Professional Documents
Culture Documents
Orthodontics
Theodore Eliades
The purpose of this article is to review the fundamentals of photocuring with
various types of lamps in orthodontics. Information on the characteristics of
lamps, photopolymerization, from the perspective of both the material composite resin adhesive and source (lamp) are discussed, with reference to light
scattering, optimum filler size, extent of polymerization, and the degree of cure
of resins irradiated with different lamps. This discussion is followed by a review
of the clinically useful listing of properties of lamps and their application to
orthodontic bonding as these are reflected in 4 key properties of the material,
such as polymerization efficiency (degree of cure), mechanical properties (bond
strength), clinical performance (failure rate), and biological properties of blue
light. (Semin Orthod 2010;16:83-90.) 2010 Elsevier Inc. All rights reserved.
From the Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, Greece.
Address correspondence to Theodore Eliades, DDS, MS, DrMed,
PhD, FIMMM, MRSC, MInstP, 57 Agnoston Hiroon, Nea Ionia
14231, Greece; Email: teliades@ath.forthnet.gr
2010 Elsevier Inc. All rights reserved.
1073-8746/10/1601-0$30.00/0
doi:10.1053/j.sodo.2009.12.008
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affect the radiant flux density reaching the adhesive resin at the margins, and therefore the
resultant light scattering effects related to indepth curing. Although the distance of the tip
from the adhesive may not result in differences
in bond strength, the actual kinetics of the DC
and bond strength are unknown, and thus
changes in one variable may not be reflected in
variations in the other. In addition, the variation
of percentage of DC as a function of bond
strength has not been examined and it is possible that the latter is unaffected after a certain
percentage of DC is reached. The percentage of
DC is a material variable, largely unaffected by
environmental conditions, and not a derivative
of a constructed test, such as bond strength,
which involves many assumptions.20 Moreover,
bond strength is a poor indicator of percentage
of DC because of the interference of bracket
design, variation in load application, loading
rate, teeth storage and preparation, and testing
conditions, among other factors. In contrast,
percentage of DC has been shown to modulate
the mechanical properties of material21,22 as well
as the resistance to degradation and dissolution,23 a key property which cannot be explored
using bond strength tests.
The intensity and amount of light required
to reach the adhesive to initiate polymerization
has been a topic of extensive investigation. Previous research has proposed the concept of a
critical light transmittance and a threshold
light intensity with curing adhesives for ceramic
brackets24; the latter has to be attained in order
for the polymerization to be initiated. This result
is presumably because of the thin film nature of
the adhesive layer, which has a very high surfaceto-volume ratio. The dominance of surface properties over bulk adhesive properties is considered to favor the use of light-cured resins
because these systems are expected to possess
superior surface characteristics.25
In the broader adhesive materials published
data, high polymerization rates have been shown
to induce 2 undesirable effects. The first relates
to the development of high stresses because of
the polymerization shrinkage in the tooth cavity.
However, there is a lack of data on this issue for
orthodontic bonding, and it seems that this
should not constitute a concern because of the
relaxation of these stresses in the bracket-adhesive interface owing to the lack of margins and
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