The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability

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Methods: A total of 20 bovine incisors were used to obtain dentin discs and divided into four experimental groups (n=10): HAL0.5: irradiation with halogen-tungsten bulb Curing Light XL 3000 at an intensity of 470 mW/cm2 over a dentin disc of 0.5 mm; LED0.5: irradiation with LED Optilight Max (GNATUS- Ribeirão Preto, SP, Brazil) at an intensity of 1200 mW/cm2 over a dentin disc of 0.5 mm; HAL1: irradiation as in HAL0.5 but over a dentin disc of 1 mm; LED1: irradiation as in LED0.5 but over a dentin disc of 1 mm. The temperature increase was measured using a digital thermometer and the cytotoxicity was evaluated using an MTT assay with a mouse fibroblast cell line (L929). Parametric Data were analyzed by ANOVA and Tukey and non-parametric data were analyzed by Kruskal Wallis with Conover-Iman for non-parametric data (all with α=0.05). Results: A significant statistical difference was found between the groups HAL0.5 and HAL1 and both were different of LED0.5 and LED1 which presented higher temperature. All the experimental groups were different of the control group (without irradiation), and promoted reduction of cellular viability. Conclusions: HAL LCU promoted a lower temperature change in the dentin compared to LED, regardless of the dentin thickness (0.5-1 mm). Both HAL and LED LCUs decreased fibroblast viability; however, LED promoted more significant cytotoxic effects." } { "@context": "http://schema.org", "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": "1", "item": { "@id": "https://f1000research.com/", "name": "Home" } }, { "@type": "ListItem", "position": "2", "item": { "@id": "https://f1000research.com/browse/articles", "name": "Browse" } }, { "@type": "ListItem", "position": "3", "item": { "@id": "https://f1000research.com/articles/9-1369/v1", "name": "The effect of halogen bulb and light-emitting diode light curing units..." } } ] } Home Browse The effect of halogen bulb and light-emitting diode light curing units... ALL Metrics - Views Downloads Get PDF Get XML Cite How to cite this article Memari Trava G, Almeida Santos J, Paula Ramos L et al. The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.12688/f1000research.25456.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. Close Copy Citation Details Export Export Citation Sciwheel EndNote Ref. Manager Bibtex ProCite Sente EXPORT Select a format first Track Share ▬ ✚ Research Article The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] Georgia Memari Trava 1 , Juliane Almeida Santos 1 , Lucas Paula Ramos https://orcid.org/0000-0002-2682-2796 1,2 , [...] Pamela Beatriz Rosário Estevam dos Santos 1 , Amjad Abu Hasna https://orcid.org/0000-0002-1112-985X 3 , Karen Cristina Yui 1 , Adriano Bressane 4 , Luciane Dias de Oliveira 1 , Marianne Spalding 1 Georgia Memari Trava 1 , Juliane Almeida Santos 1 , [...] Lucas Paula Ramos https://orcid.org/0000-0002-2682-2796 1,2 , Pamela Beatriz Rosário Estevam dos Santos 1 , Amjad Abu Hasna https://orcid.org/0000-0002-1112-985X 3 , Karen Cristina Yui 1 , Adriano Bressane 4 , Luciane Dias de Oliveira 1 , Marianne Spalding 1 PUBLISHED 25 Nov 2020 Author details Author details 1 Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Jose dos Campos, São Paulo, 12245000, Brazil 2 Taubaté Institute of Higher Education (ITES), Taubaté, São Paulo, 12090000, Brazil 3 Department of Restorative Dentistry, Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil 4 Department of Enviormental, Institute of Science and Technology, São josé dos Campos, São Paulo, 12247016, Brazil Georgia Memari Trava Roles: Data Curation, Investigation, Resources, Writing – Original Draft Preparation Juliane Almeida Santos Roles: Data Curation, Investigation, Resources, Writing – Original Draft Preparation Lucas Paula Ramos Roles: Methodology, Resources, Writing – Original Draft Preparation Pamela Beatriz Rosário Estevam dos Santos Roles: Data Curation, Methodology, Writing – Original Draft Preparation Amjad Abu Hasna Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Karen Cristina Yui Roles: Conceptualization, Writing – Review & Editing Adriano Bressane Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation Luciane Dias de Oliveira Roles: Conceptualization, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Marianne Spalding Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Writing – Review & Editing OPEN PEER REVIEW DETAILS REVIEWER STATUS Abstract Background: This study aimed to compare the temperature increase produced by halogen bulb (HAL) and light-emitting diode (LED) light curing units (LCUs) by irradiating dentin discs (0.5 mm and 1 mm thickness), and to evaluate their cytotoxic effects on fibroblast culture in the presence of dentin discs due to the increasing demand on resin composite restorations and teeth bleaching for esthetic purposes. Methods: A total of 20 bovine incisors were used to obtain dentin discs and divided into four experimental groups (n=10): HAL0.5: irradiation with halogen-tungsten bulb Curing Light XL 3000 at an intensity of 470 mW/cm 2 over a dentin disc of 0.5 mm; LED0.5: irradiation with LED Optilight Max (GNATUS- Ribeirão Preto, SP, Brazil) at an intensity of 1200 mW/cm 2 over a dentin disc of 0.5 mm; HAL1: irradiation as in HAL0.5 but over a dentin disc of 1 mm; LED1: irradiation as in LED0.5 but over a dentin disc of 1 mm. The temperature increase was measured using a digital thermometer and the cytotoxicity was evaluated using an MTT assay with a mouse fibroblast cell line (L929). Parametric Data were analyzed by ANOVA and Tukey and non-parametric data were analyzed by Kruskal Wallis with Conover-Iman for non-parametric data (all with α=0.05). Results: A significant statistical difference was found between the groups HAL0.5 and HAL1 and both were different of LED0.5 and LED1 which presented higher temperature. All the experimental groups were different of the control group (without irradiation), and promoted reduction of cellular viability. Conclusions: HAL LCU promoted a lower temperature change in the dentin compared to LED, regardless of the dentin thickness (0.5-1 mm). Both HAL and LED LCUs decreased fibroblast viability; however, LED promoted more significant cytotoxic effects. READ ALL READ LESS Keywords Halogen light, Light-emiting-diode, mouse fibroblasts, temperature increase Corresponding Author(s) Lucas Paula Ramos ( [email protected] ) Close Corresponding author: Lucas Paula Ramos Competing interests: No competing interests were disclosed. Grant information: The author(s) declared that no grants were involved in supporting this work. Copyright: © 2020 Memari Trava G et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. How to cite: Memari Trava G, Almeida Santos J, Paula Ramos L et al. The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.12688/f1000research.25456.1 ) First published: 25 Nov 2020, 9 :1369 ( https://doi.org/10.12688/f1000research.25456.1 ) Latest published: 25 Nov 2020, 9 :1369 ( https://doi.org/10.12688/f1000research.25456.1 ) Introduction Dentistry patients are looking for esthetically pleasing smiles and increasingly demanding resin composite restorations and teeth bleaching ( Al Otaibi et al., 2020 ; Sebold et al., 2020 ). These processes require photopolymerization and photoactivation by halogen bulb (HAL) and light-emitting diode (LED) light curing units (LCUs) ( Gallinari et al., 2020 ; Pieniak et al., 2014 ). However, these LCUs can increase the temperature and induce thermal transfer, depending on the light source intensity and type ( Armellin et al., 2016 ; Kim et al., 2017 ). The elevated temperature resulting from daily clinical procedures can cause an increase in pulp temperature, with the subsequent development of symptoms such as hyperalgesia, dentin hypersensitivity, and spontaneous typical pain of acute pulpitis ( Vinagre et al., 2019 ). The thermal change causes heat-induced bone tissue injury ( Eriksson & Albrektsson, 1983 ) and pulp tissue necrosis, pathology or alteration ( Matalon et al., 2010 ; Nyborg & Brännström, 1968 ). Additionally, some thermal injuries may affect the surrounding tissue cells ( Baldissara et al., 1997 ) and form lesions in the odontoblastic layer, which leads to its degeneration, protein coagulation and fluid expansion in the dentinal tubules ( Vinagre et al., 2019 ). Some contributing factors affect the extent of injury, such as the remaining dentin thickness, the type of the LCU, the type of ultrasonic device, or the type of water spray used ( Kwon et al., 2013 ). Therefore, controlling the temperature increase during the emission of LCUs is an important factor in the use of photopolymerizers. The objective of this study was to compare the temperature increase produced by HAL and LED LCUs by irradiating dentin discs (0.5 mm and 1 mm thickness), and to evaluate their cytotoxic effects on fibroblast culture in the presence of dentin discs. Methods Specimen preparation A total of 20 bovine incisors were used in this study, the crowns were separated from the roots 2 mm below the level of cemento-enamel junction and then embedded in self-curing acrylic resin (TDV, Santa Catarina, Brazil) in a prefabricated PVC mold. Later, longitudinal dentin discs (without enamel) were obtained (10 discs of 0.5 mm and 10 discs of 1 mm) by sectioning the crowns using diamond disc (0.3 mm thickness) and an EXTEC cutting machine (Labpol 8-12, Extec Corp ® , Enfield, Connecticut, USA) ( Figure 1 ). Figure 1. Schematic illustration of dentin discs. ( A ) the bovine tooth was cross-cut on the level of cemento-enamel junction of the lateral surface and the enamel was removed totally with sand paper. ( B ) the crown was fixed in self-curing acrylic resin JET (fabrication) in a PVC prefabricated mold. ( C ) Longitudinal discs were obtained (10 discs of 0.5 mm and 10 discs of 1 mm). Light irradiation and temperature measuring A digital thermometer (MT-507 Minipa, São Paulo) was used to measure the temperature variation during light irradiation with HAL and LED LCUs ( Table 1 ). The base of the specimen was covered with an insulating thermal paste (Implastec, Votorantim Ind. Brasileira, São Paulo, SP, Brazil), and the tip of the thermocouple surrounded by paste was placed in contact with the lower wall of each dentin disc. The specimens were irradiated for 20 s and the temperature was measured one time for each specimen obtaining 10 measurements for each experimental group (n= 10). Table 1. the protocol of light irradiation of each experimental group. Groups Protocol (n=10 per group) HAL0.5 Irradiation with Curing Light XL 3000 (3M) halogen-tungsten bulb at an intensity of 470 mW/cm 2 using active fiber optic tip (7 mm diameter) emitting light wavelength of 400 to 500 nm for 20 s over a dentin disc of 0.5 mm. LED0.5 Irradiation with Optilight Max (GNATUS- Ribeirão Preto, SP, Brazil) LED at an intensity of 1200 mW/cm 2 , emitting a light wavelength of 420 to 480 nm for 20 s over a dentin disc of 0.5 mm. HAL1 Irradiation with aforementioned halogen-tungsten bulb at an intensity of 470 mW/cm 2 using active fiber optic tip (7 mm diameter) emitting light wavelength of 400 to 500 nm for 20s over a dentin disc of 1 mm LED1 Irradiation with Optilight Max LED at an intensity of 1200 mW/cm 2 with emitting light wavelength of 420 to 480 nm for 20 s over a dentin disc of 1 mm. MTT analysis Mouse fibroblast cells (L929) (Rio de Janeiro Cell Bank, APABCAM, RJ, Brazil) were grown in cell culture flasks (TPP, Switzerland) containing Dulbecco’s modified Eagle medium (DMEM) (LGC Biotecnologia, Cotia, Brazil) and supplemented with 10% fetal bovine serum (Invitrogen, New York, USA) at 37°C and 5% CO 2 with atmospheric humidity. Next, 2×10 4 cells/mL were cultivated in 96-well microplates (TPP, Trasadingen, Switzerland) in the same medium for 24 hours for cell adhesion. DMEM was used as a control group (0 mg/mL). The treatment was carried-out for the groups (n= 10), in which each dentin disc was positioned over a well containing 100 µL of cell suspension in DMEM and light irradiation performed ( Table 1 ). This positioning was to simulate the clinical situation when the LCU irradiates the dentin and this irradiation may affect the fibroblast in the adjacent soft tissues ( Figure 2 ). Figure 2. Schematic illustration of dentin discs positioning over 96-well plates containing fibroblasts with DMEM. Next, MTT solution (100 µL/well) was added to the 96-well plate and the plates were incubated at 37°C with 5% CO 2 for 1 h. Then, the MTT solution was discarded and 100 µL/well of dimethylsulfoxide (DMSO; Sigma, Missouri, USA) was added and the plates were incubated again for 10 min and shaken for 10 min. The absorbance of the wells was measured using a spectrophotometer at 570 nm and data generated were converted to cell viability percentage using the formula: = OD of each group × 100 / OD of control group (OD = optical density). Statistical analysis After normality testing, data were analyzed by one-way ANOVA with Tukey’s post hoc test for parametric data or Kruskal-Wallis with post hoc Conover-Iman test for non-parametric data (α=0.05) using GraphPad Prism 6 (La Jolla, CA, USA). Results Temperature measurement A significant statistical difference was found between the groups HAL0.5 and HAL1 and both were significantly different to LED0.5 and LED1, which presented higher temperatures. However, no significant difference was observed between the two LED groups ( Figure 3 ). Figure 3. Average of the maximum temperatures reached by the 0.5 mm and 1.0 mm thick dentin discs after application of halogen light (HAL) or LED for 20 seconds. Different letters indicate statistically significant differences among the experimental groups with (P ≤ 0.05). Cytotoxicity analysis All groups were significantly different to the control group, and promoted reduction of cellular viability. There was no significant difference between the groups HAL0.5 (cell viability 43.5%) and HAL1 (cell viability 41.1%), and between the groups LED0.5 (cell viability 17.1%) and LED1 (cell viability 17.3%). However, both HAL0.5 and LED0.5 were significantly different to HAL1 and LED1 ( Figure 4 ). Figure 4. Percentage of cell viability obtained after treatments with halogen light (HAL0.5 and HAL1) and LED (LED0.5 and LED1) for 20 seconds over dentin discs. Different letters indicate statistically significant differences among the experimental groups with (P ≤ 0.05). Raw cytotoxicity and temperature results are available as Underlying data ( Paula Ramos, 2020 ). Discussion This paper investigated the heating generated by HAL and LED when irradiating dentin discs of thickness 0.5 mm and 1 mm of for 20 seconds. Hannig & Bott (1999) obtained different readings were obtained (2.9 to 7.9°C) when they evaluated six LCUs, including HAL, for 40, 10 and 5 s, finding that significantly higher pulp chamber temperatures were obtained when compared to conventional LCUs like Heliolux II. Uhl et al. (2003) evaluated the heating generated after resin composite photopolymeriztion and founded that LED LCUs represent a viable alternative to HAL LCUs for dental composite photopolymerization due lower temperature increases within the composite. Different results were obtained in the present study, as HAL generated lower temperature increases than LED in dentin. Conversely, another study showed no difference between HAL and LED LCUs in generating heat ( Drost et al., 2019 ). These different results in the literature may be related to the kind of temperature sensor and the methodology used ( Jiang et al., 2019 ). Both LED and HAL LCUs negatively influence cellular viability ( Passarelli et al., 2020 ); however, there is insufficient evidence that they cause pulp inflammation/cytotoxicity ( Benetti et al., 2018 ). In the present study, it was verified that LED was more cytotoxic than HAL LCUs; however, Gonçalves et al. (2016) found that LED had minimal cytotoxicity. This result may be influenced by the dentin thickness, as Daronch et al. (2007) found that the increase in pulp temperature was directly related to the remaining dentin thickness. In the present study, the application of LED light to the thickest dentin disc (1.0 mm) was less cytotoxic than the thinnest dentin disc (0.5 mm). The divergence observed in the present work in relation to the dentin thickness, light source and the possible greater protection that it can confer to the pulp could be related to the wavelength that the devices emit. The HAL LCU used emits a wavelength of 400–500 nm, and the dental structure is capable of absorbing light in a spectrum from 350–400 nm, meaning it can thus exhibit fluorescence at 410-500 nm. Therefore, the HAL LCU employed herein emits light at an absorbable wavelength for the dentin disc. Thus, the greater the dentin thickness, the greater the absorbance of light and the higher the concentration of photons, thus explaining the increase in the temperature of the disc ( Neumann et al., 2005 ). This study found that HAL LCU promoted a lower temperature change in the dentin compared to LED, regardless of the dentin thickness (0.5–1 mm). HAL and LED LCUs decreased fibroblast viability; however, LED resulted in greater cytotoxicity. Data availability Underlying data Harvard Dataverse: Replication Data for: Dataset. https://doi.org/10.7910/DVN/M4FYVV ( Paula Ramos, 2020 ). File ‘Dataset.tab’ contains raw data for cell viability and temperature generated in the present study. Data are available under the terms of the Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication). Faculty Opinions recommended References Al Otaibi FL, Althumairy AF, Al Ahmadi BT, et al. : Patients’ preferences on different types of esthetic treatment in saudi arabia. J Contemp Dent Pract. 2020; 21 (1): 62–67. PubMed Abstract | Publisher Full Text Armellin E, Bovesecchi G, Coppa P, et al. : LED curing lights and temperature changes in different tooth sites. Biomed Res Int. 2016; 2016 : 1894672. PubMed Abstract | Publisher Full Text | Free Full Text Baldissara P, Catapano S, Scotti R: Clinical and histological evaluation of thermal injury thresholds in human teeth: a preliminary study. J Oral Rehabil. 1997; 24 (11): 791–801. PubMed Abstract | Publisher Full Text Benetti F, Lemos CAA, de Oliveira Gallinari M, et al. : Influence of different types of light on the response of the pulp tissue in dental bleaching: a systematic review. Clin Oral Investig. 2018; 22 (4): 1825–1837. PubMed Abstract | Publisher Full Text Daronch M, Rueggeberg FA, Hall G, et al. : Effect of composite temperature on in vitro intrapulpal temperature rise. Dent Mater. 2007; 23 (10): 1283–1288. PubMed Abstract | Publisher Full Text Drost T, Reimann S, Frentzen M, et al. : Effectiveness of photopolymerization in composite resins using a novel 445-nm diode laser in comparison to LED and halogen bulb technology. Lasers Med Sci. 2019; 34 (4): 729–736. PubMed Abstract | Publisher Full Text Eriksson AR, Albrektsson T: Temperature threshold levels for heat-induced bone tissue injury: a vital-microscopic study in the rabbit. J Prosthet Dent. 1983; 50 (1): 101–107. 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PubMed Abstract Neumann MG, Miranda WG, Schmitt CC, et al. : Molar extinction coefficients and the photon absorption efficiency of dental photoinitiators and light curing units. J Dent. 2005; 33 (6): 525–532. PubMed Abstract | Publisher Full Text Nyborg H, Brännström M: Pulp reaction to heat. J Prosthet Dent. 1968; 19 (6): 605–612. PubMed Abstract | Publisher Full Text Passarelli PC, Saccomanno S, De Angelis P, et al. : Study of cellular toxicity in vitro of two resins for orthodontic use. Eur Rev Med Pharmacol Sci. 2020; 24 (2): 930–934. PubMed Abstract | Publisher Full Text Pieniak D, Niewczas AM, Walczak M, et al. : Influence of photopolymerization parameters on the mechanical properties of polymer-ceramic composites applied in the conservative dentistry. Acta Bioeng Biomech. 2014; 16 (3): 29–35. PubMed Abstract | Publisher Full Text Sebold M, Lins RBE, André CB, et al. : Flowable and Regular Bulk-Fill Composites: A Comprehensive Report on Restorative Treatment. Int J Periodontics Restorative Dent. 2020; 40 (2): 293–300. PubMed Abstract | Publisher Full Text Uhl A, Mills RW, Jandt KD: Polymerization and light-induced heat of dental composites cured with LED and halogen technology. Biomaterials. 2003; 24 (10): 1809–1820. PubMed Abstract | Publisher Full Text Vinagre A, Ramos JC, Rebelo C, et al. : Pulp Temperature Rise Induced by Light-Emitting Diode Light-Curing Units Using an Ex Vivo Model. Materials (Basel). 2019; 12 (3): 411. PubMed Abstract | Publisher Full Text | Free Full Text Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 25 Nov 2020 ADD YOUR COMMENT Comment Author details Author details 1 Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Jose dos Campos, São Paulo, 12245000, Brazil 2 Taubaté Institute of Higher Education (ITES), Taubaté, São Paulo, 12090000, Brazil 3 Department of Restorative Dentistry, Institute of Science and Technology, São José dos Campos, São Paulo, 12245000, Brazil 4 Department of Enviormental, Institute of Science and Technology, São josé dos Campos, São Paulo, 12247016, Brazil Georgia Memari Trava Roles: Data Curation, Investigation, Resources, Writing – Original Draft Preparation Juliane Almeida Santos Roles: Data Curation, Investigation, Resources, Writing – Original Draft Preparation Lucas Paula Ramos Roles: Methodology, Resources, Writing – Original Draft Preparation Pamela Beatriz Rosário Estevam dos Santos Roles: Data Curation, Methodology, Writing – Original Draft Preparation Amjad Abu Hasna Roles: Formal Analysis, Writing – Original Draft Preparation, Writing – Review & Editing Karen Cristina Yui Roles: Conceptualization, Writing – Review & Editing Adriano Bressane Roles: Data Curation, Formal Analysis, Writing – Original Draft Preparation Luciane Dias de Oliveira Roles: Conceptualization, Project Administration, Writing – Original Draft Preparation, Writing – Review & Editing Marianne Spalding Roles: Conceptualization, Formal Analysis, Methodology, Project Administration, Writing – Review & Editing Competing interests No competing interests were disclosed. Grant information The author(s) declared that no grants were involved in supporting this work. Article Versions (1) version 1 Published: 25 Nov 2020, 9:1369 https://doi.org/10.12688/f1000research.25456.1 Copyright © 2020 Memari Trava G et al . This is an open access article distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Download Export To Sciwheel Bibtex EndNote ProCite Ref. Manager (RIS) Sente metrics Views Downloads F1000Research - - PubMed Central info_outline Data from PMC are received and updated monthly. - - Citations open_in_new 0 open_in_new 0 open_in_new SEE MORE DETAILS CITE how to cite this article Memari Trava G, Almeida Santos J, Paula Ramos L et al. The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.12688/f1000research.25456.1 ) NOTE: If applicable, it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS track receive updates on this article Track an article to receive email alerts on any updates to this article. TRACK THIS ARTICLE Share Open Peer Review Current Reviewer Status: ? Key to Reviewer Statuses VIEW HIDE Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Version 1 VERSION 1 PUBLISHED 25 Nov 2020 Views 0 Cite How to cite this report: Al-Zain A and Bukhary DM. Reviewer Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r80646 ) The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-80646 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 22 Mar 2021 Afnan Al-Zain , Operative and Esthetic Dentistry Division, Restorative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia Dalea M. Bukhary , Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia Approved with Reservations VIEWS 0 https://doi.org/10.5256/f1000research.28092.r80646 The authors investigated the effect of heat generated from a quartz-tungsten-halogen and a light-emitting-diode curing unit on the temperature increase and fibroblast cell viability by irradiating 0.5-mm and 1-mm dentin slices. The article topic is important and interesting. A few ... Continue reading READ ALL The authors investigated the effect of heat generated from a quartz-tungsten-halogen and a light-emitting-diode curing unit on the temperature increase and fibroblast cell viability by irradiating 0.5-mm and 1-mm dentin slices. The article topic is important and interesting. A few points need to be justified, and sections of the methods need to be clarified. Title Authors should use scientific terminology and abbreviations. According to the literature, the scientific term for “Halogen bulb” light is “quartz-tungsten-halogen” and the correct abbreviation is “QTH”. Authors need to kindly correct this by using the scientific term and abbreviation throughout the article. Introduction In the last sentence of the first paragraph, the authors mentioned that "… LCUs can increase temperature and induce thermal transfer depending on the light source and intensity and type"; nevertheless, the LCUs used in this study had approximately a 60% difference in the light irradiance. Therefore, it was not clear why authors used units with such vast differences in irradiance values. This point will be further addressed in the methods. The authors used the term “intensity”. However, this term should no longer be used. The updated term is “irradiance”. A Glossary of Terms for Light Curing was published in 2014. Authors may kindly find these terms in several publications, and the following research article is one of them: Jeffrey A Platt, Richard B Price; Light Curing Explored in Halifax. Oper Dent November 1 2014; 39 (6): 561–563. DOI: https://doi.org/10.2341/1559-2863-39.6.561 1 Materials and Methods I appreciate the authors' novelty in the methods, but it does not simulate in vivo or clinical situations. The authors placed a dentin slice over the well-plate, which resulted in a distance between the slice and cells. It seems that this design would test the amount of light transmission through the dentin slices rather than simulating clinical situations. Did the authors consider using a larger well-plate and placing the dentin slice inside the well? This may better simulate the clinical situation where the dentin is closer to the cells since the soft tissue surrounds the tooth structure. Therefore, when light curing, the emitted light hits the tooth and the surrounding tissue simultaneously. So, it is more clinically relevant if a larger well-plate is used and the dentin slice is placed inside the well. Furthermore, authors could use different slice thicknesses as they did in this study. Authors may consider this for future research. More details, justification, or the thinking process behind the methodology would be appropriate for the readers to relate to clinical settings. Authors need to kindly clarify a few things to the readers based on the methodology; how does dentin's thickness relate to temperature increase? Does 0.5- and 1-mm slice represent curing? i.e., which class does it represent curing? a class II or a class III resin-based composite restoration or another clinical situation? What is the degree of insulating vs. presence of composite layer on top of dentin? The authors mentioned a few of these points. However, it is suggested for authors to mention more details and address these points. It is not clear why the authors obtained one section per tooth? Since teeth have variations among them, it would have been more relevant for authors to consider collecting both slices (0.5 and 1 mm) from the same tooth or collect more slices per tooth and account for within-sample variation during the statistical analysis. It is not clear why authors obtained vertical sections instead of horizontal if the sections were placed flat on top of the well-plate. Also, the dentin histology would differ from the top to the bottom of the specimens. Did the authors consider that during the study design? How would the authors justify their sections? Authors need to add justifications in the discussion section. It is not clear how the specimens were stored and tested. The authors need to add details. In what medium were the dentin slices stored? For how long were they stored? were the dentin slices hydrated or dehydrated before testing? These details may impact the light transmission, and it is important to mention them in the methods. The authors had a control group without irradiation. However, it would be relevant to include an additional control group with irradiated cells without the dentin slice's presence. It is not clear why the authors selected 20 seconds to light cure the dentin slices. The authors needed to justify this point. QTH Irradiance values are approximately half that of the LED. Therefore, it would be more relevant to double or triple the curing time when light curing with the QTH or use different units with relatively similar irradiance values. Although the literature is conflicting regarding applying the law of reciprocity on light-curing resin-based composites, the concept is relatively valid, according to some publications. The radiant exposure is the amount of energy the restoration receives over time [radiant exposure (J/cm 2 ) =irradiance x time]; therefore, we would expect the amount of radiant exposure the dentin slices received using the LED is double or more than the QTH unit. In the cytotoxicity analysis, the authors needed to consider having an additional control group without the disks, as mentioned previously. The authors did not mention the average dimensions of the dentin slices. What was the diameter of the slices relative to the diameter of each well in the 96-well plate? Results Figure 3: the control group is missing. Also, the authors need to consider adding another control group with irradiated cells with no dentin slice over the well. However, it may be challenging at this point but may be considered in future studies. Figure 4: there is a space without a bar present between the control bar and the LED 1-mm bar. This space is best to be removed. The control here is cells without light irradiation; as mentioned in Figure 3 comment, adding a control group of irradiated cells without dentin slices would be relevant. Figures 3 and 4: it is best to place the letter "A" on the bar with the highest significant bar, followed by "B", and then "C" on the lowest significant bar. It would be easier for the reader to follow. It would have been nice for authors to show cell morphology images for the different groups. The cell morphology images may be considered in future studies. The authors would expect significant differences between the QTH and LED groups due to the significant differences in irradiance values between units. Discussion Authors should discuss the results of their study first before discussing other research articles. Readers would want to know the justification of their study first. Justifications for the mentioned comments would best be added in the discussion section. Conclusion The conclusion is accurate to the results and aligned with the aim. Overall, the research is valuable, and considering the suggested comments would be beneficial for future research. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes References 1. Platt J, Price R: Light Curing Explored in Halifax. Operative Dentistry . 2014; 39 (6): 561-563 Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Dental light-curing units, resin-based composites, dental adhesives. We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Al-Zain A and Bukhary DM. Reviewer Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r80646 ) The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-80646 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Views 0 Cite How to cite this report: Al-Nahlawi T. Reviewer Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r75399 ) The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-75399 NOTE: it is important to ensure the information in square brackets after the title is included in this citation. Close Copy Citation Details Reviewer Report 07 Dec 2020 Talal Al-Nahlawi , Department of Endodontics and Operative Dentistry, Syrian Private University, Damascus, Syria Approved VIEWS 0 https://doi.org/10.5256/f1000research.28092.r75399 This study aimed to evaluate a relevant topic in operative dentistry nowadays because of the increased demand and need for light curing units in many procedures including photo-polymerization of resin composite restorations and for teeth bleaching despite the heavy discussion ... Continue reading READ ALL This study aimed to evaluate a relevant topic in operative dentistry nowadays because of the increased demand and need for light curing units in many procedures including photo-polymerization of resin composite restorations and for teeth bleaching despite the heavy discussion about the light curing efficacy on improving the bleaching. Introduction: The authors were able to successfully approach these topics in the introduction section. The objective defined at the end of this section was clearly reported. Material and methods: This study protocol is well described and standardized. The light irradiation and temperature measuring method were described in the literature in other studies. I think it would be more appropriate to cite the original studies, however, it is not of great relevance as a number of these studies were cited in the discussion section. The same should be followed in the MTT assay, it is not a unique test of this study, I think in the future, all the original studies of these tests should be cited. I should congratulate the authors for the schematic illustration of MTT assay, this part of the test of applying the dentin discs over the 96-well plate is innovative, or at least, to the best of my knowledge, it was not used in any other study. Results and Discussion: Even I don't agree with the results. However, they were well described and illustrated. And the fact the LED light curing was more cytotoxic and generated more thermal changes than the Halogen light curing unit may be explained by the LED unit intensity used in the study (1200 mW/cm2) which relatively 3 times the intensity of the halogen light curing unit used in this study 470 mW/cm2). Why did the authors use light curing units with great intensity difference? Why did the authors not evaluate the laser as well? What about laser-induced photopolymerization? There are divergent results in the literature about the thermal changes caused by LED and halogen light curing units, however, the common concept is that the LED generates less thermal changes (Mahant RH et al. 2016). 1 Still, the results of this study answered its objective, and the conclusion is supported by the findings. I think this study has the potential to be indexed justly to alert the importance of more studies about this topic of great relevance. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Mahant RH, Chokshi S, Vaidya R, Patel P, et al.: Comparison of the Amount of Temperature Rise in the Pulp Chamber of Teeth Treated With QTH, Second and Third Generation LED Light Curing Units: An In Vitro Study. J Lasers Med Sci . 2016; 7 (3): 184-191 PubMed Abstract | Publisher Full Text Competing Interests: No competing interests were disclosed. Reviewer Expertise: Endodontics and Operative Dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Close READ LESS CITE CITE HOW TO CITE THIS REPORT Al-Nahlawi T. Reviewer Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r75399 ) The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-75399 NOTE: it is important to ensure the information in square brackets after the title is included in all citations of this article. COPY CITATION DETAILS Report a concern Respond or Comment COMMENT ON THIS REPORT Comments on this article Comments (0) Version 1 VERSION 1 PUBLISHED 25 Nov 2020 ADD YOUR COMMENT Comment keyboard_arrow_left keyboard_arrow_right Open Peer Review Reviewer Status info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions Reviewer Reports Invited Reviewers 1 2 Version 1 25 Nov 20 read read Talal Al-Nahlawi , Syrian Private University, Damascus, Syria Afnan Al-Zain , Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia Dalea M. Bukhary , King Abdulaziz University, Jeddah, Saudi Arabia Comments on this article All Comments (0) Add a comment Sign up for content alerts Sign Up You are now signed up to receive this alert Browse by related subjects keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2021 Al-Zain A et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 22 Mar 2021 | for Version 1 Afnan Al-Zain , Operative and Esthetic Dentistry Division, Restorative Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia Dalea M. Bukhary , Oral and Maxillofacial Prosthodontics Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia 0 Views copyright © 2021 Al-Zain A et al. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved With Reservations info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions The authors investigated the effect of heat generated from a quartz-tungsten-halogen and a light-emitting-diode curing unit on the temperature increase and fibroblast cell viability by irradiating 0.5-mm and 1-mm dentin slices. The article topic is important and interesting. A few points need to be justified, and sections of the methods need to be clarified. Title Authors should use scientific terminology and abbreviations. According to the literature, the scientific term for “Halogen bulb” light is “quartz-tungsten-halogen” and the correct abbreviation is “QTH”. Authors need to kindly correct this by using the scientific term and abbreviation throughout the article. Introduction In the last sentence of the first paragraph, the authors mentioned that "… LCUs can increase temperature and induce thermal transfer depending on the light source and intensity and type"; nevertheless, the LCUs used in this study had approximately a 60% difference in the light irradiance. Therefore, it was not clear why authors used units with such vast differences in irradiance values. This point will be further addressed in the methods. The authors used the term “intensity”. However, this term should no longer be used. The updated term is “irradiance”. A Glossary of Terms for Light Curing was published in 2014. Authors may kindly find these terms in several publications, and the following research article is one of them: Jeffrey A Platt, Richard B Price; Light Curing Explored in Halifax. Oper Dent November 1 2014; 39 (6): 561–563. DOI: https://doi.org/10.2341/1559-2863-39.6.561 1 Materials and Methods I appreciate the authors' novelty in the methods, but it does not simulate in vivo or clinical situations. The authors placed a dentin slice over the well-plate, which resulted in a distance between the slice and cells. It seems that this design would test the amount of light transmission through the dentin slices rather than simulating clinical situations. Did the authors consider using a larger well-plate and placing the dentin slice inside the well? This may better simulate the clinical situation where the dentin is closer to the cells since the soft tissue surrounds the tooth structure. Therefore, when light curing, the emitted light hits the tooth and the surrounding tissue simultaneously. So, it is more clinically relevant if a larger well-plate is used and the dentin slice is placed inside the well. Furthermore, authors could use different slice thicknesses as they did in this study. Authors may consider this for future research. More details, justification, or the thinking process behind the methodology would be appropriate for the readers to relate to clinical settings. Authors need to kindly clarify a few things to the readers based on the methodology; how does dentin's thickness relate to temperature increase? Does 0.5- and 1-mm slice represent curing? i.e., which class does it represent curing? a class II or a class III resin-based composite restoration or another clinical situation? What is the degree of insulating vs. presence of composite layer on top of dentin? The authors mentioned a few of these points. However, it is suggested for authors to mention more details and address these points. It is not clear why the authors obtained one section per tooth? Since teeth have variations among them, it would have been more relevant for authors to consider collecting both slices (0.5 and 1 mm) from the same tooth or collect more slices per tooth and account for within-sample variation during the statistical analysis. It is not clear why authors obtained vertical sections instead of horizontal if the sections were placed flat on top of the well-plate. Also, the dentin histology would differ from the top to the bottom of the specimens. Did the authors consider that during the study design? How would the authors justify their sections? Authors need to add justifications in the discussion section. It is not clear how the specimens were stored and tested. The authors need to add details. In what medium were the dentin slices stored? For how long were they stored? were the dentin slices hydrated or dehydrated before testing? These details may impact the light transmission, and it is important to mention them in the methods. The authors had a control group without irradiation. However, it would be relevant to include an additional control group with irradiated cells without the dentin slice's presence. It is not clear why the authors selected 20 seconds to light cure the dentin slices. The authors needed to justify this point. QTH Irradiance values are approximately half that of the LED. Therefore, it would be more relevant to double or triple the curing time when light curing with the QTH or use different units with relatively similar irradiance values. Although the literature is conflicting regarding applying the law of reciprocity on light-curing resin-based composites, the concept is relatively valid, according to some publications. The radiant exposure is the amount of energy the restoration receives over time [radiant exposure (J/cm 2 ) =irradiance x time]; therefore, we would expect the amount of radiant exposure the dentin slices received using the LED is double or more than the QTH unit. In the cytotoxicity analysis, the authors needed to consider having an additional control group without the disks, as mentioned previously. The authors did not mention the average dimensions of the dentin slices. What was the diameter of the slices relative to the diameter of each well in the 96-well plate? Results Figure 3: the control group is missing. Also, the authors need to consider adding another control group with irradiated cells with no dentin slice over the well. However, it may be challenging at this point but may be considered in future studies. Figure 4: there is a space without a bar present between the control bar and the LED 1-mm bar. This space is best to be removed. The control here is cells without light irradiation; as mentioned in Figure 3 comment, adding a control group of irradiated cells without dentin slices would be relevant. Figures 3 and 4: it is best to place the letter "A" on the bar with the highest significant bar, followed by "B", and then "C" on the lowest significant bar. It would be easier for the reader to follow. It would have been nice for authors to show cell morphology images for the different groups. The cell morphology images may be considered in future studies. The authors would expect significant differences between the QTH and LED groups due to the significant differences in irradiance values between units. Discussion Authors should discuss the results of their study first before discussing other research articles. Readers would want to know the justification of their study first. Justifications for the mentioned comments would best be added in the discussion section. Conclusion The conclusion is accurate to the results and aligned with the aim. Overall, the research is valuable, and considering the suggested comments would be beneficial for future research. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Partly Are sufficient details of methods and analysis provided to allow replication by others? Partly If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Partly Are the conclusions drawn adequately supported by the results? Yes References 1. Platt J, Price R: Light Curing Explored in Halifax. Operative Dentistry . 2014; 39 (6): 561-563 Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Dental light-curing units, resin-based composites, dental adhesives. We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above. reply Respond to this report Responses (0) Al-Zain A and Bukhary DM. Peer Review Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r80646) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-80646 keyboard_arrow_left Back to all reports Reviewer Report 0 Views copyright © 2020 Al-Nahlawi T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 07 Dec 2020 | for Version 1 Talal Al-Nahlawi , Department of Endodontics and Operative Dentistry, Syrian Private University, Damascus, Syria 0 Views copyright © 2020 Al-Nahlawi T. This is an open access peer review report distributed under the terms of the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. format_quote Cite this report speaker_notes Responses (0) Approved info_outline Alongside their report, reviewers assign a status to the article: Approved The paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. Not approved Fundamental flaws in the paper seriously undermine the findings and conclusions This study aimed to evaluate a relevant topic in operative dentistry nowadays because of the increased demand and need for light curing units in many procedures including photo-polymerization of resin composite restorations and for teeth bleaching despite the heavy discussion about the light curing efficacy on improving the bleaching. Introduction: The authors were able to successfully approach these topics in the introduction section. The objective defined at the end of this section was clearly reported. Material and methods: This study protocol is well described and standardized. The light irradiation and temperature measuring method were described in the literature in other studies. I think it would be more appropriate to cite the original studies, however, it is not of great relevance as a number of these studies were cited in the discussion section. The same should be followed in the MTT assay, it is not a unique test of this study, I think in the future, all the original studies of these tests should be cited. I should congratulate the authors for the schematic illustration of MTT assay, this part of the test of applying the dentin discs over the 96-well plate is innovative, or at least, to the best of my knowledge, it was not used in any other study. Results and Discussion: Even I don't agree with the results. However, they were well described and illustrated. And the fact the LED light curing was more cytotoxic and generated more thermal changes than the Halogen light curing unit may be explained by the LED unit intensity used in the study (1200 mW/cm2) which relatively 3 times the intensity of the halogen light curing unit used in this study 470 mW/cm2). Why did the authors use light curing units with great intensity difference? Why did the authors not evaluate the laser as well? What about laser-induced photopolymerization? There are divergent results in the literature about the thermal changes caused by LED and halogen light curing units, however, the common concept is that the LED generates less thermal changes (Mahant RH et al. 2016). 1 Still, the results of this study answered its objective, and the conclusion is supported by the findings. I think this study has the potential to be indexed justly to alert the importance of more studies about this topic of great relevance. Is the work clearly and accurately presented and does it cite the current literature? Yes Is the study design appropriate and is the work technically sound? Yes Are sufficient details of methods and analysis provided to allow replication by others? Yes If applicable, is the statistical analysis and its interpretation appropriate? Yes Are all the source data underlying the results available to ensure full reproducibility? Yes Are the conclusions drawn adequately supported by the results? Yes References 1. Mahant RH, Chokshi S, Vaidya R, Patel P, et al.: Comparison of the Amount of Temperature Rise in the Pulp Chamber of Teeth Treated With QTH, Second and Third Generation LED Light Curing Units: An In Vitro Study. J Lasers Med Sci . 2016; 7 (3): 184-191 PubMed Abstract | Publisher Full Text Competing Interests No competing interests were disclosed. Reviewer Expertise Endodontics and Operative Dentistry I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. reply Respond to this report Responses (0) Al-Nahlawi T. Peer Review Report For: The effect of halogen bulb and light-emitting diode light curing units on temperature increase and fibroblast viability [version 1; peer review: 1 approved, 1 approved with reservations] . F1000Research 2020, 9 :1369 ( https://doi.org/10.5256/f1000research.28092.r75399) NOTE: it is important to ensure the information in square brackets after the title is included in this citation. The direct URL for this report is: https://f1000research.com/articles/9-1369/v1#referee-response-75399 Alongside their report, reviewers assign a status to the article: Approved - the paper is scientifically sound in its current form and only minor, if any, improvements are suggested Approved with reservations - A number of small changes, sometimes more significant revisions are required to address specific details and improve the papers academic merit. 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