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49]

Original Article

Effectiveness of light emitting diode and halogen

light curing units for curing microhybrid and
nanocomposites
Shwetha Choudhary, Suprabha BS
Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences, Manipal University, Mangalore,
Karnataka, India

Abstract
Aim: To compare the polymerization efficacy of micro-hybrid and nanocomposites cured with Quartz-tungsten halogen (QTH)
and light emitting diode (LED) light curing units (LCUs). The effectiveness of pulse cure mode in LED LCU was also investigated.
Materials and Methods: Both micro-hybrid and nanocomposite specimens were cured using four different curing protocols
giving a total of eight experimental groups. Ten cylindrical specimens were prepared for each group, and light cured for 40 s
on the top surface, thus giving a total of eighty specimens. Vicker hardness measurements were carried out on the top and
bottom surfaces after 24 h and hardness ratio was calculated.
Results: For both micro-hybrid and nanocomposites, highest mean VHN was observed for the group cured with QTH LCU, and
the lowest was observed for the group cured with second LED LCU in standard mode but the difference was significant only in
case of nanocomposite.
Conclusion: Curing nanocomposites with QTH LCU results in better micro hardness. Pulse cure mode does not effectively
increase polymerization efficacy than the standard mode of curing.
Keywords: Curing lights; hardness; nanocomposite

INTRODUCTION of composites without affecting the degree of conversion,

Clinical longevity of light cure resin composites used for
restoration of both anterior and posterior teeth has been
studied extensively.[1] Adequate curing of resin composites
is important as it influences its mechanical properties,
prevents bulk, or marginal fracture, adverse tissue
reactions, and secondary caries. Traditionally, halogen
based curing lamps, which use filters to restrict the emitted
light to blue region of the spectrum for polymerization
have been used to activate the photo initiator system in the
composites.[2] However, they have several drawbacks such
as overheating of the incandescence lamp, limited effective
lifetime of the halogen bulbs, and degradation of internal
components (bulb, reflector, and filter) overtime.[2,3] To
overcome these drawbacks, blue light emitting diode (LED),
light curing units (LCU) have been developed. These are
solid state semiconductor devices that convert electrical
energy directly to light. LED’s have lifetimes of more than
10,000 h and undergo little degradation of light output
over time.[4] In order to minimize polymerization shrinkage
Address for correspondence:
Dr. BS Suprabha, “Shreyas”, 15/17/940-13, 5th Cross Road,
Shivabagh, Kadri, Mangalore - 575 002, Karnataka, India.
E-mail: sprbhbhat@yahoo.co.in
Date of submission : 12.03.2012
Review completed : 03.12.2012
Date of acceptance : 19.01.2013
various polymerization modes have been formulated, such
as soft start, pulse delay, pulse cure, and ramp mode.[5]
A continued development in composite resins resulted in
materials with reduced particle size and increased filler
loading, significantly improving the universal applicability
of light-cured composite resins.[6,7] Micro-hybrid composites
are a combination of micro fill and larger filler particles
with an average size of 0.01-0.1 m. These have the
advantage of improved physical properties, high percent
fill and excellent aesthetics. The main drawback of this
group, as determined by larger particle size, is the difficulty
in maintaining long-term high polish.[8] To overcome this,
nano-filled composites, which have nanomeric particles
and nanoclusters in a conventional resin matrix were
introduced.[7]
Several studies have compared the efficacy of
quartz-tungsten halogen (QTH) LCU with LED LCU using
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DOI:
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Choudhary and Suprabha: Effectiveness of light curing units for curing composites
micro fill, hybrid, and micro-hybrid composite resins.[4,9-11]
The curing efficacy of recently developed nanocomposites,
which have different optical properties have not been
studied extensively with different curing modes of LED units.
Hence, this study was undertaken to compare the efficacy of
polymerization of micro-hybrid and nanocomposites cured
with QTH, and LED LCUs by hardness testing method. The
effectiveness of cure of pulse cure mode in LED LCU was
also investigated. The null hypothesis tested was that there
is no difference in the Vicker hardness of micro-hybrid and
nanocomposite cured with QTH LCU, standard regimens of
two LED LCUs, and pulse cure mode of LED LCU at top and
bottom surfaces of composite specimens respectively. In
addition, the depth of cure of the composites cured with
QTH and LED LCU was determined.
MATERIALS AND METHODS
Two light cured resin based composites, nano-composite
(Z350, 3MTM ESPETM dental products, St. Paul, USA; A2
shade), and micro-hybrid composite (Z100, 3M ESPE
dental products, St. Paul, USA; A2 shade), were used in this
study. These were cured with QTH LCU (Elipar 2500, 3M
ESPE dental products, St. Paul, MN, USA), and 2 LED LCUs
(Smartlite TMPS, Pen Style High Power LED Curing Light,
Dentsply Caulk, Dentsply, Milford, and UlightTM PB–070 LED
Curing Light, Fine Vision Electronics Co. Ltd. [FVE, Taiwan];
designated as first LED and second LED respectively). The
two LED LCUs differed in their spectrum range (450-490 nm
and 440-480 nm respectively) and curing modes. The
first LED was curable only in standard mode whereas the
second LED was curable in fast, ramp, and pulse mode as
well as standard mode. Each composite type was cured
using four different curing protocols giving a total of eight
experimental groups:
Group 1: Nanocomposite cured with QTH LCU
Group 2: Nanocomposite cured with first LED LCU in
standard mode
Group 3: Nanocomposite cured with second LED LCU in
standard mode
Group 4: Nanocomposite cured with second LED LCU in
pulse cure mode
Group 5: Micro-hybrid composite cured with QTH LCU
Group 6: Micro-hybrid composite cured with first LED
LCU in standard mode
Group 7: Micro-hybrid composite cured with second LED
LCU in standard mode
Group 8: Micro-hybrid composite cured with second LED
LCU in pulse cure mode
Method for assessing the effectiveness of cure was in
accordance with that used by Yap.[12] Ten disk shaped
specimens in each group were formed, giving a total sample
size of eighty. The discs were prepared using the Teflon
mould (Dentsply, Milford) measuring 5 mm in diameter and
2 mm in thickness.
234 Journal of Conservative Dentistry | May-Jun 2013 | Vol 16 | Issue 3
The moulds were placed on flat glass plates on top of acetate
strips and then filled with resin based composites using
cement carrier and condenser. The resin was covered with
another acetate strip and gently pressed with another glass
plate against the mould to extrude excess material and to
ensure a level of the plane on the top and bottom surfaces.
The excess material was removed using an explorer. New,
clean acetate strips was used for each specimen.
All the specimens were then irradiated by touching the
LCU guide on the top acetate strip for 40 s using the
respective LCUs. The LED’s were charged according to
manufacturer’s recommendations, and placed back in their
battery chargers after each specimen was polymerized.
The light intensity of all the curing lights were checked
with a radiometer (Demetron 100, Demetron Research
Corp, USA.), prior to use, to ensure consistency in
intensity output from the light source. All the LCUs used
in the study had intensity readings above 300 mW/cm2,
which is the minimum required intensity for complete
polymerization.[13]
The top surface was identified with an indelible marker.
The specimens were then stored in a light proof container
in distilled water at 37˚C for 24 h prior to microhardness
testing. The specimens were stored in eight different
coded containers. The specimens were blotted dry prior to
microhardness testing.
The Vickers hardness measurements were carried out
under a load of 50 g for 15 s using a Vicker Hardness Tester
(Model – Micro Vickers (MV) 1-PC (Personal computer
based) (FIE) Fuel Instruments and Engineers Private
LimitedTM. All the measurements were carried out by a
single trained independent examiner. The mean Vickers
hardness number (VHN) of the top and bottom surfaces was
calculated. To determine the depth of cure, the hardness
ratio was calculated by dividing the bottom surface VHN
by the top surface VHN. Data was analyzed using SPSS
(Statistical Package for Social Sciences) for Windows
release 11.5 (SPSS, Chicago, IL, USA). One-way ANOVA was
used to find the differences between the groups and Tukey
Honestly significant difference post hoc test, for intergroup
comparisons.
RESULTS
Table 1 shows the mean VHN values and hardness ratio of
all the groups. The highest mean hardness value of both the
top and bottom surface was observed for Group 1 and the
lowest mean was observed for Group 3. One-way ANOVA
revealed significant difference in the mean hardness values
of the top surface (P = 0.002), but no significant difference
was seen in the bottom surface. When comparing the mean
values of the hardness ratio, it was seen that all the groups
scored higher than 0.80 indicating adequate depth of cure,
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Choudhary and Suprabha: Effectiveness of light curing units for curing composites

and the difference between the hardness ratios were not transmission (light tips being free from scratches and
significant. debris), thickness, and shade of restorative material,
exposure time, distance of the light source from the
For both nanocomposites, (Group 1-4) and micro-hybrid restorative material, and light intensity.[14] To minimize
composite resins (Group 5-8), the highest mean hardness the effects of colorants on light polymerization, A2 shade
values for both the top and bottom surfaces were for the of both the composite resins was used. As light intensity
ones cured with QTH LCU and the lowest mean hardness decreases with increasing distance from the light cure tip,
values were observed for the ones cured with second the light cure tip was kept touching the acetate strip to
LED LCU using standard mode. One-way ANOVA showed standardize the procedure.[15] Curing time was limited to
that the mean VHN of both the top and bottom surfaces 40 s as per the manufacturer’s recommendations.
of nanocomposite specimens cured with QTH LCU was
significantly higher (P = 0.001 and 0.028 respectively), but In this study, both top and bottom hardness values were
not for micro-hybrid composite. obtained as the effectiveness of cure at the top surface
does not ensure proper polymerization throughout the
Table 2 shows the intergroup comparison of all the eight restoration. Light intensity is greatly reduced as light
groups. There was a statistically significant difference passes through the bulk of the material due to scattering
between the groups cured with QTH LCU and the second of light by the filler particles and the resin matrix. As
LED LCU in standard mode irrespective of the composite the bottom surface is more critically affected by the
resin type used. No statistical significant difference was light intensity, it is considered as a better gauge of the
found among the other groups. effectiveness of cure of composite.[5] The bottom surfaces
of all the specimens had lesser VHN than the top surface,
DISCUSSION which means that the degree of curing decreases with
depth. The difference in the mean hardness ratio was not
Several methodologies have been proposed to evaluate significant, indicating no significant difference in the mean
the polymerization efficacy of LCUs. Hardness testing, hardness values of top and bottom surfaces. Thus, it can
an indirect method, is a good indicator of the degree of be inferred that the specimens had undergone an almost
conversion, and VHN exhibits a good correlation with uniform degree of polymerization from top to bottom.
infrared spectroscopy, a direct method.[3] In this study, This can be due to the 2 mm thickness of the specimens,
Vickers hardness test was used to characterize the hardness which has been determined to be of an adequate depth for
of materials. proper curing.[16] Ideally, the hardness ratio should be one
if polymerization is completely effective, as the hardness of
Various factors affect polymerization and depth of cure the bottom surface should be the same as the top surface.
of resin composites. These are the effectiveness of light Taking into account light scattering and absorption within
composite, the hardness gradient should not exceed 10-20%
or hardness ratio should be 0.8 or greater for composites
Table 1: Mean and standard deviation of Vicker
hardness measurements and hardness ratio to be adequately polymerized.[17] All light curing mode
combinations fulfilled this criteria.
Groups Top VHN Bottom VHN Hardness ratio
Mean SD Mean SD Mean SD
Curing nanocomposite with QTH LCU resulted in significantly
1 77.47 3.88 67.77 3.69 0.87 0.04
2 70.54 3.18 63.74 4.67 0.90 0.03
higher top hardness indicating QTH cures nanocomposite
3 67.87 5.70 61.89 4.35 0.91 0.04 better as compared to LED LCUs. Even in case of
4 72.86 6.35 67.15 6.12 0.92 0.04 micro-hybrid composite specimens, curing with QTH LCU
5 75.47 5.66 68.09 6.42 0.90 0.04 resulted in higher hardness values, though the difference
6 70.74 7.18 64.96 5.44 0.92 0.06
7 69.43 5.40 63.47 4.92 0.91 0.04 was not statistically significant. Thus, the hypothesis that
8 73.04 3.40 65.94 5.96 0.90 0.07 there is no difference between VHN of micro-hybrid, and
P values 0.002* 0.099 0.591 nanocomposites cured with various curing protocols were
*P<0.05: Significant, VHN: Vicker hardness number proved to be null and void. Light intensity readings of all
the LCUs were standardized to be above 300 W/cm2, as
Table 2: Intergroup comparison of mean Vicker decreased light intensity is shown to affect the mechanical
hardness measurements values properties such as compressive strength.[18] The LCUs used
Variable Significance in this study varied in their power density (400 mW/cm2,
VHN top Group 7*, group 3**<group 1 950 mW/cm2 and 1000 mW/cm2), but their energy density
Group 3<group 5*** was above 16 J/cm2. At this level, the difference in the power
VNH bottom Not significant
Hardness ratio Not significant density does not influence the polymerization kinetics.[19] The
Results of one way ANOVA/Tukey post hoc test, < indicates statistical significance, difference between the hardness values may be explained
P=0.003*, 0.023**, 0.038***, VNH: Vicker hardness measurements by the differences in the ability of LED and QTH to excite

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Choudhary and Suprabha: Effectiveness of light curing units for curing composites
the photoinitiators present in the materials. Most resin
based materials have camphoroquinone as the initiator of
curing, which is sensitive to light at the blue region of the
visible spectrum. However, camphoroquinone has some
limitations; hence, some materials contain other initiators
of cure that are not excited within the wavelength range
covered by LED lamps. The bis-acyl-phosphine oxide and
the 1-phenyl-1, 2-propanodione, for example, are initiators
with absorption peaks at 380 nm and 410 nm, respectively,
which are not effectively polymerized by LED LCUs due to its
narrow spectrum range.[9] The LCUs used in this study had
spectrum range of 400-500 nm for QTH LCU, 450-490 nm
for first LED LCU and 440-480 nm for second LED LCU. Thus
the better curability of composite resins with QTH LCU
could be due to its wider spectrum range. In a study done
by Peris et al., where the micro hardness of micro fill and
micro-hybrid composite resins cured with different curing
units was evaluated, it was found that the QTH gave the
highest hardness values than the LEDs.[2] Similar results have
been obtained in studies carried out by Dunn and Bush,[4]
Cefaly et al.[9] and Oberholzer et al.[10] where the micro
hardness values of micro fill and micro-hybrid composite
resins cured with QTH was greater than that by LEDs.
Furthermore, it was found that amongst all the groups,
the highest mean value for the top surface was for
nanocomposite (Filtek Z350) specimens cured with QTH
LCU, the difference being statistically significant. In a study
conducted by Topcu et al. also, nanocomposite material
showed the highest hardness values in all polymerization
types at the top and bottom surfaces.[20] This could
be, because, the particle size of nanofillers are below
the wavelength range of visible light and thus, they do
not scatter or absorb visible light. The extremely small
size of nanofillers allows the particles to fit into spaces
between other particles and effectively increases the
overall filler level. Nanofillers also significantly reduce
the effect of polymerization shrinkage and dramatically
improve physical properties.[21] Hubbezoglu et al. did a
study comparing surface micro hardness of four different
resin composites cured using a halogen light, an LED and
a plasma arc unit. It was found that the nanocomposite
gave the highest hardness values, with LED LCU yielding
highest hardness for nanocomposites followed by hybrid
resin composites.[22] In a study carried out by Soh et al.
where they compared the effectiveness of cure of two
LED LCUs to conventional, high intensity and very high
intensity halogen lights, it was found that the effectiveness
of composite cure with LED LCU is product dependent, due
to variations in design and the size of the LED used.[3] In
this study also, it was found that QTH LCU and first LED
LCU were comparable, however, second LED LCU with
standard mode gave statistically significant difference
when compared with the QTH LCU.
When comparing the different modes in the same LCU, it
236 Journal of Conservative Dentistry | May-Jun 2013 | Vol 16 | Issue 3
was found that both the composite resins cured with second
LED LCU in pulse cure mode (Groups 4 and 8) cured better
than the ones cured in standard mode (Groups 3 and 7)
though not statistically significant, which is in accordance
with Neo et al.[5] Contradictory findings have been observed
in other studies such as by Soh et al. where the standard
modes gave significantly higher hardness values than the
other curing modes when composite resin cured with
different curing regimens were subjected to micro hardness
test.[3] In a study done by Hegde et al.[23] the intermittent
method of cure with QTH had the higher Knoop Hardness
Number Knoop hardness number (KHN) than continuous
mode of cure with both QTH and LED. This could be because
hardness measurements were made 24 h after removal of
the light source in the present study as compared to other
studies where it was done immediately. Composites cured
with different curing modes continue to polymerize but to
different extents after the light source is removed. Pulse
curing slows down the polymerization reaction, and this
may be transferred to the post-irradiation polymerization
of composites.[17]
One disadvantage of this study was use of teflon moulds,
which tend to give higher micro hardness values than
that carried out on natural teeth. Furthermore, this was
an in vitro study, which tends to overestimate the micro
hardness values hence results should be attributed
cautiously to clinical conditions.
CONCLUSION
Under the conditions of this in vitro study, the following
conclusions were made:
1. Effectiveness of LED LCUs as compared to QTH LCU is
dependent on the type of product as well as the type
of composite resin.
2. Curing nano composites with QTH LCU results in better
surface hardness at both the top and bottom surfaces.
3. For micro hybrid composites, QTH LCU and LED LCUs
result in comparable surface hardness at both top and
bottom surfaces.
4. Curing with both the QTH and LED LCUs results in
adequate depth of cure for both nano and microhybrid
composite resins as the mean hardness ratio of all the
groups were comparable.
5. Pulse cure mode in LED LCU does not effectively
increase micro hardness than the standard mode of
curing.
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How to cite this article: Choudhary S, Suprabha BS.
Effectiveness of light emitting diode and halogen light curing
units for curing microhybrid and nanocomposites. J Conserv
Dent 2013;16:233-7.
Source of Support: Nil, Conflict of Interest: None declared.
237