Glass ionomer cement

Presented
by:
Anubha
Saxena
PG IInd
year

INTRODUCTION
Glass

ionomer cement is a tooth

coloured material, introduced by
Wilson & Kent in 1972.

-a.k.a

glass polyalkenoate

Silicate Glass
Powder

Polyacrylic acid

GIC

CLASSIFICATION
Type I. For luting
Type II. For restoration
Type II.1 Restorative esthetic
Type II.2 Restorative reinforced
Type III. For liner & bases
Type IV. Fissure & sealent
Type V. As Orthodontic cement
Type VI. For core build up

COMPOSITION
Powder:
Acid soluble calcium fluroalumino
silicate glass.
Silica
- 41.9%
Alumina
- 28.6%
Aluminum fluoride
- 1.6%
Calcium fluoride
- 15.7%
Sodium fluoride
- 9.3%
Aluminum phosphate - 3.8%
Fluoride portion act as ceramic flux.
Strontium, barium or zinc oxide
provide radio opacity.

Liquid:
1.Polyacrylic acid in the form copolymer with itaconic acid & maleic
acid .
2.Tartaric acid: improves handling
characteristic
& increase working time.
3.Water : Medium of reaction &
hydrates the
reaction products

SETTING REACTION
When

the powder
& liquid are
mixed, surface of
glass particles
are attacked by
acid. Then Ca, Al,
sodium, &
fluoride ions are
leached into
aqueous medium.

 Calcium

poly salts are formed first, then followed

by aluminum poly salts which cross link with poly
anion chain.

Set

cement consist of unreacted powder particle

surrounded by silica gel in amorphous matrix of
hydrated calcium & aluminum poly salts.

Calcium

poly salts are responsible for initial set.

Aluminum

poly salts form the dominant phase.

 Water

plays an important role in

structure of cement.
After hardening, fresh cement is
extremely prone to the cracking &
crazing, due to drying of loosely
bound water .
Hence these cements must be
protected by application of varnish.

SETTING TIME
Type

4 - 5 minutes

Type

II

7 minutes

PROPERTIES
Handling

characteristics:

Previous versions of GIC had problems with

inappropriate working and setting time.

Tartaric acid inclusion resulted in:
Tartaric acid reacting with calcium as it was
released which extends working time to
reasonable values
Enhances rate of formation of aluminum
polyacrylate crosslinks which speeds up
setting.

Solubility and disintegration:

Initial solubility is high due to leaching of
intermediate products.

The complete setting reaction takes

place in 24 hrs, cement should be
protected from saliva during this period.

 Adhesion:
Glass ionomer cement bonds chemically

to the tooth structure.

Bonding is due to reaction occur between
carboxyl group of poly acid & calcium of
hydroxyl apatite.
Bonding with enamel is higher than that of
dentin, due to greater inorganic content.

 Esthetics:
GIC is tooth coloured material &

available in different shades.

Inferior to composites.
They lack translucency & rough
surface texture.
Potential for discolouration &
staining.

Biocompatibility:

Pulpal response to glass

ionomer cement is favorable.

Pulpal response is mild due to
High buffering capacity of
hydroxy apatite.
Large molecular weight of the
polyacrylic acid , which prevents
entry into dentinal tubules

 Anticariogenic

effect:

Fluoride is released from glass

ionomer at the time of mixing &

lies with in matrix. Fluoride can be
released out without affecting the
physical properties of cement.

 Initial

release is high.
But declines after 3
months.
After this, fluoride
release continuous for
a long period.
Fluoride can also be
taken up into the
cement during topical
fluoride treatment and
released again ,thus
GIC act as fluoride
reservoir.

 Strength:
Compressive strength - 150 mpa
Tensile strength - 6.6 mpa.
Hardness - 49 KHN.

 Inherent adhesion
ADVANTAGES:
to the tooth
surface.
Good marginal
seal.
Anticariogenic
property.
Biocompatibilty
Minimal cavity
preparation
required.

DISADVANTAGES:
Low fracture
resistance.
Low wear
resistance.
Water sensitive
during setting
phase .
Less esthetic
compared to
composite.

USES
1.

2.
3.
4.
5.
6.
7.
8.

Anterior esthetic restoration

material for class III & V
restorations.
For luting.
For core build up.
For eroded area .
For atraumatic restorative
treatment.
As an orthodontic bracket adhesive.
As restoration for deciduous teeth.
Used in lamination/ Sandwich

CLINICAL USE
For

luting:

Advantages:
Fluoride release
Low film thickness
Kind to pulp
Bond to tooth structure
Their use decreased after hybrid

ionomers and resin cements were

introduced since they are stronger

 As

restorative material:

used in non-stress bearing areas:

Root caries
Occlusal lesions in primary teeth
Temporary restorations
Cervical cavities (abrasion and erosion
lesions)
Anterior class III when color matching
is not an issue

 As

liners and bases:

used to protect the pulp from:

Temperature changes
Chemicals from other restorative materials
Acid etchants
Liners have lower powder: liquid ratio and

weak.
GIC bases are used to rebuild missing
tooth structure, stronger than liners and
have a higher powder: liquid ratio

 As

pits and fissure sealants:

The use of GICs as sealants have been

suggested due to:

Fluoride release.
Adhesion to moist tooth structure

Disadvantages:
Inability to fully penetrate fissures
Brittleness
Low wear resistance

 Core

build up materials:

cermet GICs are usually used for

this purpose. They are used:

In locations were esthetics are not
important
To replace missing tooth structure
where the permanent restoration is
crown.

SANDWICH TECHNIQUE
Devolped

by Mclean,
To combine the beneficial properties
of GIC & composite.

 An

effective technique for both

anterior and posterior resin based
restorations.
For pulpal protection from the acidetch technique.
And as a mechanism for sealing the
cavity in the absence of good dentin
adhesion available with the
materials of the time.

 Clinical

steps:

After cavity preparation, condition the cavity to

develop good adhesion with GIC.

Place Type III GIC into prepared cavity.
After setting, etch the enamel & GIC with
orthophosphoric acid for 15 seconds. This will
improve micromechanical bond to composite
resin.
Apply a thin layer of low viscosity enamel
bonding agent & finally place the composite
resin over GIC & light cure it.

 Advantages:
Polymerisation shrinkage is less,due to

reduced bulk of composite.

Favorable pulpal response.
Chemical bond to the tooth and
composite increasing retention form.
Provides better seal when used at
nonenamel margins.

 Advantages:
Anticariogenic property
Potential for recurrent caries low.
Decreased microleakage and gap

formation.
Better strength, finishing, esthetics of
overlying composite resin.

 Advantages

for the flowable

composite:
(as a liner under a composite)
Acts as a shock absorber, distributing

stresses applied to the more rigid

composite.
Reduce some of the negative effects of
polymerization shrinkage.

 TWO

TECHNIQUES:
1. Closed Technique
- The traditional technique.
-Involves the placement of GIC at the base
of the proximal box so as it falls just short
of the external cavo surface. After setting,
the GIC is etched with phosphoric acid
and dentin bonding agent is applied
before placing composite resin into the
proximal box and occlusal surface.

2. Open Technique
- Involves the placement of GIC into the base of
a proximal cavity and filling the preparation
with glass ionomer upto the DEJ. The last
portion of the restoration is placed with
composite resin to provide wear resistance and
esthetics on the occlusal surface.
- For clinical situations where a portion of the
restoration would have a dentin only margin (as
in a deep class II or a class V on a root surface).

- Advantage of Open Technique:

a. The large area of GIC available for
buffering any changes in acidic pH.
-Disadvantage of Open Technique:
b. Over time the GIC succumbs to acid
breakdown over the surface resulting
in food packing and recurrent caries
within glass ionomer.

 Factors

necessary for successful

tooth restoration:
Removal of infected dentin and enamel

completely
Treating the enamel and dentin
appropriately with bonding materials.
Manipulating properly the to-be-bonded
restorative material.
Contouring the restoration to provide
proper form and function.

 Advantages:
Polymerisation shrinkage is less,due to

reduced bulk of composite.

Favorable pulpal response.
Chemical bond to the tooth.
Anticariogenic property
Better strength, finishing, esthetics of
overlying composite resin.

GIC MODIFICATIONS
1. Water settable glass ionomer
cement:
Liquid is delivered in a freeze dried
form, which is incorporated into the
powder.
Liquid used is clean water.

 Advantages:
low viscosity in the early mixing stages
improved shelf
Improved strength

2. Resin modified glass ionomer

cement:
Resin composite + conventional GIC
Powder component consist of ion
leachable fluroalumino silicate glass
particles & initator for light curing.
Liquid component consist of water
& poly acrylic acid with
methacrylate & hydroxyl ethyl
methacrylate monomer.

 Advantages:
greater working time
command set on application of visible

light
good adaptation and adhesion
acceptable fluoride release
aesthetics similar to those of composites
superior strength characteristics

 Disadvantages:
setting shrinkage
limited depth of cure especially with

more opaque lining cements.

3. Metal modified glass ionomer cement:

Glass ionomer have been modified by addition of
filler particles to improve strength , fracture
toughness & resistance to wear.
Silver alloy mix / miracle mix: This is made by mixing of spherical silver
amalgam alloy powder with glass ionomer
powder.
Cermet:
Bonding of silver particles to glass ionomer
particles by fusion through high temperature
sintering.

 Cermets
Grey in color
Greater value of compressive strength

and fatigue limit than conventional glass

ionomers
Flexural strength and resistance to
abrasive wear appear no better than
values recorded for conventional GIC
Rapid setting improved erosion
resistance

4. Giomer
It is basically a modified Glass
Ionomer.
It is a hybrid of Glass Ionomer and
Composite.
The GIOMER concept is based on the
novel PRG (Pre-Reacted Glass
Ionomer) technology, where special
PRG fillers are included in the resin
matrix which differs it from

 PRG

technology is used in production

of two types of fillers.
S-PRG(Surface Pre-reacted GI) eg.

Beautiful by Shofu
F-PRG(Full Pre-reacted GI) eg. Reactimer
by shofu

 Properties
Fluoride release
Esthetics (shade conformity)
Ease in Polishing
Strength (resistance to wear)
High radiopacity
Anti-Plaque Effect
Biocompatibility
Long term clinical stability

 Composition
Bisphenol A Glycidyl Dimethacrylate
TEGDMA
Inorganic Glass Filler
Aluminuoxide
Silica
PRG filler
DL-camphorquinone

 Indications
Diastema Closure
Discoloration
Non-Carious Defect(attrition/ abrasion/

surface defects
Carious Defect
Fracture
Malformation
Faulty and Old Restoration

Diastema closure

Discoloration

Non-Carious Defect(attrition/
abrasion/ surface defects

Carious defect

Fracture

Malformation

Faulty and old

restoration

 Compomer
These are recently introduced products

marketed as a new class of dental

materials.
These materials are said to provide the
combined benefits of composites (the
comp in their name) and glass
ionomers (omer).

 These

materials have two main

constituents:
dimethacrylate monomer(s) with two

carboxylic groups present in their

structureand
filler that is similar to the ion-leachable
glass present in GICs.

 The ratio of carboxylic groups to backbone

carbon atoms is approximately 1:8.

There is no water in the composition of
these materials, and the ion-leachable
glass is partially silanized to ensure some
bonding with the matrix. These materials
set via a free radical polymerization
reaction, do not have the ability to bond to
hard tooth tissues,and have significantly
lower levels of fluoride release than GICs.

 Although low, the level of fluoride

release has been reported to last at least

300 days.
They do not set via an acid-base
reaction and do not bond to hard-tooth
tissues, they cannot and should not be
classified with GICs.

 Properties
Fluoride release,
Radiopaque,
Quick cure time and
Good handling characteristics (no slumping, easy

to shape/polish, no sticking)
Can be light-cure or self-cure
Packaging can be unit dose (capsule) or multidose (syringe)
Curing time: 10-20 secs (depending on brand)
Esthetics

 Indications
Deciduous teeth
Cervical defects

 Disadvantages
Lower flexural modulus of elasticity,
Compressive strength,
Flexural strength,
Fracture toughness and hardness,
Higher wear rates

References
Davidson,

C. (2009) Advances in glass-ionomer cements. Journal of

Minimum Intervention Dentistry.

Forsten

L. Fluoride release of glass ionomers. J Esthet Dent 1994; 6:216-

22.
Forsten

L. Resin-modified glass ionomer cements: fluoride release and

uptake. Acta Odontol Scand 1995; 53:222-5.

McCabe,

J. and Walls, A. Applied Dental Materials 9 th edition Chap.24

pp.245-256

Millar

BJ, Abiden F, Nicholson JW. In vitro caries inhibition by polyacidmodified composite resins (compomers). J Dent 1998; 26:133-6.

Nagaraja

Upadhya P and Kishore G. (2005) Glass Ionomer Cement The

Different Generations. Trends Biomater. Artif. Organs, Vol 18 (2)

Th
an
k
you
!