Decrease in Power Output of New

Light-emitting Diode (LED) Curing Devices

with Increasing Distance to Filling Surface
Gerrit R. Meyera/Claus-Peter Ernstb/Brita Willershausenc

Purpose: This study compares the percentage decrease in power output of light-emitting diode (LED) and
quartz-tungsten-halogen (QTH) curing devices at different distances between the light guide tip and a
radiometer.
Materials and Methods: Three LED curing devices (Elipar FreeLight/3M ESPE, Luxomax/Akeda,
e-Light/GC) were compared to two QTH curing devices (Elipar TriLight/3M ESPE, Optilux 501 convention-
al and Turbo light guides/Kerr-Demetron). Power density was measured with a Fieldmaster GS/Coherent
unit (Sensor LM-3 HTD) at increasing distances from the light guide tip (0 to 20 mm at 1-mm increments,
n=6).
Results: The mean decrease in power density available for curing at a distance of 10 mm between the
light guide tip and the radiometer was 68% for the FreeLight, 83% for the e-Light, 42% for the Luxomax,
38% for the TriLight, 33% for the Optilux with the standard light guide, and 44% for the Optilux with the
turbo light guide. The power density of the Luxomax was only 40% of that of the other LED curing devices
at 0 mm distance.
Conclusion: The blue LED curing devices Elipar FreeLight and GC e-Light showed a significantly higher
percentage decrease in power output at a distance of 10 mm from the light guide tip to the radiometer
compared to the QTH curing devices. Therefore, although blue LED curing devices might have the same
curing potential compared to a QTH device when placed in direct contact to a resin composite, blue LED
curing devices may not provide a sufficient cure when placed at a clinically relevant distance of 10 mm
to the resin composite surface.

J Adhes Dent 2002; 4: 197–204. Submitted for publication: 07.01.02; accepted for publication: 25.06.02.

uring composites with halogen light is the cur-
C rent standard curing method. These quartz-tung-
sten-halogen (QTH) lights emit visible light, which
a Assistant Professor, Department of Operative Dentistry, Johannes
Gutenberg University, Mainz, Germany.
b
Associate Professor, Department of Operative Dentistry, Johannes
Gutenberg University, Mainz, Germany.
c Full Professor and head of Department of Operative Dentistry, Jo-
hannes Gutenberg University, Mainz, Germany.
Reprint requests: Dr. Gerrit R. Meyer, Department of Operative Den-
tistry, Augustusplatz 2, 55131 Mainz, Germany. Tel: +49-6131-177246,
Fax.: +49-6131-173406. e-mail: gemeyer@mail. uni-mainz.de
has a wavelength spectrum of 380 to 760 nm.11
Blue light, as a part of this spectrum, is in the range
of about 400 to 500 nm.11 When used in dentistry,
this blue light is absorbed by the photoinitiator,
which stimulates other molecules (amines). These
amines initiate the polymerization reaction, leading
to a stable, photopolymerized resin-based compos-
ite, which is the most commonly used dental restor-
ative material in Europe today.
Halogen light is emitted from a bulb which is filled
with iodine or bromine gas and contains a tungsten
filament. When connected to an electric current, the
tungsten filament glows. This produces a very pow-
erful light and constant light exposure, but also a
considerable amount of heat. When halogen lights
are used for curing, the regular polymerization time

Vol 4, No 3, 2002 197

Meyer et al
is 20 to 40 s, depending on the shade and opacity
of the material used.5,9,29 During the last several
years, curing lights have become more powerful,
and scientists have been looking for new and easier
ways to produce a high-energy blue light from differ-
ent sources.
Today there are two groups of curing devices on
the market: the first is a group of curing devices
that produce white light, which is then filtered to
the range of blue light (400 to 500 nm). The con-
ventional QTH curing devices and the plasma arc
curing devices (PAC) belong to this group. Both
techniques – QTH as well as PAC – are limited with
respect to increasing power output. Due to the fact
that energy is primarily converted into heat, the en-
ergy conversion in a QTH bulb or PAC light is very
poor. In QTH lights, 98% of the supplied energy is
delivered as heat, and only 2% is available as us-
able light.10 This is one of the reasons that led to
the development of high-power curing devices that
produce only light in the wavelength needed for
photopolymerization without further generation of
heat. The laser seemed to be an interesting alter-
native due to the fact that the peak of emitted light
can be set precisely around 468 nm,14 the absorp-
tion maximum of the most commonly used photo-
initiator camphoroquinone.28 Despite this advan-
tage, the total energy conversion is also very poor.
Although laser curing devices are able to bring opti-
mal material properties into resin composites, this
complex and very expensive technique seems to be
hard to improve.
An alternative possibility for producing blue light
for curing is the blue LED, a most promising tech-
nique which should be able to deliver a reliable and
stable power output without excessive heat.15 Both
laser and blue LEDs produce ”real blue light” at the
origin of the light source and therefore belong to a
group of curing devices different from the QTH and
PAC lights.
LEDs have low power requirements. Most types
can be operated with battery power supplies. They
operate at relatively low voltages between about 1
and 4 volts, and draw electric currents between
about 10 and 40 milliamperes. Therefore, wireless
devices can be manufactured. LEDs are also effi-
cient: most of the power supplied to an LED is con-
verted into radiation in the desired form of about
450 to 490 nm, with minimal heat production.13 The
overall energy conversion is around 7%, about ten
times higher than in a conventional halogen light.15
Due to the minimal heat production, a fan will rarely
198
be needed. This will provide a smaller, miniaturized
device, which operates more quietly than a curing
device with a fan. Without a fan, no vents are nec-
essary; this will lead to better hygenic conditions
due to easier access for cleaning the device. The
lifespan of a LED is longer than that of a QTH bulb.
At the moment, LED technology seems to have the
greatest potential for further improvements.
The most important part of a light-emitting diode
is the semi-conductor chip located in the center of
the bulb that emits visible light when an electric
current passes through it.
Blue LEDs can be used to cure resin composite
restorative materials in a manner comparable to
that of a QTH or PAC light. As known from QTH cur-
ing devices, the power output has to be at least
200 mW/cm2.17,22 A comparison of the power out-
puts of QTH and LED devices shows that LED cur-
ing devices provide a power output of about 30% to
35% of the output of QTH curing devices, as mea-
sured by means of a radiometer. However, this
does not automatically mean that a blue LED cur-
ing device has approximately 30% of the curing ca-
pacity of a QTH device. A study which compared an
LED device (350 mW/cm2) with a standard halo-
gen device (750 mW/cm2) found comparable phys-
ical properties of resin composite samples cured
with the different devices.12 This shows that the
quality of polymerization does not exclusively de-
pend on light intensity measured with a radio-
meter.
The absorption curve of the photoinitiator cam-
phoroquinone is about 360 nm and 520 nm, with a
maximum of 468 nm.28 For this reason, the optimal
emission spectrum of a lamp should be in the range
of 440 nm to 480 nm. In conventional halogen
lights, almost 95% of the emission spectrum is in
the range of about 400 nm to 510 nm. The maxi-
mum of the emission spectrum of a blue LED is
465 nm, which is relatively close to that of the pho-
toinitiator camphoroquinone. Therefore, the proba-
bility that a photon emitted by a blue LED curing de-
vice can be absorbed by camphoroquinone could,
obviously, be higher than it is in the case of a halo-
gen device. This higher probability of the photon be-
ing absorbed in the case of the LED curing device
might explain the fact that the LED lights are more
effective despite their relatively lower power output.
In other words, LED curing devices have a lower mea-
surable power output than conventional QTH curing
devices, but the emitted blue light is nevertheless
capable of starting a polymerization process.
The Journal of Adhesive Dentistry

All the studies carried out on the polymerization
potential of blue LED curing devices placed the light
guide in contact with the resin composite sam-
ple,8,12 which made a laboratory setup easier but
does not replicate the actual clinical situation,
where the light guide is likely to be placed at a dis-
tance to (not touching) the resin composite surface
to be cured. This will be the case for most posterior
cavities.6,20,29 When comparing the decrease in
power output of a blue LED curing device to that of
a QTH curing device, it is therefore necessary to
take measurements not only at zero distance be-
tween the light guide tip and the composite, but
also at varying distances between the light guide
tip and the resin composite surface. Based on
these considerations, as well as on the assump-
tion that it might be possible that blue LED light
scatters more widely than light emitted from a QTH
device, the following hypothesis was formulated:
The decrease of power output of an LED curing de-
vice is significantly higher than that of a QTH curing
device when the light guide tip is placed at a dis-
tance of 10 mm to a radiometer. This effect might
influence the curing capacity of such a device when
the device is placed at a clinically relevant distance
from the resin composite surface.
MATERIALS AND METHODS
For this study, three recently introduced LED curing
devices (Elipar FreeLight, 3M ESPE, Seefeld, Ger-
many; Luxomax, Akeda, Lystrup, Denmark; e-Light,
GC Europe N.V., Leuven, Belgium) were used to ex-
amine the percentage decrease of power output
within a given distance from a radiometer sensor.
Two halogen devices (Elipar TriLight, 3M ESPE,
Seefeld, Germany; Optilux 501, SDS Kerr Demet-
ron, Danbury, CT, USA) served as control. With the
Optilux 501, both the standard 8-mm light guide
and a focussing ”Turbo” light guide were used.
To determine power output, the laser energy ra-
diometer Fieldmaster GS (Coherent, Santa Clara,
CA, USA) was used with its sensor LM3-HTD (Co-
herent). This laser radiometer provides a digital
output in 1 mW/cm2 increments, which generates
more easily readable and more exact results than
conventional analog radiometers (information from
manufacturer).
All measurements (n=6) started at 0 mm, with
the light guide tip touching the sensor of the radi-
ometer. Then, the distance between the light guide
Vol 4, No 3, 2002
Meyer et al
Fig 1 Schematic plotting of the test setup to investigate
the power output of light curing devices with increasing dis-
tance to the radiometer.
and the radiometer sensor was increased in 1 mm
steps up to a maximum distance of 20 mm. The
curing devices were mounted to a stable metal
stand to ensure parallelism of the light guide facing
the sensor, which was affixed to the table. For exact
gauging of the distance from the light guide tip to
the sensor, a tape measure was attached to the
metal stand (Fig 1). A black paper blind in the same
diameter as the light guide tip was placed axially on
the radiometer sensor to cover the sensor area,
which was larger than the light guide tip diameter.
Every curing device was set to standard polymeriza-
tion mode for 20 s. To obtain a stable power out-
put, every light was turned on for 20 s before the
first measurement started, because a cold bulb
could have affected the accuracy of the results. Af-
ter each measurement, the devices were allowed to
cool down for as long as it took to stop the fan of
the halogen curing lights. The LED lights also need-
ed a cooling time of 1 to 2 min after a few measure-
ments; otherwise, the complete 20 s polymeriza-
tion time would not have been reached.
Measurements at the 10 mm distance were tak-
en for extensive investigation, as this simulates a
clinically relevant distance from a light guide tip to
a tooth cavity floor. Microsoft Excel was used for a
descriptive statistical analysis of all results. The
variation coefficient was used to describe the pre-
cision of measurement. A variation coefficient be-
low 5% for all examinations is defined as appropri-
ate to ensure a proper method.
199
Meyer et al
RESULTS
The mean values of power density measured with
the Fieldmaster GS/Coherent unit are shown in
Fig 2 for all distances investigated in this study. At
zero distance between the light guide tip and the ra-
diometer, the mean power density of the Elipar
TriLight was 378.3 ± 12.8 mW/cm2, that of the Op-
tilux 501 with the standard light guide 406.3 ±
2.4 mW/cm2, and with the turbo light guide 506.2
± 9.6 mW/cm2. The blue LED curing device Lux-
omax showed a mean power density of 53.5 ±
1.8 mW/cm2, the Elipar FreeLight 137.2 ±
5.5 mW/cm2, and the GC e-Light 137.8 ±
5.8 mW/cm2. The available power output of the Lux-
omax was only 40% of the other LED curing devices.
The mean percentage decrease of the power
density measurements is shown in Fig 3. The vari-
ation coefficient (VC), as a dimension for the preci-
sion of measurement, was below 5% for all investi-
gated curing devices. For the conventional QTH cur-
ing devices, the mean percentage decrease in pow-
er output at a distance of 10 mm to the sensor was
38% ± 4.5% (VC 2.0%) for the Elipar Trilight, and
33% ± 6.2% (VC 2.3%) for the Optilux with the stan-
dard light guide and 44% ± 3.7% (VC 1.3%) with the
focussing light guide. At the same distance of
10 mm, the mean decrease in percentage power
200
Fig 2 Plotting of the mean power output
[mW/cm2] of the curing devices investigat-
ed at increasing distances (0 to 20 mm)
from the radiometer.
output of blue LED curing lights was 68% ± 0.8%
(VC 1.9%) for the Elipar FreeLight, 83% ± 0.6% (VC
3.0%) for the e-Light, and 42% ± 0.5% (VC 1.7%) for
the Luxomax curing device.
DISCUSSION
When curing resin composite by means of a light
curing device, it must be kept in mind that light en-
ergy is absorbed as the light passes through
air.16,23,25,26 Pires et al18 reported a remaining
power density of 78% at a distance of 2 mm and of
47% at a distance of 6 mm. Prati et al19 found sim-
ilar results with the mean power output falling to
61% at a 2 mm distance and to 23% at 6 mm dis-
tance. Therefore, it is recommended that the light
guide tip be placed as close as possible to the res-
in composite surface while polymerizing. In clinical
reality, this is difficult to achieve because of the dis-
tance between the light guide tip and the cavity
floor, which is reported to be up to 7 mm.3,4,6,24,29
Price et al20 showed that a typical Class II prepara-
tion of extracted human molars has a distance of
6.3 mm (SD ± 0.7 mm) from the light guide tip to
the gingival floor, but only if the light guide tip is
placed exactly on the tooth or the filling surface, as
the case may be.
The Journal of Adhesive Dentistry

Fig 3 Plotting of the mean percentage
reduction in power output [%] measured at
zero distance from the radiometer for the
curing devices investigated, when the dis-
tance to the radiometer was increased in
1-mm increments from the radiometer.
During outpatient treatment, however, two addi-
tional factors can lead to an increase in the dis-
tance between the light guide and the filling sur-
face: fillings that are difficult to reach and the use
of light guides with suboptimal shapes and/or siz-
es. In the present study, a 3 mm greater distance
to the sensor was allowed, as in clinical reality it is
often difficult to position the light guide tip exactly
on the tooth surface. The data presented here that
were obtained by measurements with a Fieldmas-
ter GS sensor differ from data determined by
means of a conventional radiometer.20 This is due
to the different technologies employed in different
radiometers. A conventional radiometer20 deter-
mines the light output by means of a small photo-
diode, photoresistor, thermoelement, or photoelec-
tric resistor, ie, a device smaller than the light guide
tip diameter. The photons, emitted from a light
source hitting the sensor of a conventional radio-
meter, conduct electric current.11 The current pro-
duced depends on the wavelength of the light. This
current has to be amplified to obtain measurable
values. If a light curing device delivers light output
focussed to the center of the light guide instead of
an even distribution over the complete light guide
tip surface, this higher output, due to the position
and size of the radiometer relative to the light
guide, will be attributed to the entire surface of the
Vol 4, No 3, 2002
Meyer et al
light guide and will thus result in power output read-
ings that are erroneously high. Therefore, the con-
ventional curing radiometer should only be used
when testing light guides of identical diameters.
Because of the different light guide diameters of
the curing devices examined in this study, a radio-
meter with a larger sensor surface had to be used.
The blinds placed on top of the sensor with its cen-
ter in the center axis of the curing device ensured
the use of a sensor surface equal to that of the light
guide diameter. The LM3-HTD sensor of the Field-
master GS is larger than the light guide tip and can
therefore determine the power output distributed
from the complete light guide surface. This sensor
uses a flat spectral sensitivity from 0.3 nm to 10.6
µm. The light is absorbed by a thermally conductive
sensor plate. The thermoelectric effect or ”See-
beck” effect works with two or more solder joints,
consisting of two different metals. One part of the
solder joint warms up when light hits its surface.
This radial thermal gradient on the sensor plate is
proportional to the occurring light power. The ther-
mal gradient is measured by means of a circular
thermal element which is connected to the back
side of the sensor plate. Due to the fact that the
temperature is proportional to the voltage, the elec-
tric current produced provides an exact value of the
power density of the scanned light. The higher the
201
Meyer et al
light power, the higher the voltage. The front side of
the sensor plate is coated with a lacquer, a
so-called black-body-absorber, to obtain a wide
spectral sensitivity. The vacuum-produced thermal
elements, which consist of gold and bismuth, have
a sensitivity of about 1 mV per Watt of optical power.
This signal is amplified by an indicator, and then the
power density of light is displayed in W.2
Recommendations for minimal power output of
curing devices1,21 and results of other radiometer
studies20 are mostly obtained from conventional
radiometers27 and cannot be compared to the data
presented here due to the different technical spec-
ifications.
The results of this study clearly show different
power output levels for the QTH and the LED devic-
es. Relying on power density values alone, one can
assume that a blue LED has only 35% of the curing
capacity of a QTH device. Radiometers and other
devices for the determination of light intensity mea-
sure the power output in a certain range of wave-
lengths. However, only a part of this spectrum is
used for the activation of a photoinitiator. We as-
sume that the blue light emitted from an LED is a
more narrowly banded spectrum aimed at the pho-
toinitiator camphoroquinone than the broad spec-
trum of the blue light filtered from a QTH device.
Therefore, the overall lower power output of an LED
may be able to cure to the same degree as the high-
er power output of QTH light.12
The present study assumes that the clinical ef-
fectiveness of blue LED and QTH light cannot be
compared by means of a radiometer alone, but rath-
er will additionally require investigations of depth of
cure in resin composite samples or their physical
properties. This assumption is made because an
LED light has a light emission spectrum different
from that of a QTH light. As a first step in the direc-
tion of determining the effectiveness of blue LED
versus QTH lights, however, this study focussed
only on a comparison of the percentage decrease
in the power density of the investigated devices.
While no absolute comparisons between the tested
devices were possible, a direct comparison within
the group of the QTH curing devices as well as within
the group of the LED devices could be made.
The Optilux 501 with the standard light guide and
the Elipar TriLight delivered comparable mean power
output data. As Price et al20 have shown, the use
of a turbo light guide only results in a higher power
output when the light guide is placed very close to
the radiometer. In this study, the turbo light guide
202
of the Optilux 501 curing device showed a 25% high-
er output at zero mm distance from the sensor than
did the standard light guide. The focussing effect of
the turbo light guide means that, with increasing dis-
tance to the surface, the light energy diffuses at a
rate much greater than is the case with the standard
light guide. At 10 mm distance, the power output of
the turbo light guide decreased by 44%, whereas the
power output of the standard light guide decreased
by 33%. In the present study, an overlap area was
determined in which an equal mean power output
was measured for both of the light guides used. This
occurred within a distance to the sensor of 10 to
11 mm. Price et al20 found a comparable overlap ef-
fect within a distance of 2.8 to 4.8 mm using an Op-
tilux 500 and a conventional digital radiometer
(Cure Rite, Caulk/Dentsply, Milford, Delaware,
USA). The reason for this effect might be the differ-
ent curing device (Optilux 501 instead of 500) or the
technology behind the thermoelectric sensor.
Comparing the power output of the LED devices,
the lower power density of the Luxomax vs the
FreeLight and e-Light may be explained by the fact
that it contains 7 LEDs, which do not seem to be
powerful enough to reach the power density avail-
able from the other two LED devices investigated.
It is noteworthy that the power densities measured
for the Elipar FreeLight and the GC e-Light were al-
most equal: Because the Elipar FreeLight consists
of 19 LEDs, and the e-Light consists of 64 LEDs, a
higher power output at zero distance was expected
for the e-Light. This might also be explained by a
focussing effect. The focussing capacity of the
light guide of the FreeLight is not as strong as that
of the turbo light guide of the Optilux 501, but the
FreeLight’s focussing effect nevertheless seems
to compensate for the scattering of the emitted
light. The e-Light is equipped with a parallel light
guide without any kind of focussing effect. The
more drastic decrease of the power density of the
e-Light compared to that of the FreeLight within a
distance of 10 mm thus may also be explained by
the aforementioned focussing effect of the
FreeLight. With the GC e-Light, only 17% of the
power density at zero distance was measured,
while the Elipar Freelight showed 32%. Both were
far below the remaining power densities of 62%
and 67% for QTH curing devices at a 10 mm dis-
tance. To prove this theory, it would also have
been necessary to use a standard light guide with
the Elipar FreeLight in this investigation, but the
same backside diameter of the Elipar Trilight light
The Journal of Adhesive Dentistry

guide from the same manufacturer did not fit into
the clutch of the Elipar FreeLight, so this compari-
son was not possible.
Comparing the power output decrease of all de-
vices, the LED curing lights Elipar FreeLight and GC
e-Light showed a significantly higher percentage de-
crease in power output at a distance of 10 mm
than the QTH curing devices. Therefore, the experi-
ment conducted for this study supports the hypoth-
esis formulated at the beginning of this article,
namely, that the decrease of power output of an
LED curing device is significantly larger than that of
a QTH curing device if the light guide tips of the Eli-
par FreeLight and GC e-Light are placed at a dis-
tance of 10 mm to a radiometer.
The power density of the Luxomax did not de-
crease as significantly, yet was only 40% of that of
the other LED curing devices at zero mm distance.
It seems that the light emitted by a blue LED curing
device scatters more widely than conventional QTH
light. A reason for this could be a nonisotropic radi-
ation of LEDs, reflection phenomena of the light
guide, or the impossibility of collecting more paral-
lel-emitted light at the backside of the light guide by
means of a common reflector.
Using new blue LED curing devices has many ad-
vantages, such as cable-free handling, almost
noise-free curing, and less heat production. Howev-
er, it is important to know whether or not the per-
centage decrease in curing energy for an LED de-
vice is larger when compared to a standard QTH de-
vice at a clinically relevant distance to the filling
surface. This would affect the depth of curing, and
hence the lifetime of a resin composite filling could
be significantly reduced.
CONCLUSION
The results presented here suggest the following
conclusions. First, the blue LED curing devices Eli-
par FreeLight and GC e-Light provided comparable
power output. The mean power output at zero dis-
tance was significantly higher than that of the Lux-
omax. Second, both the Elipar FreeLight and GC
e-Light showed a significantly higher percentage de-
crease in power output than the QTH curing devices
investigated. Third, the percentage decrease in
power output of the GC e-Light was even greater
than that of the Elipar FreeLight.
Therefore, a lower curing potential may be ex-
pected for these blue LED curing devices when the
Vol 4, No 3, 2002
Meyer et al
distance to the resin composite increases. Due to
the fact that this study did not determine the depth
of cure within a clinically relevant distance to the
light guide, no conclusions can be drawn with re-
gard to the actual curing potential of the investigat-
ed devices. Until further information on depth of
cure at a clinically relevant distance is available, it
is advisable to place the light guide of blue LED cur-
ing devices as close as possible to the resin com-
posite surface.
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The Journal of Adhesive Dentistry