Pulpal Temperature Variances During Step-by-step Adhesive Restorative Procedure Using Three Different High-irradiance Light-curing Units
The rise in temperature in pulp tissues is related not only to heat transfer by high-irradiance light-curing units (LCUs), but also to restorative procedures. This research aimed to compare the rise in pulp temperature (PT) induced by three LCUs at each restorative step while considering the influence of resin composite shade and thickness. To accomplish this, the investigators used a proposed experimental model replicating pulp fluid circulation with a controlled, simulated intraoral temperature in bovine incisors. The recorded external and internal PT ranged from 36.7°C to 37.1°C and 32.7°C to 33.0°C, respectively. A significant decrease of internal temperature was recorded during class V preparation, followed by a progressive and representative rise of temperature in the subsequent restorative steps. The temperature was significantly higher during light curing of the adhesive system using Valo compared to light curing using Elipar and Radii Cal. However, none of the analyzed devices produced a temperature that exceeded the pulp tolerance limit (a temperature increase over 5.5°C). The paired test showed no significant difference in pulp temperature associated with the thickness of the increment of resin composite. However, shade was found to have more influence on the amount of energy absorbed by pulp tissue—A1 samples showed significantly higher temperature variation compared to samples using the A4 shade of resin composite. To conclude, the microcirculation and the performance of procedures under constant air-water flux dissipate the heat absorbed by the pulp. Additionally, the data suggest that all three LCUs analyzed can be safely used in clinical procedures, and that the resin composite shade may influence the amount of irradiance delivered to the tooth surface and represents a significant factor in pulp temperature variance.SUMMARY

Samples of bovine incisors with no fractures or any other defects used in the study, and respective digital images in facial position.

Representation of the simulated microcirculation setup: (A) Controlled thermostatic bath; (B) Controlled thermostatic reservoir; (C) Peristaltic pump at a rate of 1.0-1.4 ml/min; (D) and (E) Digital thermometer thermostat adjusted to 37°C; (F) Tooth support; (G) Thermocouple handheld optical power; (H) LCU device; (I) PM400 energy meter; and (J) Computer

Temperature variance profile in accordance to (A) Valo; (B) Elipar; and (C) Radii Cal groups—Mean values in degrees centigrade (°C) at measurement points: T1 (external temperature); T2 (internal temperature); T3 (class V preparation); T4 (adhesive light- curing); T5 and T6 (first and second 2mm layer incremental filling, respectively); T7 (4mm bulk layer filling: Groups G3, G6 and G9); T8 (final lighting cure) and T9 (finishing and polishing).

Temperature variance profile in accordance to (A) A1 shade; (B) A4 shade; and (C) A1 Bulk filling—Mean values in degrees centigrade (°C) at measurement points: T1 (external temperature); T2 (internal temperature); T3 (class V preparation); T4 (adhesive lightcuring); T5 and T6 (first and second 2 mm layer incremental filling, respectively); T7 (4 mm bulk layer filling: Groups G3, G6 and G9); T8 (final lighting cure) and T9 (finishing and polishing).
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