Light Curing Explored in Halifax

I do not remember a time during my dental career when direct resin restorations were not being disparaged by someone. Some of the expressed concerns have validity. Certainly the earlier composite resins offered little wear resistance or ability to predictably create a bonded interface. The chemical activation system used in early materials also limited the ability of a practitioner to form and sculpt restorations.

I remember being taught that the placement of a composite resin restoration should include the same level of care and attention to detail provided to direct gold restorations. I have held the opinion that many of the problems associated with composite resin restorations can be attributed to approaching their placement in a way that mimics the approach taken when placing amalgam, a material that is much more forgiving of less-than-optimal handling.

An important issue in the placement of light-activated composite resin is the amount and type of light energy that is actually being received by the material. Inadequate light curing can easily result in compromised restorative material properties, compromises that likely have a negative influence on restoration longevity. It has been well documented that, worldwide, many offices have been using inadequate amounts of energy and less-than-optimal technique and are delivering inadequate amounts of energy when light curing resins.^1-9 If that is the case, then it should be no surprise to anyone when reading reports about the substandard performance of posterior composite resin restorations.^10-13

More than 40 key opinion leaders and company scientists met at Dalhousie University in May 2014 to discuss ways to address issues surrounding light curing. Arranged by Dr. Richard B. Price, the symposium participants included:

Bob Angelo, Ahmed Abuelyaman, Suham Alexander, Sibel Antonson, Steve Armstrong, Oliver Benz, Uwe Blunck, Ellen Bruzell, John Burgess, Peter Burtscher, Liang Chen, Ivo Correa, Matt Dailey, Colin Deacon, Omar El-Mowafy, Christopher Felix, Jack Ferracane, Reinhard Hickel, Thomas Hill, Neil Jessop, Hilde Kopperud, Daniel Labrie, Hui Lu, Bernhard Möginger, Lori Moilanen, John O'Keefe, Joe Oxman, Frank Pfefferkorn, Jeffrey Platt, Richard Price, Jean-François Roulet, Fred Rueggeberg, Janine Schweppe, Adrian Shortall, Jeffrey Stansbury, Howard Strassler, Byoung Suh, Andreas Utterodt, David Watts, and Stacy Wyatt.

The symposium received support and active participation from Benco, BISCO, BlueLight Analytics, DENTSPLY, Gigahertz-Optik, Henry Schein, Heraeus-Kulzer, Ivoclar Vivadent, Kerr, Patterson Dental, SDI, 3M-ESPE, and Ultradent.

The group adopted a glossary of terms that are based on the International System of Units (SI) definitions associated with light technology and is encouraging the use of them during communication on the subject (Table 1).¹⁴ In addition, a consensus statement reflecting areas of agreement within the group was drafted and is included here as Figure 1.

Table 1: Glossary of Terms for Light Curing^a

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Inadequate light curing can easily result in compromised restorative material properties. These compromises will likely have a negative influence on restoration longevity.

The included guidelines are provided for the benefit of your patients and are simultaneously being published here and in the following journals: Journal of Adhesive Dentistry, Dental Materials, and Journal of the Canadian Dental Association.