How to Use a Dental Curing Light Correctly

According to the American Dental Association, nearly 150 million resin-based restorations and sealants are placed every year. Almost all of these use light-cured resin-based composites. Thus, a light-curing device is now commonly found in dental practices across the country. Some assume that a “point and shoot” technique is sufficient. However, in order to achieve optimal results, dental curing lights must be used correctly.

In the dental field, a curing light can use ultraviolet or visible light, depending on what it is designed for. Both dentist and patient need to wear eye protection to limit damage to the retina for even the 20 seconds to a minute that the light is in use during rapid curing, and the light needs to be well maintained so that it will work properly and effectively. It’s also important to use the right curing light for the right resin product; many lights are designed to handle a range of resins safety.

Using a curing light accomplishes two things. In the first place, it makes sure that the resin cures properly and adheres evenly. When applying fillings, this is critical to keep the filling in place in the mouth. For sealants, the curing light limits the risk of cracks and other problems with the sealant. With adhesives for implants( dental implant motor ) and braces, the rapid, even cure is also designed to limit problems in the future.

How a dentist uses a light-curing unit makes a large difference in the amount of energy a restoration receives. Even when the device is handled correctly, if the energy level is insufficient, then the resulting restoration may not attain expected longevity; this may explain why resin-based restorations last only five to seven years when actual life expectancy should be 15 years or more.

Both light intensity – or irradiance – and the dental application should factor into a dentist’s decision regarding his or her choice of curing light. For instance, irradiance is measured by calculating power output, or milliwatts (mW), of a curing light across the surface area of the curing light guide. A curing light must deliver a minimum irradiance of 400mW/cm2 for a time interval to adequately polymerize a 1.5-2mm thick resin composite.

Clinicians also should consider the clinical application at hand. It has been documented that irradiance of curing lights attenuate/decrease significantly when it passes through restorative materials, such as ceramic restorations or resin composites. The percentage of decrease in irradiance depends on filler type, filler loading, shades, refractive index, opacity, translucency and thickness of restorative materials. Curing lights with high irradiance compensate for the decrease in the loss of total energy and allow dentists to cure resin composites completely. In general, an irradiance of 1000mW/cm2 or higher is considered ideal to cure resin-based materials through indirect restorations.

 

What’s the Basics of Dental Curing Light

Dental curing light is used for the polymerization of light-cured resin-based materials. In the contemporary world of dentistry, curing lights have become an integral part of all specialties and dental practices. Today, almost all resin composites, dental adhesives and adhesive cements utilize light energy for complete polymerization, which further determines the long-term clinical success of a procedure.

While much attention has been given to the details of diagnosis, preparation and the development of improved adhesives and resins, light curing is often taken for granted. It’s a well-accepted fact that inadequate polymerization of the materials can lead to clinical failures, such as sensitivity, marginal discoloration, fractured restorations and de-bonding issues, making it critical to select an ideal curing light.

Curing lights allow us to initiate the polymerization reaction “on demand” for a vast array of materials. However, there is, perhaps, more misinformation and hype regarding this type of dentist equipment compared to just about anything else we use on a daily basis. Most of these controversies center on how long you have to cure specific types of restorations as well as how deep you can cure specific types of materials.

Both light intensity – or irradiance – and the dental application should factor into a dentist’s decision regarding his or her choice of curing light. For instance, irradiance is measured by calculating power output, or milliwatts (mW), of a curing light across the surface area of the curing light guide. A curing light must deliver a minimum irradiance of 400mW/cm2 for a time interval to adequately polymerize a 1.5-2mm thick resin composite.

Clinicians also should consider the clinical application at hand. It has been documented that irradiance of curing lights attenuate/decrease significantly when it passes through restorative materials, such as ceramic restorations or resin composites. The percentage of decrease in irradiance depends on filler type, filler loading, shades, refractive index, opacity, translucency and thickness of restorative materials.

Curing lights with high irradiance compensate for the decrease in the loss of total energy and allow dentists to cure resin composites completely. In general, an irradiance of 1000mW/cm2 or higher is considered ideal to cure resin-based materials through indirect restorations.

 

The Importance of Dental Curing Light

Recently, a new concept to dentistry, the LED, has entered the market. There have been significant sales promotions from the several companies selling LED lights. As a result of the promotions, dentists appear to be more confused than before. In spite of the confusion, sales of these lights has been good, and, with the exception of a poor start by one light that is now off the market, some dentists appear to be relatively satisfied with lights such as the Elipar FreeLight (3M/ESPE, St. Paul, Minn.), the NRG LED Dental Curing Light (Dentsply Caulk, York, Pa.) and the GC E-Light (GC America, Alsip, Ill.).

A light-curing device is now commonly found in dental practices across the country. Some assume that a “point and shoot” technique is sufficient. However, in order to achieve optimal results, dental curing lights must be used correctly. Read on to find out more about how to use a dental curing light so that the resin-based restorations you place in patients’ mouths will be as successful as manufacturers’ claims.

In a collection of articles written for ADA Professional Product Review, Jack L. Ferracane, Professor and Chair, Restorative Dentistry Division Director, Biomaterials and Biomechanics, Oregon Health & Science University in Portland, Oregon states that there is “considerable evidence that delivering inadequate energy to the restoration will result in a restoration that has less than optimal properties and poor clinical performance.”

Ferracane goes on to say that light-cured resin-based composite restorations most often need replacing because of secondary caries and restoration fracture. Other reasons include staining, marginal breakdown, wear, a broken tooth or nerve death. Inadequate delivery of light or energy to the restoration can result in the early breakdown of a light-cured restoration. Therefore, a dental curing light must deliver adequate light energy to attain the best physical, chemical, and optical properties of a resin-based composite restoration.

I would like to comment on what I think are a few mis-understandings about dental curing lights. These are the units that cause dental materials, such as composites, sealants, and cements, to set or polymerize in the mouth. These units produce a visible blue light that these materials absorb, causing them to set.

These lights have been on the market for several years, they have created considerable controversy. Some practitioners have reported that the rapid cure afforded by PAC lights causes damage to both resin-based composite restorations and the tooth preparations.

What’s the Advantages of Different Curing Lights

Without question, light-curing is desirable, but practitioners are confused about the most appropriate light-curing concept to use in their practices. Because of this confusion, some practitioners have continued to use older lights in spite of the advantages offered by some of the newer ones. The light-emitting diode, or LED, concept is challenging more established modes of curing, and some dentists are buying LED lights. And many practitioners who have purchased the even faster plasma arc curing, or PAC, lights are not willing to go back to the slower LED light-curing method.

Since the late 1970s, halogen lights (such as the Optilux 500, Kerr, a Division of Sybron Dental Specialties, Orange, Calif.) have 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 of conventional halogen curing lights:

– Some cost less than other light systems.
– They are based on a simple technology.
– They generate little or no heat.
– Their technology is well-known and nonthreatening.

In the last few years, there has been an emphasis on enhanced conventional 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 size as they exit from the curing light. The Turbo Tip (Kerr) exemplifies this concept. Numerous enhanced halogen curing lights (such as the Optilux 501, Kerr) are on the market, and they have been popular choices for practitioners.

The advantages of  enhanced halogen lights:

– They offer a faster resin cure.
– They operate via a known, proven technology.

Recently, a new concept to dentistry, the LED, has entered the market. There have been significant sales promotions from the several companies selling LED lights. As a result of the promotions, dentists appear to be more confused than before.

The advantages of LED curing light:

– LED lights are cordless, small and lightweight.
– Diodes are long-lasting without the need for frequent replacement.
– They generate no heat during curing.
– They offer a moderate curing time of about 10 to 20 seconds.
– They are quiet in operation.

Some practitioners have reported that the rapid cure afforded by PAC lights causes damage to both resin-based composite restorations and the tooth preparations. Although this subject has been debated for several years, current clinical usage, as well as research, have disproved the allegations of damage caused by the faster lights.

The advantages of PAC Lights:

– Curing time averages three seconds for a typical shade A2 resin-based composite restoration.
– The time savings observed with PAC lights amounts to a significant sum of money over a year’s use.
– Short curing time makes overall procedures shorter and more Dental Products,Dental Supplies integrated.

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Clinical Tips on Dental Curing Light

Dental curing lights, and the science behind them, have seen amazing growth and changes in the last few years. Here’s a look at some of the amazing things that have happened and why you should be aware of them.

The need for a reliable and effective curing light has grown as resin composites and light-cured materials such as sealants and adhesives have grown in popularity. Today the dental curing light is a key part of any dental practice’s armamentarium.

There are many options to consider when selecting the right curing light for your dental practice, but the focus of your search should be to find a light compatible with your preferred restorative materials. A light that operates at a variety of wavelengths will cure the largest number of materials, but it remains important to inquire if the light you want to purchase will work with the photoinitiators in the materials you use. Beyond the actual light the unit produces you also will want to decide if a cordless model is a good fit for you practice.

Another consideration is the body style of the light with pistol grip and wand styles the most common options. The light you choose should be comfortable in your hands and easy for you to maneuver so you can cure restorations throughout your patients’ mouths. A final consideration should be the construction of the light and the warranty backing its performance. You want to be sure your light will work whenever you need it.

Minimize heat by having the assistant direct a stream of air or a high-volume vacuum over the tooth crown during light curing. Placing a wet cotton roll directly on the tooth crown opposite the side of exposure will also lessen temperature rise, but not to the same extent as using air.

Minimize direct exposure to light sources using effective “blue-blocking” eyeglasses or shields for the clinician and patient.

Determine the loss of beam intensity with distance by holding the light guide at different distances from a dental curing radiometer. Curing potential of a restorative material depends on total energy received. Determine power at tip end, and multiply that by the recommended exposure duration — the product is the light energy intensity delivered. When moving the tip away, measure that power level and divide it into the light energy intensity calculated above. The result will be the exposure duration needed to account for power loss with increasing distance.

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