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Lasers Med Sci (2012) 27:145–151
DOI 10.1007/s10103-010-0857-y

ORIGINAL ARTICLE

The effect of curing light and chemical catalyst on the degree
of conversion of two dual cured resin luting cements
Eduardo José Souza-Junior & Lúcia Trazzi Prieto & Giulliana Panfiglio Soares &
Carlos Tadeu dos Santos Dias & Flávio Henrique Baggio Aguiar &
Luís Alexandre Maffei Sartini Paulillo

Received: 31 March 2010 / Accepted: 28 October 2010 / Published online: 23 November 2010
# Springer-Verlag London Ltd 2010

Abstract The aim of this study was to evaluate the
influence of different curing lights and chemical catalysts
on the degree of conversion of resin luting cements. A total
of 60 disk-shaped specimens of RelyX ARC or Panavia F
of diameter 5 mm and thickness 0.5 mm were prepared and
the respective chemical catalyst (Scotchbond Multi-Purpose
Plus or ED Primer) was added. The specimens were lightcured using different curing units (an argon ion laser, an
LED or a quartz-tungsten-halogen light) through shade A2
composite disks of diameter 10 mm and thickness 2 mm.
After 24 h of dry storage at 37°C, the degree of conversion
of the resin luting cements was measured by Fouriertransformed infrared spectroscopy. For statistical analysis,
ANOVA and the Tukey test were used, with p≤0.05.
Panavia F when used without catalyst and cured using the
LED or the argon ion laser showed degree of conversion
values significantly lower than RelyX ARC, with and
without catalyst, and cured with any of the light sources.
Therefore, the degree of conversion of Panavia F with ED
Primer cured with the quartz-tungsten-halogen light was
significantly different from that of RelyX ARC regardless
E. J. Souza-Junior (*) : L. T. Prieto
Piracicaba Dental School, Department of Restorative Dentistry,
University of Campinas - UNICAMP,
P.O. Box 52, Avenida Limeira, 901, Areião,
13414-903, Piracicaba, SP, Brazil
e-mail: edujcsj@gmail.com
G. P. Soares : F. H. B. Aguiar : L. A. M. S. Paulillo
Piracicaba Dental School, Department of Restorative Dentistry,
State University of Campinas – UNICAMP,
Piracicaba, SP, Brazil
C. T. dos Santos Dias
Department of Exact Science, University of São Paulo,
São Paulo, Brazil

of the use of the chemical catalyst and light curing source.
In conclusion, RelyX ARC can be cured satisfactorily with
the argon ion laser, LED or quartz-tungsten-halogen light
with or without a chemical catalyst. To obtain a satisfactory
degree of conversion, Panavia F luting cement should be
used with ED Primer and cured with halogen light.
Keywords Curing light . Degree of cure . Resin cement .
Photoactivation

Introduction
With the new developments in adhesive dentistry, resin luting
cements have become widely used due to their ability to bond
indirect restorations to the tooth structure [1, 2]. These
materials can minimize some adverse effects of direct
composite restorations, such as polymerization contraction
stress [3] and gap formation at the tooth/restoration interface
[4]. Therefore, the procedure involving resinous luting of
thick and opaque indirect restorations and fiber posts needs
an adequate cure to reach a satisfactory degree of conversion
of the cement used [2, 5]. The degree of conversion is
affected by the attenuation of the light that reaches the resin
cement, by the distance of the light source tip, irradiance and
energy density applied, and by the transmission properties of
the indirect restoration [5]. An insufficient degree of
conversion can lead to deficient mechanical properties of
the resin luting cement, including inadequate hardness [6, 7],
wear resistance [8] and water sorption, residual monomer
[9], and problems with biocompatibility. A low degree of
resin polymerization increases the risk of restoration failure
and marginal fracture, gap formation and the occurrence of
secondary caries [4], and reduces the retention of the indirect
restoration or the post [10].
146

In an attempt to overcome these problems, dual curing
resin cements were developed to combine important
properties of chemical-cured and light-cured materials so
as to provide efficient cure in deeper areas and places with
reduced light penetration [2, 11]. However, in some
situations, the polymerization reaction may be mainly
activated by a chemical mechanism (self-cure). Chemical
catalysts have been used with luting materials with the aim
of promoting better resin cement properties [2]. These
catalyst formulations contain coinitiator systems, such as
tertiary amine/benzoyl peroxide, that may improve the rate
of monomer conversion when mixed with the material,
especially in regions with poor light penetration [2].
On the other hand, choosing the correct light source for
curing is important to achieve a satisfactory degree of cure
of the resin luting cement. Traditionally, quartz-tungstenhalogen (QTH) lights have been widely used in dental
practice. They have a spectral wavelength in the range 400–
500 nm and an irradiance in the range 300–1,000 mW/cm2
[12, 13]. However, they have some drawbacks, such as
gradual reduction in irradiance over time, the need for
filters for wavelength selection, limited depth of cure, and
considerable heat generation [14, 15]. Blue light emitting
diode (LED) units have a narrow spectral range, which
targets the absorption wavelength of camphorquinone, with
a peak value of 468 nm, allowing low amounts of wasted
energy and minimum heat generation [14, 16]. It has been
claimed that this could provide higher monomer conversion
efficiency and reduce the exposure time required [17].
Studies have shown that current LED curing units can
replace, in most situations, conventional QTH light units
[15, 18].
The argon ion laser has arisen as an alternative light
source for polymerizing resin composites, resin luting
cements, and for bleaching procedures [19–21]. For
camphorquinone-based resins, the activation emits a blue
light in the wavelength range 400–500 nm with peak values
at about 468 and 480 nm, depending on the monomer
formulation, and it has an irradiance at up to 2,000 mW/cm2
[21–24]. Furthermore, the argon ion laser has certain
characteristics, such as low beam divergence, collimation,
monochromaticity, coherency, absorption selectivity and
fiber delivery ability, that make it particularly suitable for
clinical use to cure resinous materials with a greater degree
of cure and improved physical and mechanical properties
[22, 23, 25]. Although these laser units may accelerate the
cure of composites, they can promote a temperature increase
at the light-curing tip [21].
The effect of the chemical catalyst on the properties of
resin luting cements has not yet been clarified. Also,
determining the most effective light source for curing resin
cements still needs more study. Therefore, the aim of this
study was to evaluate the influence of the incorporation of a

Lasers Med Sci (2012) 27:145–151

chemical catalyst on cement manipulation and different
light curing units on the degree of conversion of resin luting
cements.

Materials and methods
Experimental design
The dual cured resin luting cement Panavia F (Kuraray
Medical, Tokyo, Japan) and RelyX ARC (3 M ESPE, St.
Paul, MN), with their respective chemical catalysts incorporated by manipulation of the material, were tested. The
composition of the materials is shown in Table 1. A total of
60 disk-shaped specimens of diameter 5 mm and thickness
0.5 mm were prepared from the resin cements using the
respective chemical catalysts. For specimen preparation, the
cements were placed in a silicon mold (Express XT; 3 M
ESPE, St Paul, MN) and then covered with Mylar film and
a glass slide, in order to form a flat surface.
For Panavia F alone, equal amounts (27 g) of base and
catalyst were weighed on an analytical balance [2], mixed
for 15 s, and then immediately photocured. In the groups to
which the ED Primer had been added, one drop of each of
the primer liquids A and B was mixed for 10 s, and gently
air-dried for 5 s for solvent evaporation. Thereafter, 1.4 mg
of this solution was mixed with equal amounts (27 g) of
base and catalyst of Panavia F for 15 s, and immediately
photocured [2].
Specimens of RelyX ARC alone were prepared in the same
way as the Panavia F specimens, with equal amounts (27 g) of
base and catalyst, mixed for 15 s and then photocured. For
specimens with the added chemical catalyst (catalyst of
Scotchbond Multi-Purpose), 1.4 mg of the liquid was mixed
with equal amounts (27 g) of base and catalyst of RelyX ARC
for 15 s, and immediately photocured.
A disk (10 mm in diameter and 2 mm thick) of a
nanofilled resin composite shade A2 (Filtek Z350; 3 M
ESPE) was prepared to simulate an indirect restoration. The
resin luting cements were light-cured through the composite
for 40 s, using three light sources: argon ion laser at
600 mW/cm 2 (Accucure 3000/Lasermed); LED at
1,400 mW/cm2 (FLASHlite 1401/Discus Dental); and
QTH light at 600 mW/cm2 (VIP/Bisco, Schaumburg, IL).
The irradiance of all curing sources was measured with a
radiometer before light activation (Demetron Kerr Corporation, Orange, CA). The light spectra of all curing units are
shown in Fig. 1.
Degree of conversion
After 24 hours of dry storage at 37°C in the dark, the
degree of conversion (DC) of the specimens was deter-
Lasers Med Sci (2012) 27:145–151

147

Table 1 Materials used in the study with composition and manufacturer’s information
Resin cements

Composition

Manufacturer

Panavia F

Paste A (batch 00250B): 10-Methacryloyloxydecyl dihydrogen phosphate,
hydrophobic aromatic dimethacrylate, hydrophobic aliphatic dimethacrylate,
hydrophilic dimethacrylate, silanated sílica, photoinitiators, DL-camphorquinone,
benzoyl peroxide
Paste B (batch 00027B): Hydrophobic aromatic dimethacrylate, hydrophobic aliphatic
dimethacrylate, hydrophilic dimethacrylate. Sodium aromatic sulfinate, accelerator,
sodium fluoride, silanated barium glass

Kuraray Medical,
Tokyo, Japan

ED Primer

Primer A (batch 00272A): 2-Hydroxyethyl methacrylate, methacryloyloxydecyl
Kuraray Medical,
dihydrogen phosphate, NM-aminosalicylic acid, diethanol-p-toluidine, water
Tokyo, Japan
Primer B (batch 00147A): NM-Aminosalicylic acid, T-isopropylic benzenic
sodium sulfinate, diethanol-p-toluidine, water
RelyX ARC (batch GU9JG) Paste A: Silane-treated ceramic, bis-glycidyl methacrylate, triethylene glycol dimethacrylate, 3 M ESPE,
photoinitiators, amine, silane-treated silica, functionalized dimethacrylate polymer
St Paul, MN
Paste B: Silane-treated ceramic, triethylene glycol dimethacrylate, bis-glycidyl methacrylate,
silane-treated silica, benzoyl peroxide, functionalized dimethacrylate polymer
Catalyst for Scotchbond
Bisphenol A diglycidyl ether dimethacrylate, 2-hydroxyethyl methacrylate, benzoyl peroxide 3 M ESPE,
Multi-Purpose (batch 9BE)
St Paul, MN

mined using Fourier transform infrared spectroscopy
(FTIR) with a Spectrum 100 instrument (PerkinElmer,
Shelton, CT). For each specimen 32 spectra were analyzed.
The ratio between the intensities of aliphatic C=C (at
1,637.3 cm−1) and aromatic C=C (at 1,608.3 cm−1) peaks
for uncured and cured samples were used to calculate the
degree of conversion, according to the following equation:



½Abs ðC ¼ C aliphÞ=Abs ðC::: C aromÞŠ cured resin
DC ¼ 1 À
:::
½Abs ðC ¼ C aliphÞ=AbsðC C aromÞŠ uncured risen
 100

where DC is the degree of conversion, Abs(C=C arom) is
the height of the benzene ring peak, and Abs(C=C aliph) is
the height of the aliphatic C=C bond peak, for both cured
and uncured composites.

A one-way ANOVA was performed to compare the
differences among the tested groups at a preset alpha of
0.05, followed by Tukey’s post hoc test.

Results
Means and standard deviations of the degree of conversion
of the resin luting cements are shown in Table 2. Panavia F
photocured with the LED and with the argon ion laser
without chemical catalyst exhibited the lowest degree of
conversion, which was significantly different from that of
the other groups tested (p≤0.05). For the RelyX luting
cement, no statistically significant differences in the degree
of conversion were found between the light sources and the
presence of chemical catalyst on manipulation. Photopolymerization with the QTH light showed better degree
of conversion, which was significantly different from the
degree of conversion with the LED and with the laser for
Panavia F without catalyst incorporation. However, for
RelyX ARC alone, there were no differences between the
degrees of conversion achieved with any of the light curing
units (p≥0.05). Figures 2 and 3 show the means of the
degrees of conversion for Panavia F and RelyX ARC.

Discussion

Fig. 1 Spectra of the light curing units used

The resin luting cements used in this study (RelyX ARC
and Panavia F) are widely used in clinical practice for
cementing fiber posts and indirect restorations. Most resin
luting materials contain a diketone photoinitiator, such as
camphorquinone with a broad absorption spectral peak at
148

Lasers Med Sci (2012) 27:145–151

Table 2 Degrees of (percentage) conversion of the tested groups.
Values are means (standard deviations)
Group

Degree of conversion (%)

1. RelyX ARC+LED
2. RelyX ARC+Laser+catalyst
3. RelyX ARC+LED+catalyst
4. RelyX ARC+Laser
5. RelyX ARC+QTH
6. RelyX ARC+QTH+catalyst
7. Panavia F+QTH+catalyst
8. Panavia F+QTH
9. Panavia F+LED+catalyst
10. Panavia F+Laser+catalyst
11. Panavia F+LED
12. Panavia F+Laser

68.68 (9.10) A
67.58 (5.84) A
62.0 (4.73) AB
60.4 (10.1) AB
59.2 (11.3) AB
54.26 (5.84) ABC
54.1 (5.61) ABC
44.9 (9.49) BC
42.0 (6.23) BC
35.6 (3.07) C
10.91(8.68) D
7.10 (5.53) D

Different letters mean statistical significant difference among the groups

468 nm in the blue region of the visible spectrum [26, 27].
However, the spectral distribution of the output from the
curing light source and the maximum absorption peak of a
photoinitiator can affect the chemical and physical properties
of a given resin.
Some resinous photocure or dual cure materials, such as
resin cements, may have a lower concentration of camphorquinone or other photoinitiator such as phenyl propanedione [28] (PPD) and monoacrylphosphine oxide [29]
(TPO), and sometimes the percentage of photoinitiator is
not clarified by the manufacturer because a patent on the
product has been applied for. For Panavia F, the manufacturer omits the percentage of the camphorquinone-based
photoinitiator system, and the percentage and composition
of the photoinitiator component for RelyX ARC is
unknown. The degree of conversion of RelyX ARC was
not influenced by either the curing light or chemical
catalyst (54.26% to 68.68%); however, Panavia F just
reached an adequate monomer conversion rate (44.9% and

Fig. 2 Degrees of conversion (means±SD) for Panavia F (*p0.05)

Fig. 3 Degrees of conversion (means±SD) for RelyX ARC

54.1%) when QTH light was used, regardless of the
incorporation of ED Primer. The results suggest that RelyX
ARC may contain camphorquinone in a higher percentage
than Panavia F, since the curing units with a narrower
spectrum range for the absorption peak of this photoinitiator (the LED and the argon ion laser) did not influence
monomer conversion, compared to the QTH curing light.
Therefore, Panavia F, when cured with the LED and the
laser without ED Primer incorporation, reached a poor
degree of conversion in comparison with that achieved with
the QTH light. Thus, ED Primer should be incorporated
with Panavia F in any manipulation procedure in order to
achieve a satisfactory degree of monomer conversion and,
consequently, clinical success.
Faria-e-Silva et al. [2] found that the degree of conversion
of Panavia F was approximately 60% when photocured with
halogen light under a resin composite disk. In this study, the
highest degree of conversion of Panavia F was 54.1% when
used with the chemical catalyst and cured with the QTH
light. However, other authors [30] have stated that when
cured directly with a LED, this cement reaches about 48%
monomer conversion; however, in this study when this
cement was cured with the LED unit under a resin composite
disk, the degree of conversion reached about 10.91%, which
is unsatisfactory for clinical applications.
The curing units used in this work emitted different
irradiances and final energy densities after 40 s for photoactivation was adopted for all light sources (QTH and laser,
600 mW/cm2 and 24 J; LED, 1,200 mW/cm2 and 48 J).
Although higher values of irradiance induce greater heat
generation, the composite disk attenuated the temperature
alteration caused by the LED since the composite had a low
thermal conductivity [27, 29], and did not affect the degree
of conversion of the tested resin cements. The curing unit
energy density did not influence the degree of conversion of
Panavia F cured without ED primer, since QTH provided a
significantly higher degree of conversion than the LED when
ED Primer was not used. This finding may be associated
with the photoinitiator content of Panavia F and the broad
Lasers Med Sci (2012) 27:145–151

spectral range of QTH light that can reach alternative
photoinitiators better than the second-generation LED used
in this study, even though the latter emits a higher irradiance
for the same curing time than the QTH light. For
conventional camphorquinone-based resin composites, no
difference has been observed in the development of physical
properties, such as the degree of conversion, when LED and
QTH units are compared [13, 31].
The argon ion laser has been described as a promising
light source for curing resinous materials [21]. In spite of
some benefits, such as an economic benefit of 25–33%,
adequate depth of cure, and enhancement in resin physical
properties after polymerization, the laser absorption peak is
at 488 nm, displacing the camphorquinone absorption peak
at 468 nm [32, 33]. In some situations, this distance can
make activation with the argon ion laser inefficient [21, 34].
In this study, the argon ion laser, working with the same
energy density as the QTH light, achieved an inadequate
degree of conversion of Panavia F alone, due to the offset
narrower spectral peak at about 488 nm, which could not
initiate the photoinitiators present in this cement under the
resin composite disk. When used with ED Primer, Panavia
F cured with argon ion laser did not display a significantly
different degree of monomer conversion than that cured
with the QTH or LED. For RelyX ARC there was no
difference in the degree of conversion between the curing
lights, indicating that the argon ion laser is suitable for
cementing of indirect restorations, similar to the QTH and
LED lights, when this material is used.
For the photoactivation procedure, a resin composite disk
was prepared to simulate an indirect restoration, which is able
to provide adequate physical and mechanical cement properties [17]. It is important to simulate a clinical situation
representative of cementing an indirect restoration, since
light would be attenuated by the composite [2, 5] or ceramic
[17, 26, 35, 36], and the degree of cure might be lower than
with direct curing. Besides, the resin luting thickness was
0.5 mm, which is close to that seen in clinical situations, and
it allowed satisfactory measurement by FTIR [1, 5]. Some
studies [26, 30] used specimens with a cement thickness of
about 1–2 mm, which is not clinically acceptable, as it may
result in a lower degree of conversion at the bottom of the
sample due to the depth of cure of the resinous material [21,
30] and differences in the light curing irradiance that reaches
all surfaces of the composite [14, 37].
The resin cements were activated totally by dual curing.
The chemical curing of the luting materials with incorporation of the chemical catalyst was not tested because the
results of some studies have shown that chemical curing
alone does not promote an adequate degree of conversion
of resin cements [2, 5]. On the other hand, many
manufacturers state that resin cement photoactivation may
be delayed for 5 or 10 minutes, since important chemical

149

curing can occur and such a delay does not stop the
conversion of monomers by the free radical polymerization
center [2]. In this study specimens were immediately
photocured for the sake of standardization because the
manufacturers of some resin luting cements do not
recommend such a delay in photoactivation.
The chemical catalysts used in this study contained
benzoyl peroxide, which might be able to start some
chemical cure at the material matrix [5]. The self-cure is
initiated with a reaction between benzoyl peroxide and
tertiary amine that releases free radicals which promote
monomer conversion regardless of exposure to light curing
[38]. Thus, the catalyst of the Scotchbond Multi-Purpose
system contains only benzoyl peroxide as an initiator
system. This catalyst did not influence the degree of cure
of RelyX ARC, regardless of the light curing source. This
may be explained by the chemical reaction that normally
occurs between benzoyl peroxide and the tertiary amine
present in the composite material. If the tertiary amine
supply is lower than the benzoyl peroxide content, the
reaction cannot initiate, and the degree of conversion
remains undisturbed [38]. However, ED Primer is a system
that contains a tertiary amine/benzoyl peroxide system,
providing a complete self-cure reaction that could have
improved the physical properties of Panavia F when mixed
with this resin cement [2]. For Panavia F, a primer A and B
mixture incorporated with the cement increased the degree
of conversion when the LED and the argon ion laser were
used; whereas a similar degree of conversion was obtained
when the QTH curing light was used. So for Panavia F, the
ED Primer is essential for maintaining a satisfactory degree
of monomer conversion when cured with the light sources
most frequently used in clinical practice.
For indirect esthetic restorations, light plays an important
role in promoting satisfactory conversion of the resin
cement, ensuring adequate cementation [2, 5]. However,
the attenuation of the irradiance by ceramic or resin indirect
restorations with a 2-mm thickness is such that only a half
of the irradiance reaches the resin cement beneath these
materials [5, 39]. For metallic crowns, the chemical curing
and incorporation of the catalyst into the resin luting
cement might compensate for the total attenuation of the
curing light, since that would cause an effect only around
the margin. Thus, clinicians should incorporate the chemical
catalyst into the manipulation of resin cements, since it
improves or does not affect the degree of conversion of these
luting materials.

Conclusion
Based on these results, it can be concluded that the argon
ion laser, LED, and QTH light promote an adequate degree
150

of conversion for RelyX ARC, regardless of the
addition of the chemical catalyst. Nevertheless, Panavia
F, when photocured with the LED or argon ion laser,
should be mixed with the chemical catalyst (ED Primer)
to achieve a satisfactory degree of conversion, especially
in situations affected by the attenuation of light. Thus,
Panavia F should be used with the incorporation of the
ED Primer on manipulation and photocured with a QTH
light unit.
Aknowledgments We are grateful to CAPES for supporting this
study and to William Cunha Brandt for his scientific contribution.

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Grau de Conversão de cimento resinoso - Degree of Conversion - resin cement

  • 1. Lasers Med Sci (2012) 27:145–151 DOI 10.1007/s10103-010-0857-y ORIGINAL ARTICLE The effect of curing light and chemical catalyst on the degree of conversion of two dual cured resin luting cements Eduardo José Souza-Junior & Lúcia Trazzi Prieto & Giulliana Panfiglio Soares & Carlos Tadeu dos Santos Dias & Flávio Henrique Baggio Aguiar & Luís Alexandre Maffei Sartini Paulillo Received: 31 March 2010 / Accepted: 28 October 2010 / Published online: 23 November 2010 # Springer-Verlag London Ltd 2010 Abstract The aim of this study was to evaluate the influence of different curing lights and chemical catalysts on the degree of conversion of resin luting cements. A total of 60 disk-shaped specimens of RelyX ARC or Panavia F of diameter 5 mm and thickness 0.5 mm were prepared and the respective chemical catalyst (Scotchbond Multi-Purpose Plus or ED Primer) was added. The specimens were lightcured using different curing units (an argon ion laser, an LED or a quartz-tungsten-halogen light) through shade A2 composite disks of diameter 10 mm and thickness 2 mm. After 24 h of dry storage at 37°C, the degree of conversion of the resin luting cements was measured by Fouriertransformed infrared spectroscopy. For statistical analysis, ANOVA and the Tukey test were used, with p≤0.05. Panavia F when used without catalyst and cured using the LED or the argon ion laser showed degree of conversion values significantly lower than RelyX ARC, with and without catalyst, and cured with any of the light sources. Therefore, the degree of conversion of Panavia F with ED Primer cured with the quartz-tungsten-halogen light was significantly different from that of RelyX ARC regardless E. J. Souza-Junior (*) : L. T. Prieto Piracicaba Dental School, Department of Restorative Dentistry, University of Campinas - UNICAMP, P.O. Box 52, Avenida Limeira, 901, Areião, 13414-903, Piracicaba, SP, Brazil e-mail: edujcsj@gmail.com G. P. Soares : F. H. B. Aguiar : L. A. M. S. Paulillo Piracicaba Dental School, Department of Restorative Dentistry, State University of Campinas – UNICAMP, Piracicaba, SP, Brazil C. T. dos Santos Dias Department of Exact Science, University of São Paulo, São Paulo, Brazil of the use of the chemical catalyst and light curing source. In conclusion, RelyX ARC can be cured satisfactorily with the argon ion laser, LED or quartz-tungsten-halogen light with or without a chemical catalyst. To obtain a satisfactory degree of conversion, Panavia F luting cement should be used with ED Primer and cured with halogen light. Keywords Curing light . Degree of cure . Resin cement . Photoactivation Introduction With the new developments in adhesive dentistry, resin luting cements have become widely used due to their ability to bond indirect restorations to the tooth structure [1, 2]. These materials can minimize some adverse effects of direct composite restorations, such as polymerization contraction stress [3] and gap formation at the tooth/restoration interface [4]. Therefore, the procedure involving resinous luting of thick and opaque indirect restorations and fiber posts needs an adequate cure to reach a satisfactory degree of conversion of the cement used [2, 5]. The degree of conversion is affected by the attenuation of the light that reaches the resin cement, by the distance of the light source tip, irradiance and energy density applied, and by the transmission properties of the indirect restoration [5]. An insufficient degree of conversion can lead to deficient mechanical properties of the resin luting cement, including inadequate hardness [6, 7], wear resistance [8] and water sorption, residual monomer [9], and problems with biocompatibility. A low degree of resin polymerization increases the risk of restoration failure and marginal fracture, gap formation and the occurrence of secondary caries [4], and reduces the retention of the indirect restoration or the post [10].
  • 2. 146 In an attempt to overcome these problems, dual curing resin cements were developed to combine important properties of chemical-cured and light-cured materials so as to provide efficient cure in deeper areas and places with reduced light penetration [2, 11]. However, in some situations, the polymerization reaction may be mainly activated by a chemical mechanism (self-cure). Chemical catalysts have been used with luting materials with the aim of promoting better resin cement properties [2]. These catalyst formulations contain coinitiator systems, such as tertiary amine/benzoyl peroxide, that may improve the rate of monomer conversion when mixed with the material, especially in regions with poor light penetration [2]. On the other hand, choosing the correct light source for curing is important to achieve a satisfactory degree of cure of the resin luting cement. Traditionally, quartz-tungstenhalogen (QTH) lights have been widely used in dental practice. They have a spectral wavelength in the range 400– 500 nm and an irradiance in the range 300–1,000 mW/cm2 [12, 13]. However, they have some drawbacks, such as gradual reduction in irradiance over time, the need for filters for wavelength selection, limited depth of cure, and considerable heat generation [14, 15]. Blue light emitting diode (LED) units have a narrow spectral range, which targets the absorption wavelength of camphorquinone, with a peak value of 468 nm, allowing low amounts of wasted energy and minimum heat generation [14, 16]. It has been claimed that this could provide higher monomer conversion efficiency and reduce the exposure time required [17]. Studies have shown that current LED curing units can replace, in most situations, conventional QTH light units [15, 18]. The argon ion laser has arisen as an alternative light source for polymerizing resin composites, resin luting cements, and for bleaching procedures [19–21]. For camphorquinone-based resins, the activation emits a blue light in the wavelength range 400–500 nm with peak values at about 468 and 480 nm, depending on the monomer formulation, and it has an irradiance at up to 2,000 mW/cm2 [21–24]. Furthermore, the argon ion laser has certain characteristics, such as low beam divergence, collimation, monochromaticity, coherency, absorption selectivity and fiber delivery ability, that make it particularly suitable for clinical use to cure resinous materials with a greater degree of cure and improved physical and mechanical properties [22, 23, 25]. Although these laser units may accelerate the cure of composites, they can promote a temperature increase at the light-curing tip [21]. The effect of the chemical catalyst on the properties of resin luting cements has not yet been clarified. Also, determining the most effective light source for curing resin cements still needs more study. Therefore, the aim of this study was to evaluate the influence of the incorporation of a Lasers Med Sci (2012) 27:145–151 chemical catalyst on cement manipulation and different light curing units on the degree of conversion of resin luting cements. Materials and methods Experimental design The dual cured resin luting cement Panavia F (Kuraray Medical, Tokyo, Japan) and RelyX ARC (3 M ESPE, St. Paul, MN), with their respective chemical catalysts incorporated by manipulation of the material, were tested. The composition of the materials is shown in Table 1. A total of 60 disk-shaped specimens of diameter 5 mm and thickness 0.5 mm were prepared from the resin cements using the respective chemical catalysts. For specimen preparation, the cements were placed in a silicon mold (Express XT; 3 M ESPE, St Paul, MN) and then covered with Mylar film and a glass slide, in order to form a flat surface. For Panavia F alone, equal amounts (27 g) of base and catalyst were weighed on an analytical balance [2], mixed for 15 s, and then immediately photocured. In the groups to which the ED Primer had been added, one drop of each of the primer liquids A and B was mixed for 10 s, and gently air-dried for 5 s for solvent evaporation. Thereafter, 1.4 mg of this solution was mixed with equal amounts (27 g) of base and catalyst of Panavia F for 15 s, and immediately photocured [2]. Specimens of RelyX ARC alone were prepared in the same way as the Panavia F specimens, with equal amounts (27 g) of base and catalyst, mixed for 15 s and then photocured. For specimens with the added chemical catalyst (catalyst of Scotchbond Multi-Purpose), 1.4 mg of the liquid was mixed with equal amounts (27 g) of base and catalyst of RelyX ARC for 15 s, and immediately photocured. A disk (10 mm in diameter and 2 mm thick) of a nanofilled resin composite shade A2 (Filtek Z350; 3 M ESPE) was prepared to simulate an indirect restoration. The resin luting cements were light-cured through the composite for 40 s, using three light sources: argon ion laser at 600 mW/cm 2 (Accucure 3000/Lasermed); LED at 1,400 mW/cm2 (FLASHlite 1401/Discus Dental); and QTH light at 600 mW/cm2 (VIP/Bisco, Schaumburg, IL). The irradiance of all curing sources was measured with a radiometer before light activation (Demetron Kerr Corporation, Orange, CA). The light spectra of all curing units are shown in Fig. 1. Degree of conversion After 24 hours of dry storage at 37°C in the dark, the degree of conversion (DC) of the specimens was deter-
  • 3. Lasers Med Sci (2012) 27:145–151 147 Table 1 Materials used in the study with composition and manufacturer’s information Resin cements Composition Manufacturer Panavia F Paste A (batch 00250B): 10-Methacryloyloxydecyl dihydrogen phosphate, hydrophobic aromatic dimethacrylate, hydrophobic aliphatic dimethacrylate, hydrophilic dimethacrylate, silanated sílica, photoinitiators, DL-camphorquinone, benzoyl peroxide Paste B (batch 00027B): Hydrophobic aromatic dimethacrylate, hydrophobic aliphatic dimethacrylate, hydrophilic dimethacrylate. Sodium aromatic sulfinate, accelerator, sodium fluoride, silanated barium glass Kuraray Medical, Tokyo, Japan ED Primer Primer A (batch 00272A): 2-Hydroxyethyl methacrylate, methacryloyloxydecyl Kuraray Medical, dihydrogen phosphate, NM-aminosalicylic acid, diethanol-p-toluidine, water Tokyo, Japan Primer B (batch 00147A): NM-Aminosalicylic acid, T-isopropylic benzenic sodium sulfinate, diethanol-p-toluidine, water RelyX ARC (batch GU9JG) Paste A: Silane-treated ceramic, bis-glycidyl methacrylate, triethylene glycol dimethacrylate, 3 M ESPE, photoinitiators, amine, silane-treated silica, functionalized dimethacrylate polymer St Paul, MN Paste B: Silane-treated ceramic, triethylene glycol dimethacrylate, bis-glycidyl methacrylate, silane-treated silica, benzoyl peroxide, functionalized dimethacrylate polymer Catalyst for Scotchbond Bisphenol A diglycidyl ether dimethacrylate, 2-hydroxyethyl methacrylate, benzoyl peroxide 3 M ESPE, Multi-Purpose (batch 9BE) St Paul, MN mined using Fourier transform infrared spectroscopy (FTIR) with a Spectrum 100 instrument (PerkinElmer, Shelton, CT). For each specimen 32 spectra were analyzed. The ratio between the intensities of aliphatic C=C (at 1,637.3 cm−1) and aromatic C=C (at 1,608.3 cm−1) peaks for uncured and cured samples were used to calculate the degree of conversion, according to the following equation: ½Abs ðC ¼ C aliphÞ=Abs ðC::: C aromÞŠ cured resin DC ¼ 1 À ::: ½Abs ðC ¼ C aliphÞ=AbsðC C aromÞŠ uncured risen  100 where DC is the degree of conversion, Abs(C=C arom) is the height of the benzene ring peak, and Abs(C=C aliph) is the height of the aliphatic C=C bond peak, for both cured and uncured composites. A one-way ANOVA was performed to compare the differences among the tested groups at a preset alpha of 0.05, followed by Tukey’s post hoc test. Results Means and standard deviations of the degree of conversion of the resin luting cements are shown in Table 2. Panavia F photocured with the LED and with the argon ion laser without chemical catalyst exhibited the lowest degree of conversion, which was significantly different from that of the other groups tested (p≤0.05). For the RelyX luting cement, no statistically significant differences in the degree of conversion were found between the light sources and the presence of chemical catalyst on manipulation. Photopolymerization with the QTH light showed better degree of conversion, which was significantly different from the degree of conversion with the LED and with the laser for Panavia F without catalyst incorporation. However, for RelyX ARC alone, there were no differences between the degrees of conversion achieved with any of the light curing units (p≥0.05). Figures 2 and 3 show the means of the degrees of conversion for Panavia F and RelyX ARC. Discussion Fig. 1 Spectra of the light curing units used The resin luting cements used in this study (RelyX ARC and Panavia F) are widely used in clinical practice for cementing fiber posts and indirect restorations. Most resin luting materials contain a diketone photoinitiator, such as camphorquinone with a broad absorption spectral peak at
  • 4. 148 Lasers Med Sci (2012) 27:145–151 Table 2 Degrees of (percentage) conversion of the tested groups. Values are means (standard deviations) Group Degree of conversion (%) 1. RelyX ARC+LED 2. RelyX ARC+Laser+catalyst 3. RelyX ARC+LED+catalyst 4. RelyX ARC+Laser 5. RelyX ARC+QTH 6. RelyX ARC+QTH+catalyst 7. Panavia F+QTH+catalyst 8. Panavia F+QTH 9. Panavia F+LED+catalyst 10. Panavia F+Laser+catalyst 11. Panavia F+LED 12. Panavia F+Laser 68.68 (9.10) A 67.58 (5.84) A 62.0 (4.73) AB 60.4 (10.1) AB 59.2 (11.3) AB 54.26 (5.84) ABC 54.1 (5.61) ABC 44.9 (9.49) BC 42.0 (6.23) BC 35.6 (3.07) C 10.91(8.68) D 7.10 (5.53) D Different letters mean statistical significant difference among the groups 468 nm in the blue region of the visible spectrum [26, 27]. However, the spectral distribution of the output from the curing light source and the maximum absorption peak of a photoinitiator can affect the chemical and physical properties of a given resin. Some resinous photocure or dual cure materials, such as resin cements, may have a lower concentration of camphorquinone or other photoinitiator such as phenyl propanedione [28] (PPD) and monoacrylphosphine oxide [29] (TPO), and sometimes the percentage of photoinitiator is not clarified by the manufacturer because a patent on the product has been applied for. For Panavia F, the manufacturer omits the percentage of the camphorquinone-based photoinitiator system, and the percentage and composition of the photoinitiator component for RelyX ARC is unknown. The degree of conversion of RelyX ARC was not influenced by either the curing light or chemical catalyst (54.26% to 68.68%); however, Panavia F just reached an adequate monomer conversion rate (44.9% and Fig. 2 Degrees of conversion (means±SD) for Panavia F (*p0.05) Fig. 3 Degrees of conversion (means±SD) for RelyX ARC 54.1%) when QTH light was used, regardless of the incorporation of ED Primer. The results suggest that RelyX ARC may contain camphorquinone in a higher percentage than Panavia F, since the curing units with a narrower spectrum range for the absorption peak of this photoinitiator (the LED and the argon ion laser) did not influence monomer conversion, compared to the QTH curing light. Therefore, Panavia F, when cured with the LED and the laser without ED Primer incorporation, reached a poor degree of conversion in comparison with that achieved with the QTH light. Thus, ED Primer should be incorporated with Panavia F in any manipulation procedure in order to achieve a satisfactory degree of monomer conversion and, consequently, clinical success. Faria-e-Silva et al. [2] found that the degree of conversion of Panavia F was approximately 60% when photocured with halogen light under a resin composite disk. In this study, the highest degree of conversion of Panavia F was 54.1% when used with the chemical catalyst and cured with the QTH light. However, other authors [30] have stated that when cured directly with a LED, this cement reaches about 48% monomer conversion; however, in this study when this cement was cured with the LED unit under a resin composite disk, the degree of conversion reached about 10.91%, which is unsatisfactory for clinical applications. The curing units used in this work emitted different irradiances and final energy densities after 40 s for photoactivation was adopted for all light sources (QTH and laser, 600 mW/cm2 and 24 J; LED, 1,200 mW/cm2 and 48 J). Although higher values of irradiance induce greater heat generation, the composite disk attenuated the temperature alteration caused by the LED since the composite had a low thermal conductivity [27, 29], and did not affect the degree of conversion of the tested resin cements. The curing unit energy density did not influence the degree of conversion of Panavia F cured without ED primer, since QTH provided a significantly higher degree of conversion than the LED when ED Primer was not used. This finding may be associated with the photoinitiator content of Panavia F and the broad
  • 5. Lasers Med Sci (2012) 27:145–151 spectral range of QTH light that can reach alternative photoinitiators better than the second-generation LED used in this study, even though the latter emits a higher irradiance for the same curing time than the QTH light. For conventional camphorquinone-based resin composites, no difference has been observed in the development of physical properties, such as the degree of conversion, when LED and QTH units are compared [13, 31]. The argon ion laser has been described as a promising light source for curing resinous materials [21]. In spite of some benefits, such as an economic benefit of 25–33%, adequate depth of cure, and enhancement in resin physical properties after polymerization, the laser absorption peak is at 488 nm, displacing the camphorquinone absorption peak at 468 nm [32, 33]. In some situations, this distance can make activation with the argon ion laser inefficient [21, 34]. In this study, the argon ion laser, working with the same energy density as the QTH light, achieved an inadequate degree of conversion of Panavia F alone, due to the offset narrower spectral peak at about 488 nm, which could not initiate the photoinitiators present in this cement under the resin composite disk. When used with ED Primer, Panavia F cured with argon ion laser did not display a significantly different degree of monomer conversion than that cured with the QTH or LED. For RelyX ARC there was no difference in the degree of conversion between the curing lights, indicating that the argon ion laser is suitable for cementing of indirect restorations, similar to the QTH and LED lights, when this material is used. For the photoactivation procedure, a resin composite disk was prepared to simulate an indirect restoration, which is able to provide adequate physical and mechanical cement properties [17]. It is important to simulate a clinical situation representative of cementing an indirect restoration, since light would be attenuated by the composite [2, 5] or ceramic [17, 26, 35, 36], and the degree of cure might be lower than with direct curing. Besides, the resin luting thickness was 0.5 mm, which is close to that seen in clinical situations, and it allowed satisfactory measurement by FTIR [1, 5]. Some studies [26, 30] used specimens with a cement thickness of about 1–2 mm, which is not clinically acceptable, as it may result in a lower degree of conversion at the bottom of the sample due to the depth of cure of the resinous material [21, 30] and differences in the light curing irradiance that reaches all surfaces of the composite [14, 37]. The resin cements were activated totally by dual curing. The chemical curing of the luting materials with incorporation of the chemical catalyst was not tested because the results of some studies have shown that chemical curing alone does not promote an adequate degree of conversion of resin cements [2, 5]. On the other hand, many manufacturers state that resin cement photoactivation may be delayed for 5 or 10 minutes, since important chemical 149 curing can occur and such a delay does not stop the conversion of monomers by the free radical polymerization center [2]. In this study specimens were immediately photocured for the sake of standardization because the manufacturers of some resin luting cements do not recommend such a delay in photoactivation. The chemical catalysts used in this study contained benzoyl peroxide, which might be able to start some chemical cure at the material matrix [5]. The self-cure is initiated with a reaction between benzoyl peroxide and tertiary amine that releases free radicals which promote monomer conversion regardless of exposure to light curing [38]. Thus, the catalyst of the Scotchbond Multi-Purpose system contains only benzoyl peroxide as an initiator system. This catalyst did not influence the degree of cure of RelyX ARC, regardless of the light curing source. This may be explained by the chemical reaction that normally occurs between benzoyl peroxide and the tertiary amine present in the composite material. If the tertiary amine supply is lower than the benzoyl peroxide content, the reaction cannot initiate, and the degree of conversion remains undisturbed [38]. However, ED Primer is a system that contains a tertiary amine/benzoyl peroxide system, providing a complete self-cure reaction that could have improved the physical properties of Panavia F when mixed with this resin cement [2]. For Panavia F, a primer A and B mixture incorporated with the cement increased the degree of conversion when the LED and the argon ion laser were used; whereas a similar degree of conversion was obtained when the QTH curing light was used. So for Panavia F, the ED Primer is essential for maintaining a satisfactory degree of monomer conversion when cured with the light sources most frequently used in clinical practice. For indirect esthetic restorations, light plays an important role in promoting satisfactory conversion of the resin cement, ensuring adequate cementation [2, 5]. However, the attenuation of the irradiance by ceramic or resin indirect restorations with a 2-mm thickness is such that only a half of the irradiance reaches the resin cement beneath these materials [5, 39]. For metallic crowns, the chemical curing and incorporation of the catalyst into the resin luting cement might compensate for the total attenuation of the curing light, since that would cause an effect only around the margin. Thus, clinicians should incorporate the chemical catalyst into the manipulation of resin cements, since it improves or does not affect the degree of conversion of these luting materials. Conclusion Based on these results, it can be concluded that the argon ion laser, LED, and QTH light promote an adequate degree
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