Depth of cure of dental resin composites: ISO 4049 depth and microhardness of types of materials and shades.

The optimal degree of curing throughout the bulk of a visible light-activated dental resin composite is acknowledged to be important to the clinical success of a resin composite restoration. Unfortunately, the dentist has no means of monitoring the cure of the resin surfaces not directly exposed to the curing light. Techniques, such as the layered buildup of restorations in 2 mm increments with longer activation times than 20 seconds, have been suggested. This study investigated the depth of cure (DOC) of a commercial resin composite in three types: flowable, hybrid and packable and in three shades: B1, A3 and D3 after 20 second activation with a quartz halogen light (620 mW/cm2). Depth of cure was measured by scraping the uncured material and by using a Knoop Hardness profile, starting from the surface exposed to the light. Using a minimum Knoop Hardness ratio of 0.8 bottom/top only, the flowable in shade B1 achieved a 2 mm DOC. Using the less restrictive scraping test, only the B1 shade of flowable and hybrid significantly exceeded a 2 mm DOC. Knoop Hardness at the DOC obtained by scraping ranged from 55%-70% of the top surface hardness. These data suggest that a 2 mm buildup layering technique may not result in adequate curing of the bottom layer for such a wide range of materials and that manufacturers need to provide quantitative information about DOC at specific activation times and light intensities for their entire range of resin materials and shades so that the dentist can devise a placement technique that will ensure adequate cure of the bulk of a restoration.