual dental composite depth of cure when compare dot
halogen light curing unit and finally concluded that light emitting diode achieved a
greater depth of cure and also said then performance does not significantly reduce
with time when compared to conventional halogen light curing units.
Altho** OB 3a"t!ng /C '2>>>) /eviewed and connected the scientific
background of light curing with clinical re.uirements and new technical opportunities
in order to conclude the best technology for next generation light curing units. And
concluded proper light 0%3 A minimum dose of light is needed 0wavelength
dependent3= 073 Internal stress can be reduced by giving the sample time to flow
before gel point is reached= 093 An upper intensity limit has to be respected to limit
%(%
Re#iew of Literature
temperature increase as well as light intensity dependent deactivation of activated
photoinitiators. These conclusions can best be reali!ed by using the soft start
approach. A comparison of different light generation technologies shows that -45s
are most likely to shape the next generations of curing lights. 5ue to their superior
power conversion rate as well as to their optimum spectral emission small and handy
devices can be reali!ed that work battery>powered and totally silent.
#a""en DB et al '2>>>) ;tudied the use of protective barriers with curing
light tips and how they will affect the intensity of the light output of commercial light
curing units as measured by a commercial radiometer and concluded that barrier
protection can be used with curing light tips only after determination that the emitted
light intensity output is ade.uate.
Ca"el LCDavi)%on an) Anton IC De Gee '2>>>) reviewed the techni.ues of
light interaction of dental composites with special attention to polymeri!ation efficacy
and shrinkage stress control and concluded that prolonged irradiation time is more
effective for proper conversion than increased energy.
GCL,nn o-ell an) Richa") '2>>>) summari!ed the use of argon laser in
dentistry at powers of 7,( mw ,( mW for %( seconds per increment and concluded
that argon laser provides good curing of light activated restorative materials in shorter
period of time with better physical properties compared to conventional halogen
curing light.
Iac. IC #ichol. '2>>>) studied that the wavelength needed for polymeri!ing
dental composites is *', units and standard blue light has a range of wavelengths
%(7
Re#iew of Literature
from *((>B(( units. #or lasers the range of wavelength is much smaller then that of
blue light that is *B(>,7( units.
Ola* Altho** an) /a"tin '2>>>) reviewed and connected the scientific
background of light curing with clinical re.uirements and new technical opportunities
in order to conclude the best technology for next generation light curing units and
concluded that -45s are most likely to shape next generation of curing lights due to
their super power conversion, optimum spectral emission, small and handy devices,
battery powered and finally totally silent.
Lone, R #B "ice R( '2>>4) /eviewed different light>curing units used for
polymeri!ing restorative resins and their heat production during operation and
concluded that temperature increased by *7I to ,BI when the Turbo -ight Guide
was used compared to the standard light guide for thick and thin dentin specimens.
/itton (AB #il%on N3C '2>>4) Investigated the use, care and maintenance
of light units in everyday clinical practice and concluded that practitioners should
address practical aspects of their increasing reliance on light units, and to this end,
guidance is offered on visible light curing and the care and maintenance of light units.
3amme%*ah" DB et al '2>>2) ;tudied that the availability of light>curable
resin systems has led to the development of a variety of technologies for producing
the light necessary to cure them. 1uart! tungsten halogen, plasma arc curing, laser,
and, recently, light>emitting diode have all been important technologies used to
produce light through dental curing units. 4ach technology has uni.ue advantages and
disadvantages. Thus, it is important for dental professionals to understand the
%(9
Re#iew of Literature
polymeri!ation processes and the ways in which these processes are affected by light
energy.
St",)om CC '2>>2) ;tudied that successful curing depends directly on many
factors of which the most important is the correct functioning of the curing unit to
emit light of sufficient intensity and .uality. If the contribution of any of these factors
is at a less than ade.uate level, the light>sensitive materials will not polymeri!e
completely, which in the long term may be responsible for secondary caries and
decreased longevity of the restoration. #actors which may reduce the light output
include ageing of the bulb and filter, damage of the light guide or fiber optics,
deposits on the light tip due to composite build>up or autoclave scale, erosion of light
tip surface due to immersion sterili!ation, and line voltage fluctuations.
E)-a") ICS-i*t '2>>2) compared light emitting diodes, plasma GI$ and
.uart! tungsten halogen light curing units and concluded that -45 curing light have
much lower irradiance and re.uire longer exposure time to polymeri!e resin
composites than plasma arc curing units.
Go")on ICCh"i%ten%en '2>>2) discussed advantages and disadvantages of
tungsten halogen, enhanced halogen lights, light emitting diodes and plasma arc
curing light and concluded all curing units currently available have shown to cure
resin based composites effective in some what different modes.
Iohn OC(!"ge%% et al '2>>2) compared the performance and limitations of
four types of light curing units and predicted hat curing light of the future will be light
emitting diodes. 2e also discussed different curing modes to improve marginal
integrity and marginal leakage.
%(*
Re#iew of Literature
Richa") (CTC "ice et al '2>>3) compared .uart! tungsten>halogen, light
emitting diode and plasma arc curing lights and concluded that -45 lights used not
able to ade.uately polymeri!e , resin composites and 1T2 delivered the greatest total
energy and always produced the hardest resin composites.
Nomoto R et al '2>>=) 4valuated the light output from -45>curing units
according to the current I;6 standards aperture si!e on irradiance was also evaluated.
And concluded that the irradiance through a *>mm aperture should be used in the
determination of the relationship between depth of cure and light exposure.
Nomoto RB et al '2>>=) 4valuated the characteristics of two kinds of
recently developed light>curing unit= plasma arc and blue light emitting diodes 0-453,
in comparison with a conventional tungsten>halogen light>curing unit and concluded
that both the plasma arc and -45 units re.uired longer irradiation times than those
recommended by their respective manufacturers. $linicians should be aware of
potential thermal rise and JA>A ha!ard when using plasma arc units.
#ataha ICB et al '2>>=) assessed the effects of three common dental photo>
curing light sources 0.uart!>tungsten>halogen 01T23, plasma>arc 0:A$3, and laser3 on
the cellular function of fibroblasts in vitro and concluded that these photo>curing
sources pose some risk of disrupting cellular function in vivo. #urther study is
necessary in other cell types and under more clinically relevant conditions to estimate
the in vivo risk of photo>curing to oral tissues.
Ale:an)e" Uhl et al '2>>=) studied second generation of light emitting diodes
for polymeri!ation of oral biomaterials and concluded that second generation -45)s
%(,
Re#iew of Literature
have the potential to replace halogen light curing units if composites are selected
carefully.
Iohn CC#atana et al '2>>=) studied the effects of three common photocuring
light sources, .uart! tungsten halogen, plasma arc and laser on cellular "unction of
fibroblasts and concluded that those sources posed some risk of disputing cellular
"unction in vivo.
%(B
Conclusion
CONCLUSION
At this time, all the light>curing technologies in the market work
ade.uately when used as directed by the manufacturers. The trend in the profession is
to accept faster curing of resin>based composite. Although there is continuous
confusion on the sub"ect but the rational conclusion is that any of the current concepts
available today will work ade.uately. sources like conventional .uart! tungsten
halogen sources 01T23, high intensity 1T2 /amped, pulse delay methods, argon ion
lasers, plasma arc units and the new light emitting diodes 0-45)s3. All these recent
devices claim advantages of reduced curing time. 5evices have complex construction
and are costlier compared to halogen sources. 6ut of all these curing lights, -45)s
have created a revolution in curing technology. -45)s have a life time of over %(,(((
hours and undergo little degradation of light out put over time. -45)s have relatively
low power consumption, which makes them suitable for portable use. ased on these
developments blue light emitting diodes act as a source of promise to the dentist.
2owever long term clinical results and their effects on some of the properties of the
materials remain .uestionable.
%('
"i'liography
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