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ABSTRACT
Background: This study aimed to investigate the impact of the duration of light
curing unit (LCU) usage and the use of infection control barriers on the hardness of
Bulk Fill composite resin after curing. The hypotheses were that extended usage of
the LCU would not reduces its output power and resin hardness, and that the
presence of polyethylene film barriers exacerbates the reduction in resin hardness.
Methods: Based on the absence or presence of polyethylene film (PE) and the
number of layers used, a 3M LED curing light (EliparTM DeepCure-S; 3M ESPE, St
Paul, MN, USA) was divided into three groups: PE0, PE1, and PE3. The curing light
was used 30 times daily for 20 s per exposure, at frequencies of 0, 6, and 12 months.
Maximum output power tests were conducted for each group of curing lights.
Custom-made plastic modules were used to stack Bulk Fill composite resin (Filtek
Bulk Fill Posterior Restorative; 3M ESPE) to a thickness of 4 mm. Each group of
curing lights was used to cure the modules in a direct contact manner for 20 s.
Vickers hardness measurements were taken at the top and bottom surfaces of the
resin specimens using a digital microhardness tester. A one-way or two-way ANOVA
analyzed the power of LCUs, Vickers hardness of Bulk Fill composite resin, and
hardness decrease percentage across groups. Pairwise comparisons used the Tukey
test (a = 0.05).
Submitted 7 May 2024 Results: As the duration of usage increased, both the power of the curing light and
Accepted 9 August 2024
Published 26 September 2024
the hardness of the resin significantly decreased. Significant differences were
observed in power and resin hardness among the PE0, PE1, and PE3 groups. When
Corresponding author
Shuli Deng, dengshuli@zju.edu.cn the duration of usage was 6 months or less, only multi-layered PE films led to a
significant increase in the percentage decrease of hardness of cured resin from top to
Academic editor
Amjad Abu Hasna bottom. However, at 12 months, both single-layer and multi-layered PE films
Additional Information and
resulted in a significant increase in the percentage decrease of hardness of cured resin
Declarations can be found on from top to bottom.
page 10 Conclusion: The output power of the light curing unit decreases with prolonged
DOI 10.7717/peerj.18021 usage, thereby failing to meet the curing requirements of Bulk Fill composite resin.
Copyright The use of single-layer PE as an infection control barrier is recommended.
2024 He et al.
Distributed under
Subjects Dentistry, Drugs and Devices
Creative Commons CC-BY 4.0
Keywords Light curing unit, Hardness, Power, Bulk Fill composite resin
How to cite this article He X, Zhang D, Deng S. 2024. Effect of duration and infection control barriers of light curing unit on hardness of
Bulk Fill composite resin. PeerJ 12:e18021 DOI 10.7717/peerj.18021
INTRODUCTION
Since the publication of the first successful case using resin-based composite materials
filled by Bowen (1963), light-curing composite resins have become widely utilized in
clinical dentistry due to their aesthetic appearance, high plasticity, and ease of
manipulation (Fidalgo-Pereira et al., 2022; Guan, Zhu & Zhang, 2023). Concurrently, light
curing unit (LCU), serving as essential equipment for curing light-cured resin materials,
have become indispensable in dental practice (Lee, Young Kim & Seo, 2024). Regular
inspection and maintenance of LCUs are imperative tasks for dental care personnel
(Altaie et al., 2021).
Traditional light-curing composite resins, when cured with LCUs, achieve a curing
depth of only 2 mm per cycle. Consequently, the filling of deep cavities requires layering,
resulting not only in increased chairside time but also the potential for the formation of
bubbles or saliva contamination between layers (Asyraf et al., 2023; El-Safty, Silikas &
Watts, 2012). To meet the demands of clinicians and the market for increased curing depth
and simplified operational steps, Bulk Fill composite resin emerged. This material allows
for a one-time filling of 4 mm, streamlining the procedure and saving chairside time. In
addition to these benefits, Bulk Fill composite resin exhibits favorable physical and
mechanical properties, including superior flexural and compressive strength, as well as
excellent glossiness and wear resistance, compared to traditional composite resins (Parra
Gatica, Duran Ojeda & Wendler, 2023). As a result, it has gained increasing favor among
dentists, consequently raising the performance expectations of LCUs.
In dental treatment, to ensure the thorough curing of Bulk Fill composite resin, it is
recommended to minimize the distance between the light guide tip of the LCU and the
composite resin, typically within the range of 1–3 mm (Price, Felix & Andreou, 2004).
Consequently, the light guide tip inevitably comes into contact with the patient’s saliva
during procedures, posing a risk of cross-contamination. LCU are not resistant to high
temperatures and pressures (Soares et al., 2020). Given the impeative to prevent the spread
of diseases such as hepatitis B, acquired immunodeficiency syndrome (AIDS), and more
recently, COVID-19, the use of protective infection control barriers on such equipment
has become paramount (Dos Santos, 2021; Janoowalla et al., 2010; Verbeek et al., 2020).
However, while employing physical barriers is crucial, the impact of barrier materials on
light intensity cannot be overlooked (Khode et al., 2017; Soares et al., 2020). If the output
light intensity falls below the acceptable standards, it can compromise the effective curing
of Bulk Fill composite resin, subsequently affecting the treatment outcomes (Al Nahedh,
Al-Senan & Alayad, 2022). Research has shown that food wrap material can be as effective
a barrier as some commercial products (McAndrew et al., 2011). Due to its accessibility and
low cost, this study opted to utilize polyethylene film (PE), a common food wrap material,
with varying layers as an infection control barrier.
This study aimed to investigate the impact of the duration of LCU usage and the use of
infection control barriers on the hardness of Bulk Fill composite resin after curing. The
purpose of the study was to evaluate the effects of prolonged LCU usage and the presence
of PE barriers on the curing efficiency and hardness of Bulk Fill composite resin. The null
RESULTS
The impact of usage time on LCU output power
ANOVA showed regular power checks of the LCU revealed a significant decrease in LCU
power with increasing usage duration (p < 0.05) (Fig. 2). The power of the new LCU was
LCU usage, the Vickers hardness at the top of the resin for the PE0 group was 86.8 ± 9.2
HV, for the PE1 group it was 77.2 ± 5.4 HV, and for the PE3 group it decreased to 49.4 ±
2.6 HV. Differences in Vickers hardness at the top of the resin were observed among all
groups (p < 0.05). Comparing different usage durations (Fig. 4A), within the PE0 group,
the Vickers hardness at the top of the resin cured with 12-month-old LCU showed
significant differences compared to those cured with 0-month and 6-month-old LCUs
(p < 0.05). In the PE1 group, only the Vickers hardness at the top of the resin cured with
12-month-old LCU showed significant differences compared to that cured with 0-month-
old LCU (p < 0.05). For the PE3 group, the Vickers hardness at the top of the resin cured
with LCUs of different usage durations differed significantly (p < 0.05).
Figure 4B showed that at 0 months of LCU usage, the Vickers hardness at the bottom of
the resin for the PE0 group was 72.6 ± 3.1 HV, for the PE1 group it was 65.2 ± 3.8 HV, and
for the PE3 group it was 56.4 ± 3.5 HV. The PE3 group exhibited significant differences in
Vickers hardness at the bottom of the resin compared to both the PE0 and PE1 groups
(p < 0.05). At 6 months of LCU usage, the Vickers hardness at the bottom of the resin for
the PE0 group was 64.2 ± 6.1 HV, for the PE1 group it was 56.4 ± 2.4 HV, and for the PE3
group it decreased to 29.5 ± 2.3 HV. Significant differences in Vickers hardness at the
bottom of the resin were observed among all groups (p < 0.05). At 12 months of LCU
usage, the Vickers hardness at the bottom of the resin for the PE0 group was 49.7 ± 5.4 HV,
for the PE1 group it was 40.7 ± 2.7 HV, and for the PE3 group it decreased to 22.1 ± 1.8
HV. Differences in Vickers hardness at the bottom of the resin were observed among all
groups for LCUs of different usage durations (p < 0.05). Comparing different usage
durations (Fig. 4B), within the PE0 group, the Vickers hardness at the bottom of the resin
cured with 12-month-old LCU showed significant differences compared to those cured
with 0-month and 6-month-old LCUs (p < 0.05). For the PE1 group, differences in Vickers
hardness at the bottom of the resin cured with LCUs of different usage durations were
observed (p < 0.05). For the PE3 group, the Vickers hardness at the bottom of the resin
DISCUSSION
Since usage time had significantly different adverse effects on the light output (Fig. 2) and
hardness of the cured resin (Fig. 4), the first hypothesis was rejected. As the infection
control barrier had significantly different adverse effects on both the light output (Fig. 3)
and the power output or the hardness of the cured resin, the second hypothesis was
rejected (Fig. 4). In present study, we found that the output power of the light curing unit
decreases with prolonged usage, thereby failing to meet the curing requirements of Bulk
Fill composite resin. The use of single-layer PE as an infection control barrier is
recommended.
Unlike traditional nanocomposites that require layering with each layer not exceeding
2 mm (Besegato et al., 2019), the Bulk Fill resin currently used in clinical practice allows for
a one-time filling of 4 mm (Silva et al., 2023). The bulk-fill composite is selected for its high
filler content and clinical performance, ensuring durability and effective curing in deep
cavities (Osiewicz et al., 2022). Therefore, the Bulk Fill resin higher demands on the LCU.
CONCLUSIONS
The output power of the light curing unit decreases with prolonged usage, thereby failing
to meet the curing requirements of Bulk Fill composite resin. The use of single-layer PE as
an infection control barrier is recommended.
Funding
This study was supported by the Key R&D program of Zhejiang (2022C03060) and
General Research Project of Zhejiang Provincial Department of Education (Y201942154).
The funders had no role in study design, data collection and analysis, decision to publish,
or preparation of the manuscript.
Grant Disclosures
The following grant information was disclosed by the authors:
Key R&D program of Zhejiang: 2022C03060.
General Research Project of Zhejiang Provincial Department of Education: Y201942154.
Competing Interests
The authors declare that they have no competing interests.
Author Contributions
. Xinmin He conceived and designed the experiments, performed the experiments,
analyzed the data, prepared figures and/or tables, authored or reviewed drafts of the
article, and approved the final draft.
. Denghui Zhang performed the experiments, prepared figures and/or tables, authored or
reviewed drafts of the article, and approved the final draft.
. Shuli Deng conceived and designed the experiments, authored or reviewed drafts of the
article, provided resources, and approved the final draft.
Data Availability
The following information was supplied regarding data availability:
Supplemental Information
Supplemental information for this article can be found online at http://dx.doi.org/10.7717/
peerj.18021#supplemental-information.
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