Finite element analysis of heat

generation from different lightpolymerization sources during

cementation of all-ceramic crowns
Elif Pak Tunc, DDS, PhDa
Istanbul University, Faculty of Dentistry, Istanbul, Turkey
Statement of problem. Exothermic composite resin chemical reactions and visible light generators can produce heat
during a restorative polymerization process. These thermal changes in restored teeth may cause pain and irreversible
pulpitis.
Purpose. The purpose of this study was to analyze the temperature distribution and heat flow patterns of a crowned
mandibular second premolar tooth model using 3 different light-polymerization technologies and a finite element
technique.
Material and methods. A 2-dimensional finite element model was used to simulate a clinical condition. Heat flow and
thermal stress distribution in a tooth during cementation of an all-ceramic crown using 4 commercially available lightpolymerization units (LPUs), each with different wavelengths (Elipar TriLight, Elipar Freelight, Apollo 95 E, and ADT
1000 PAC ), were investigated. The temperature values were measured at 3, 10, 12, and 40 seconds for each lightpolymerizing unit (LPU) at 6 different finite element nodes. Two-dimensional temporal and spatial distribution of the
thermal stress within the tooth, including the thermal coefficiants and boundary conditions of the dental materials,
were obtained and evaluated.
Results. The temperature at the nodal points did not exceed 42C, which is a threshold value for tissue vitality within
the recommended operating periods at the dentin and pulp surface for all LPUs, except for Elipar TriLight. In the case
of Elipar TriLlight, the temperatures at the dentin and pulp surfaces were 47C and 42C, respectively.
Conclusions. When the light-polymerization units were used according to the manufacturers operating procedures
and without prolonged operating periods, with the exception of Elipar TriLight, the investigated LPUs did not produce
significant heat. However, when the operating periods were prolonged, unacceptable temperature increases were observed, especially with the high-intensity LPUs. (J Prosthet Dent 2007; 97: 366-374)

Clinical Implications

Clinicians should be aware of the potential thermal hazard to

the pulp while using LPUs because when they are not operated
correctly, LPUs with different intensities may increase the potential for generating unacceptable temperatures in vital tissue.

In recent years, the demand for

tooth-colored restorations increased
the use of all-ceramic dental prostheses and composite resin luting
agents. The cementation process for
a restoration is important because
inadequate polymerization diminishes the physical properties, strength,

stiffness, water absorbtion, and color stability of a cement.1,2 Dual-polymerizing composite resin cements
were developed to provide adequate
polymerization in areas where visible
light access is compromised and to
shorten the polymerization time periods.3-5 As the use of dual-polymerizing

composite resin cements has expanded over recent years, various types of
light-polymerizing units (LPUs) have
been introduced to decrease polymerization periods, to avoid polymerization shrinkage, and to minimize tooth
pulp damage resulting from the polymerization process in dentistry.6-8

Research Assistant, Department of Prosthodontics.

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June 2007
Although a temperature increase
inside a tooth during the polymerization of dual-polymerizing composite
resin cements may be explained by
both the exothermic reaction process
of the luting material and the energy
absorbed during irradiation,6,7,9-13
unfortunately, polymerization units
themselves create a temperature rise
during operation, and this risk increases when LPUs are used with a
high energy output and for prolonged
operation times.14,15 Kleverlaan and
de Gee6 reported temperature rises
of between 11.2C and 16.2C in
composite resin during polymerization, depending on the light source
and type of composite resin. Also, in
vitro measurements with thermocouples, differential scanning calorimetry, and differential thermal analyses
have demonstrated temperature rises
between 10C and 18C within the
composite resin and adjacent tooth
structures.16,17 Despite the cooling effect of blood circulation in the pulp
chamber, previous publications have
shown that a risk of heat-induced
pulpal injury exists.6,14 A temperature
rise of 5.5C can cause damage to the
pulp.14 An intrapulpal temperature exceeding 42C could result in irreversible pulp damage.8,18-20
Successful use of a polymerization
unit depends on correct functioning
of the instrument. For adequate polymerization; sufficient radiant intensity, correct wavelength of the visible
light, and ample polymerization time
are essential.21 The use of high intensity lights reduces the polymerization
time, but also increases the risk of
pulp damage.6,14,16,17 Quartz-tungsten halogen (QTH) lights have been
used extensively for many years in the
polymerization of composite resin cements. The relatively broad emission
spectrum (380 nm-520 nm) of QTH
LPUs allows them to initiate the polymerization of currently available
composite resins.6,22 These units operate at light intensities between 400
and 800 mW/cm2 and are capable of
polymerizing material up to 2 mm in
thickness after 40 seconds.23

Tunc

Light-emitting diodes (LED), specifically LEDs with gallium nitride blue

as a semiconductor, demonstrate
advantages in preventing overheating due to spectral purity, achieving
highly efficient dental composite resin
polymerization. Energy that ranges
between 450-490 nm is ideal for activating materials that use camphorquinone as an initiator. Less power is
required to operate these devices,
eliminating the need for filters and a
cooling fan, since heat-producing infrared wavelengths are eliminated.24
LEDs do not degrade over time and
the light they produce has a constant
intensity.8,25-29
Plasma Arc Curing (PAC) LPUs
are characterized by a high output in
a rather narrow range of wavelengths
around 470 nm.30 High-intensity polymerization of light-polymerizing
composite resin can be a time-saving procedure with PAC LPUs. These
units are relatively expensive, but
are commercially available in several
models.31
The calibration of the effects of
thermal changes on restored teeth
presents experimental difficulties.
Mathematical modelling of the process using a finite element method
(FEM) offers an alternative approach.32 de Vree et al33 developed
a simulation model to study heat
transport problems, and the authors
concluded that the described model
was a reliable and valuable tool in
fundamental studies on thermal behavior of restored teeth. Spierings et
al34 reported the lack of any empirical
validation for the theoretical model to
calculate the temperature distribution
within teeth and tested their theoretical model by comparing it with an in
vivo experiment under thermal conditions. The authors concluded that the
heat transfer coefficient (HTC) was an
important parameter in the process
of energy transport into teeth and the
simulated FEM model was demonstrated to be a good approximation
of the physical reality concerning the
HTC. However, blood circulation in
the pulp chamber and fluid motion in

the dentinal tubules are also important in heat conduction in teeth.7,20

The lack of modelling for the effect
of blood flow on the pulpal response
may limit a finite element analysis
(FEA) study to directly apply the measured temperature values to the temperature changes that would occur in
vivo.7
The FEM is widely used in dental
research.32-35 According to Romeed et
al,35 the use of 2-dimensional (2-D)
or 3-dimensional (3-D) FEA in investigating the mechanical behavior of
a maxillary premolar restored with
a complete crown was dependent
on many interrelated factors. The
authors concluded that for a single
tooth unit, 2-D FEA may be helpful in
investigating key aspects of a dental
restoration. For complex dental structures and tooth units, 3-D FEA may
offer the best understanding. The aim
of this FEA study was to analyze the
temperature distribution and heat
flow patterns which occur during the
light-polymerization process by using
4 different types of light-polymerization sources in a crowned mandibular
second premolar tooth.

MATERIAL AND METHODS

The tooth model, with the tooth
geometry based on Ash,36 is shown in
Figure 1. The tooth crown model was
designed (Fig. 2, A) as an all-ceramic
crown.37-39 The cement film thickness
was set at 24 m.39 Data for the thermal properties of the modelled materials and heat transfer coefficients are
shown in Table I.32,39,40-42
A 2-dimensional FEM (FlexPDE
4.2; PDE Solutions Inc, Sunol, Calif )
was used to calculate the temperature distributions with time. Figure
1 shows the schematic illustration
of the FEM model divided into 1266
cells and 2597 nodal points. In applying the FEM, the physical problem
was formulated through the use of a
2-dimensional and time-dependent
heat conduction equation, 43
c

T ( x , y , t )
2 T ( x, y, t ) 2 T ( x, y, t )
= k(
+
)
t
x 2
y 2

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Volume 97 Issue 6

1 Schematic illustration of FEM model of buccolingual cross section of restored tooth (length: 22.5 mm and width: 8 mm). Different colors indicate 4 different sections (crown, cement, dentin,
pulp) starting from occlusal surface toward center.

rs
cs
ds
ps
cp
Occlusal crown
thickness (2 mm)
Cervical crown
thickness (1 mm)

rp

A
B
2 A, Schematic view of crown design. B, Schematic view of reference points
(rs-restoration surface, cs-cement surface, ds-dentin surface, ps-pulp surface,
cp-cervical pulpal area, rp-radicular pulpal area).

Table I. Thermal properties and heat transfer coefficients of modelled materials

Material

Thermal Expansion
Coefficient
(1/C)

Thermal
Conductivity
(cal/mm-1 s-1 C)

Density x Specific Heat

(cal/mm-3 C)

Porcelain32,39,40

13.1 x 10-6

0.250 x 10-3

0.754 x 10-3

Composite resin41

39.4 x 10-6

0.258 x 10-3

0.470 x 10-3

Dentin32,39,40

11.4 x 10-6

0.150 x 10-3

0.588 x 10-3

Pulp42

180 x 10-6

1.599 x 10-4

0.238 x 10-3

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June 2007
with the appropriate initial and
boundary conditions related to this
situation.
In the previous equation, , c,
k, are the density, specific heat, and
the heat conductivity of the materials under investigation, respectively.
T(x,y,t) is the temperature of the heat
conducting medium and depends on
both the time and space variables x
and y. The initial condition was T(x,0)
= 35.2C. At the occlusal surface of
the tooth, a constant heat flux q (W/
m2) boundary condition was applied.
Overall, external boundaries were assumed to be at a constant temperature
of 37C. The model was divided into
4 separate sections: crown, cement,
dentin, and pulp. For each separate
section, different thermal proper-

ties were used (Table I). The material

properties , c, and k were assumed
to be independent of both dependent
and independent variables (temperature, time, and space variables).
The specifications of 3 classes
of LPUs with 1 representative device
from QTH and LED technologies and
2 representatives from the PAC category were used for this simulation.
For each LPU, a different operation
time was chosen depending on the
light intensity of the unit (Table II).
Except for the LED LPU, full light output power was used for each unit.
With the LED LPU, 2 different types
of operating options were used for
the analysis. In the first option, full
light output power was used from the
first second of polymerization for 12

seconds. In the second option, the

light output increased exponentially
and reached maximum power during
the first 12 seconds.
The temperature values were measured at the surface of the 4 different sections: restoration surface (rs),
cement surface (cs), dentin surface
(ds), and pulp surface (ps) and, also,
at 2 different locations in the pulp,
cervical pulpal area (cp) and radicular
pulpal area (rp) (Fig. 2, B). For each
LPU, temperature increases were evaluated within its own recommended
operating period. Temperature readings exceeding 42C were accepted as
the critical value for the maintenance
of vital tissue.18

Table II. Investigated polymerization units and maximum light outputs as purported by manufacturer
Light-polymerization Unit
(Manufacturer)

Wave Length
(nm)

Maximum Light
Output (Mw/cm2)

Time of Exposure
(s)

Quartz-Tungsten Halogen LPU

400-515

800

40

440-490

400

12

470

980

10

470

1370

(Elipar TriLight; 3M ESPE,

Ontario, Canada)
Light Emitting Diode LPU
(Elipar Freelight; 3M ESPE)
Plasma Arc Curing LPU
(1000 PAC; American Dental
Technologies, San Carlos, Calif )
Plasma Arc Curing LPU
(Apollo 95/DMD; DMDS,
Fleury dAude, France)

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Volume 97 Issue 6
RESULTS
Figures 3 through 7 show temperature distributions with time at
nodes rs, cs, ds, ps, cp, rp, and transient heat conduction in the tooth by
LPUs during polymerization. Figure
3 shows the temperature changes
in the crowned tooth when the LED
LPU (Elipar Freelight) was used with
full light output power. Temperature
values at node rs increased during
the first 3 seconds up to 39.5C and
at the first 10 seconds up to 42C
(a critical value for vital tissue). The
values continued to increase up to
43.5C at 12 seconds and to 48.5C
at 40 seconds. When node cs was
considered, the temperature value at
the relevant point was near 38C at
3 seconds and 40C at 10 seconds.
The temperature values at 12 and 40
seconds were 40.5C and 45.5C,
respectively. Temperature value at
node ds did not increase during the
first 3 seconds and did not exceed
42C within the first 40 seconds of
exposure. Also, at nodes ps, cp, and
rp, temperature values did not show
substantial differences from the initial
values after the first 3 seconds and
did not exceed 42C within the first

40 seconds of exposure.
When the LED LPU (Elipar
Freelight) was used with exponential
light exposure (Fig. 4), the temperature value at node rs at 12 seconds
was 40.5C. When node cs was considered, the temperature value at the
relevant point was 39C at 12 seconds. Both options (standard and exponential) with the LED LPU showed
no critical temperature increase at any
of the selected nodes during operation within the recomended polymerization period of 12 seconds. At node
ds, the temperature value increased
up to nearly 41.5C with the standard
and 41C with the exponential exposure process at 40 seconds.
The temperature values at node
rs, cs, and ds increased up to 60.5C,
54C, and 46.5C, respectively, at 40
seconds when the QTH LPU (Elipar
TriLight) was used (Fig. 5). At node
ps, the temperature value exceeded
42C, which is the limiting factor for
the vital tissue18 at 40 seconds of exposure. Within the recomended polymerization period (40 seconds), at
almost all the nodes, temperature increases were observed.
Figure 6 shows the temperature
changes in the crowned tooth when

the PAC LPU with 980 mW/cm2

output (ADT 1000 PAC) was used.
The temperature value at node rs increased up to 51C at 10 seconds,
and when node cs was considered,
the temperature value at the relevant
point was 44.5C at 10 seconds. The
temperature value at node ds showed
no substantial increase in the first 10
seconds, but within the 40 seconds of
exposure it increased up to 48.5C.
Similarly, the temperature value at
node ps increased up to 43C within
the 40 seconds of exposure.
The temperature value at node rs
increased within the first 3 seconds
up to 46.5C when the PAC LPU with
1370 mW/cm2 output (Apollo 95 E)
was used (Fig. 7). When node cs was
considered, the temperature value
at the relevant point was 40C at 3
seconds. At nodes ds and ps, the temperature values showed no increase
in the first 3 seconds, but increased
up to 53.5C and 46C, respectively,
within the 40 seconds of exposure.
When the optimum recommended
polymerization periods were assumed
for each PAC LPU, no harmful increase
in temperature important to the vital
tissue was recorded.

Temperature (C)
rs
cs
ds
ps
cp
rp

48

Temperature (C)

46

44

42

40

38

10

15

20

25

30

Time (s)

35

40

max
r
q
p
o
n
m
l
k
j
i
h
g
f
e
d
c
b
a
min

55.4
55.0
54.0
53.0
52.0
51.0
50.0
49.0
48.0
47.0
46.0
45.0
44.0
43.0
42.0
41.0
40.0
39.0
38.0
37.0

3 A, Temperature changes (C) at all nodes when using LED LPU (Elipar Freelight) with full light output power. B,
Transient heat conduction in tooth. Highest stress is shown in red and lowest stress in pink.

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June 2007

Temperature (C)
rs
cs
ds
ps
cp
rp

Temperature (C)

46

44

max
q
p
o
n
m
l
k
j
i
h
g
f
e
d
c
b
a
min

42

40

38

10

15

20

25

30

35

40

Time (s)

53.7
53.0
52.0
51.0
50.0
49.0
48.0
47.0
46.0
45.0
44.0
43.0
42.0
41.0
40.0
39.0
38.0
37.0
37.0

4 A, Temperature changes (C) at all nodes when using LED LPU (Elipar Freelight) with exponential light output
power. B, Transient heat conduction in tooth. Highest stress is shown in red and lowest stress in pink.

Temperature (C)

60

rs
cs
ds
ps
cp
rp

Temperature (C)

55

50

45

40

10

15

20

25

Time (s)

30

35

40

max
r
q
p
o
n
m
l
k
j
i
h
g
f
e
d
c
b
a
min

73.9
72.0
70.0
68.0
66.0
64.0
62.0
60.0
58.0
56.0
54.0
52.0
50.0
48.0
46.0
44.0
42.0
40.0
38.0
37.0

5 A, Temperature changes (C) at all nodes when using QHT LPU (Elipar TriLight) with full light output power. B,
Transient heat conduction in tooth. Highest stress is shown in red and lowest stress in pink.

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Volume 97 Issue 6

65

60

Temperature (C)

Temperature (C)

rs
cs
ds
ps
cp
rp

55

max
o
n
m
l
k
j
i
h
g
f
e
d
c
b
a
min

50

45

40

10

15

20

25

30

35

82.1
81.0
78.0
75.0
72.0
69.0
66.0
63.0
60.0
57.0
54.0
51.0
48.0
45.0
42.0
39.0
37.0

40

Time (s)

6 A, Temperature changes (C) at all nodes when using Plasma Arc LPU (ADT 1000 PAC) with full light output
power. B, Transient heat conduction in tooth with highest stress in red and lowest stress in pink.

75
70

Temperature (C)

Temperature (C)

rs
cs
ds
ps
cp
rp

65
60
55
50
45
40
0

10

15

20

25

30

Time (s)

35

40

max
u
t
s
r
q
p
o
n
m
l
k
j
i
h
g
f
e
d
c
b
a
min

100.0
99.0
96.0
93.0
90.0
87.0
84.0
81.0
78.0
75.0
72.0
69.0
66.0
63.0
60.0
57.0
54.0
51.0
48.0
45.0
42.0
39.0
37.0

7 A, Temperature changes (C) at all nodes when using Plasma Arc LPU (Apollo 95 E) with full light output power.
B, Transient heat conduction in tooth with highest stress in red and lowest stress in pink.

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June 2007
DISCUSSION
Various studies have demonstrated temperature rises between 10C
and 18C within the composite resin
and adjacent tooth structures during polymerization, depending on the
type of light source and composite
resin used.6,16,17 Similarly, the present
study also showed that at node ds,
the range of temperature increase was
from 7.5C to 29C and at node ps,
the change in temperature was from
2C to 9C.
The temperature rise is complex
and depends on many different components, especially the heat generation directly from the LPU and the exothermic polymerization reaction.11,25
The decisive factor, however, for the
temperature increase during lightactivated polymerization of composite resin is the energy absorbed while
the irradiation occurs,6 whereas, the
exothermic composite resin polymerization process is of secondary importance.10 The material-dependent
variations caused by the depth of the
restoration, type of the restorative
materials, shade, and translucency
also affect the final result.7,13 In this
study, to eliminate the effects of these
variations and to investigate the thermal effects of different types of LPUs,
the materials used in the experimental
design were assumed to be the same
for all the different types of LPUs. The
evaluations were carried out by considering the optimum operating time,
which was taken to be different for
each LPU (Table II).
Light polymerization with the units
that are characterized by a higher energy output may result in substantially
higher pulp chamber temperatures
than the light sources with lower energy outputs. Since high-intensity lamps
reduce the polymerization time, the
substantial temperature rise caused
by the energy output from the LPUs
in a shorter period of time may not be
a relevant factor to pulpal damage.6,7
Hannig and Bott7 reported the highest
pulp chamber temperature rise with
the PAC systems after 10 seconds.

Tunc

None of the LPUs used in this study,

except QTH LPU (Elipar TriLight),
showed a temperature increase exceeding the limiting threshold temperature of 42C for vital tissue18
within the optimum operating periods at the dentin and pulp surfaces.
When the polymerization period was
extended to 40 seconds, the highest
temperature rise was reached with the
PAC systems. According to Hannig
and Bott,7 the potential risk for heatinduced pulpal injury during composite resin polymerization was increased
whenever visible-light polymerizing
units with high energy outputs were
used with prolonged operation periods as opposed to low energy output
light sources. This theory correlates
with the findings of the present study.
Knezevic et al15 compared QHT
and LED technologies and indicated
that halogen polymerization units
with a standard polymerization mode
generated the highest increase in temperature. The authors concluded that
LED technology generated the lowest
temperature rise. Uhl et al13 reported
that LED LPUs represent an alternative to QHT LPUs for the light polymerization of composite resin systems
because of the considerably lower
temperature increase within the material. In the present study, when the
optimum polymerization periods
were considered, the highest temperature rises were recorded with the QTH
LPU (Elipar TriLight) at reference
nodes ds and ps. The minimal temperature rise was observed with the
LED LPU (Elipar Freelight) where the
light output increased exponentially
and reached its maximum during the
first 12 seconds.
Although 3-dimensional FE models better represent the complex dental structures of the restored tooth
units, 2-dimensional FEM offers high
mesh refinement and can predict the
inhomogeneity of a structure and
may find application in investigating
the mechanical and thermal behavior of a dental restoration in a single
tooth unit.35,41 However, the reason a
2-dimensional FEM was used to solve

the thermal stress analysis problem in

this study was because the heat flow
starts from the outer surface of the
crown and moves toward the center,
so the pattern of heat flow and stress
generation by temperature gradient
will be similar in 2- and 3-dimensional
models.41
The temperature values measured
in this study cannot be directly applied to temperature changes in vivo
because the experimental design did
not consider the cooling effect of
blood circulation in the pulp chamber
and fluid motion in the dentinal tubules.7,20 However, it was considered
in this study that light-polymerization
sources with high intensities may increase the potential for generating unacceptable temperatures in vital tissue
when they are not operated correctly.
In the present study, the materials
used in the structure of the problem
were standardized to better understand the thermal effects of different
types of LPUs. In future studies, investigating the material-dependent variations may help to better understand
the complex thermal problems.

CONCLUSIONS
Within the limits of this 2-dimensional FEA study, the following conclusions can be drawn:
1. With the exception of QTH LPU,
none of the investigated LPUs produced significant heat when they were
used in accordance with the manufacturers recommendations and without
prolonged operating time periods.
2. Only the QTH LPU showed temperature increases that approached
the critical value (42C) for the maintenance of vital tissue within the recomended time of exposure for polymerization.
3. The minimal temperature rise
was observed with the LED LPU,
where the light output increased exponentially.

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Volume 97 Issue 6
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Universtity of Istanbul, Faculty of Dentistry
Department of Prosthetic Dentistry
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TURKEY
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Acknowledgements
The author thanks Prof Dr Murat Tunc for his
valuable comments on this paper.
0022-3913/$32.00
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