Durey Kathryn, Santini Ario, Miletic Vesna
Prim Dent Care. 2008 Jan;15(1):33-8. doi: 10.1308/135576108783328409.
The purpose of the present study was to measure the intrapulpal temperature rise occurring during polymerisation of different shades of resin-based composites (RBCs), and two light-emitting diode (LED) units.
Seventy non-carious permanent molars, that had been extracted for orthodontic purposes and stored in 2% thymol for not more than four months, were selected. Patient age range was 11-18 years. Standard cavity preparation with standardised remaining dentine thickness and placement of thermocouples (TCs) was prepared using a novel split-tooth technique. Cavities were filled with one of two shades of RBC (A2 and C4, Filtek Z250, 3M ESPE, Seefeld, Germany), and cured with two LED high-intensity units (Elipar Freelight2, 3M ESPE, Seefeld, Germany; Bluephase, Ivoclar Vivadent, Schaan, Liechtenstein) and a conventional halogen light-curing unit (LCU) (Prismetics Lite 2, Dentsply, Weybridge, Surrey, UK) as a control.
Pulp temperature rises during bonding [A2 results: H;2.67/0.48:E;5.24/1.32;B;5.99/1.61] were always greater than during RBC curing [A2 results: 2.44/0.63;E3.34/0.70;B3.38/0.60], and these were significant for both LED lights but not for the halogen control, irrespective of shade (Mann-Whitney test: 95% confidence limits). Temperature rises were at times in excess of the values normally quoted as causing irreversible pulp damage. Pulp temperature rises during bonding were higher with the LED lights than with the halogen control. There was no significant difference in temperature rise between the two LED lights when bonding but there was a significant difference between the two LED lights and the halogen control LCUs (Kruskal-Wallis Test: 95% confidence limits).
The results support the view that there is a potential risk for heat-induced pulpal injury when light-curing RBCs. The risk is greater during bonding and with high energy, as compared to low-energy output systems. As the extent of tolerable thermal trauma by the pulp tissues is unknown, care and consideration should be given to the choice of LCU and the exposure time when curing RBCs, and especially during bonding.
本研究旨在测量不同色度的树脂基复合材料(RBC)聚合过程中以及两种发光二极管(LED)装置照射下牙髓腔内温度的升高情况。
选取70颗因正畸原因拔除的非龋性恒牙,保存在2%的麝香草酚中不超过4个月。患者年龄范围为11 - 18岁。采用一种新颖的劈牙技术进行标准洞形制备,保持标准化的剩余牙本质厚度并放置热电偶(TC)。窝洞用两种色度的RBC(A2和C4,Filtek Z250,3M ESPE,德国塞费尔德)之一充填,并用两种LED高强度装置(Elipar Freelight2,3M ESPE,德国塞费尔德;Bluephase,义获嘉伟瓦登特,列支敦士登沙恩)以及一个传统卤素光固化装置(LCU)(Prismetics Lite 2,登士柏,英国萨里郡韦布里奇)作为对照进行固化。
粘结过程中牙髓温度升高[A2结果:H;2.67/0.48:E;5.24/1.32;B;5.99/1.61]总是大于RBC固化过程中的温度升高[A2结果:2.44/0.63;E3.34/0.70;B3.38/0.60],并且对于两种LED灯来说这些升高都是显著的,但对于卤素对照则不显著,与色度无关(曼 - 惠特尼检验:95%置信区间)。温度升高有时超过通常所引用的会导致不可逆牙髓损伤的值。粘结过程中LED灯照射下的牙髓温度升高高于卤素对照。两种LED灯在粘结时温度升高没有显著差异,但两种LED灯与卤素对照LCU之间存在显著差异(克鲁斯卡尔 - 沃利斯检验:95%置信区间)。
结果支持这样的观点,即光固化RBC时存在热诱导牙髓损伤的潜在风险。与低能量输出系统相比,粘结过程中以及高能量照射时风险更大。由于牙髓组织可耐受的热创伤程度未知,在固化RBC时,尤其是粘结过程中,应谨慎选择LCU并考虑照射时间。