Introduction

The development of the Original Glass Ionomer cement by Wilson
and Kent 1969 was significant in that it made available for the first time a
restorative dental material that had long-term adhesion to the tooth
strctre! along with cariostatic potentials"
#ecent development in the chemistry and clinical application of
Glass-Ionomer cements offer great promise in the treatment of early
carios lesion"
History
The GI$ were invented by Wilson and Kent in 1969s and developed
by %clean and Wilson dring 19&'s ()"I" vol" *+ ,o" 9! 199-."
This cement was invented particlarly to overcome the deficiencies
and limitations of silicate cements i"e" high solbility mechanical adhesion
to tooth and severe plp irritant which was the principal restorative
material ntil than"
Invention
The invention of GI$ reslted directly from basic stdies on dental
silicate cements (Wilson et al 19&*. and stdies where in the phosphoric
acid in silicate cement was replaced by organic chelating acids (Wilson
196/."
1
0 significant contribtion was also made by 1"$" 2mith in 196/
who sed polyacrylic acid in his 3inc polycarbo4ylate cement"
Ths! GI$ 5 (Termed by 6"7" Kent. has been described as a hybrid
of dental silicate cements and 3inc polycarbo4ylate cements"
6t the reaction between the Glasses and polyacrylic acid was
ncontrollable which was later controlled by addition of tartaric acid"
EARLY DEVELOPMENT
2cientific development of GI$ has occrred in two steps8
a" 9irstly! effort was devoted to improving properties to ma:e it a flly
practical material for anterior restoration"
b" 2econdly! properties were modified in order to e4tend its range of
applications"
In 196' and 1966! in their early research 0"1" Wilson e4amined
cements prepared by mi4ing silicate glass powder with a;eos soltions
of varios organic acids! inclding polyacrylic acid"
The disadvantages of these polyacrylates cements were8
a" $ements were almost nwor:able"
b" 2et slowly and slggishly"
c" ,ot hydrolytically stable i"e" dissolved in water"
<ater in 196/ and 1969 Wilson! Kent and <ewis fond that by
employing novel glasses formlation hydrolytically stable cements cold
*
be prodced as the setting of these cement was controlled by 0l
*
O
=
> 2iO
*
ratio in the glass"
This discovery enabled more reactive glasses to be prepared sitable
to forming rapid setting cements with polyacrylic acid"
The first GI$ lac:ed wor:ability and hardened slowly"
7ventally Kent et al! (19&=! 19&9. fond a glass that was high in
florides (G-*''. which was termed as 02?0-I (0lminosilicates
polyacrylates."
This cement also had8
a" 2low set"
b" %inimm wor:ing time"
c" ?ost set hardening was slow"
In 19&* Wilson and $risp discovered that tartaric acid modified the
cement forming reaction ths8
i" Improving maniplation"
ii" 74tended wor:ing time"
iii" Increased setting rate"
This refinement of 02?0-I was termed as 02?0 II which was the
first practically sed GI$ and was sed mainly for $lass III restorations"
=
Disadvantages of ASPA II
a" @ardened very slowly and dring this stage was vlnerable to
moistre contamination"
b" ?oor aesthetic properties becase of se of !"## glass with a
very high floride content"
c" <i;id tended to gel 8 This last problem was solved by the
development of a copolymer of acrylic and itaconic acid that did
not gel at high concentrations (+'A. in a;eos soltion"
This was termed as 02?0 IB" The 02?0 IB was inferior to 02?0
II in other properties"
In 19&- %clean and Wilson sed GI$ as a fissre sealants"
02?0 IBa 5 9or lting prposes developed in 19&& by Wilson et al"
02?0 C 5 Was developed by $risp et al in 19&9 with e4cellent
translcency"
In 19&& 5 %clean and Wilson introdced sandwich techni;e >
laminate techni;e"
Definition$
0" GI$ is an acid-base reaction cement as defined by Wilson
(19&/. and Wygant (19+/.! the prodct of reaction being a
-
hydrogel salt which acts as a binding matri4 (0lan 1" Wilson!
GI$."
6" 0ccording to 2:inners 5 Glass ionomer is the generic
name of a grop of materials that se silicate glass powder and
an a;eos soltion of polyacrylic acid" 0lso :nown as
D?olyal:enoate cementE"
$" 0 cement that consists of a basic glass and an acidic
polymer which sets by an acid base reaction between these
components as described by Wilson and ,icholson ()I vol" *+
,o" 9! 199-."
%LASSI&I%ATION$ 'y S(inners
0" Type I 5 <ting cements"
Type II 5 #estorative materials"
Type III 5 <iners and base"
Type IB 5 %etal reinforced - %iracle mi4
- $ermet
Type IC 5 9or geriatric and pediatric patients"
6" 6y Wilson and %clean 19//aF %ont 19/9a (6ased on
application. (Opt" 1ents! 199-."
Type I 5 <ting crowns! bridges and orthodontic brac:ets"
Type II 5 #estorative cements"
Type II 1 5 7sthetic restoration cements"
Type II * 5 #einforced restoration cements"
Type III
- <ining cements with powder > li;id ratio 1"+ 8 1"
+
- 1entine sbstitte or base with powder > li;id
ratio =81"
6
%OMPOSITION
The composition of glass ionomer cement is comple4 and varied"
)Dis*ensing +ediu+, +ode of su**-y
- GI$ is dispensed in1" ?owder and li;id form
*" $apslated form"
=" ?owder and water (powder contains dried acid too.
-" <ight-cre system
The basic composition of powder and li;id formlation is as
follows8
Po.der 8 is an acid solble calcim floroalmino silicate glass
$omposition of * GI$ powders
S*ecies /eig0t 1
A '
2iO
*
-1"9 =+"*
0l
*
O
=
*/"6 *'"1
0l9
=
1"6 *"-
$a9
*
1+"& *'"1
,a9 9"= ="6
0l?O
-
="/ 1*"'
&unction of eac0 co+*onent$
a" 2ilica (2iO
*
.! 0lmina (0l
*
O
=
.! 9lorite ($a9
*
. ta:e part in reaction
with acid to form a solble gel"
b" 9loride
i" <owers the fsion temperatre"
ii" Improves the wor:ing characteristics of paste"
iii" Increases the strength of set cement"
&
iv" In moderate amonts enhances translcency"
v" $ontribtes to anticariogenic property of cement by
releasing floride over a prolonged period"
c" 0lmina
- Increased content increases compressive
strength"
- 1ecreases translcency"
d" $rylite (,a
=
0l96.
- <owers the fsion temperatre (acts as a fl4."
- Increases the translcency of set cement"
e" 0lminim phosphate
- Improves translcency of set cement"
- Gives strength to the cement"
,otes 8
The ratio of 0l
*
O
=
> 2iO
*
is crcial and is re;ired to be 18*"
The increase in ratio gives rise to8
1" Glasses which are more basic and reactive"
*" #edction in setting time of cement"
LI23ID
Originally the li;id was an a;eos soltion of polyacrylic acid
+'A"
Disadvantages$
a" <i;id was too viscos"
b" Tended to gel with time"
/
c" $rrent cements contain the acid in the form of copolymer of
itaconic! maleic or tricarbo4ylic acid"
&unctions of acids$
a" Tend to increase the reactivity of li;id"
b" 1ecreases the viscosity"
c" #edces the tendency for gelation"
E4*-anation$
The copolymeric acids are irreglarly arranged as compared to
niform arrangement of acrylic acids in li;id" This configration redces
hydrogen bonding between acid molecles and ths redces the degree of
gelling"
Pre*aration of g-asses
The raw material are fsed to a niform glass by heating them to
temperatre of 11''G$ to 1+''G$"
- <anthanm! strontim! barim or 3inc o4ide
additions provide radioopacity"
- The glass is grond into a powder having
particles in the range of *'-+'Hm"
%HEMISTRY O& SETTIN
- The reaction is an acid-base reaction"
- 0lso :nown as ato-cre cements becase of this
reaction"
9
STAES ARE$
2tage I 8 #elease and migration of glass ions after acid attac:"
2tage II 8 Ion binding of cations to polyacrylic and precipitation of salts"
i. Gelation"
ii. @ardening"
2tage III 8 @ydration of salts (2trength of material is achieved."
Stage I$
- When the powder and li;id are mi4ed to form a
paste! the srface of the glass particles is attac:ed by the acid"
- $alcim! floride! alminim and sodim ions
are leached into the a;eos medim"
Stage II$
- The polyacrylic acid chains are cross-lin:ed by
the calcim ions and form a solid mass"
- Within ne4t *- hors! a new phase forms in
which alminim ions become bond within the cement mi4"
This leads to a more rigid set cement"
- 2odim and florine ions do not participate in the
cross-lin:ing of the cement"
- Instead some of the sodim ions replace
hydrogen ions of carbo4ylic grop and remaining combine with
1'
florine to form sodim floride niformly dispersed in the set
cement"
- 1ring the matring process the cross-lin:ed
phase is also hydrated by the same water sed as the medim"
Stage III$
- @ydration of salts (#ole of water in setting
process."
- When flly hardened GI$ is flly impervios to
oral flids"
- The cement is most vlnerable to contamination
by moistre at stage II"
- This vlnerability occrs while cement forming
ions ($a
I
0l
I
. from the glass are being transferred to the
polyacid! where ltimately they are loc:ed in a resistant gel" If
water comes in contact with this srface before it hardens (2tage
III. the calcim and alminim ions-will be washed ot and lost
for cement formation"
- Water will be absorbed! cement will lose its
translcency and wea:ened srface will erode"
0ccording to 2:inners! water is most important consitent of
cement li;id"
11
- 1ring the initial reaction! this water can readily
be removed by dessication and is :nown as Dloosely bond
waterE"
- 0s the reaction contines! the same water
hydrates the matri4 and cannot be removed by dessication and is
:nown as DTightly bond waterE"
Effect of .ater on ce+ent$
1. 1ehydration of cement cases fissring and
crac:ing as the water of hydration is lost"
*. 74posre of cement to saliva cases the
srface to soften as the vital cement forming ions are lost"
E4*osure of ce+ent to .ater can 5e *revented 5y$
a" Jse of cotton rolls! gingival retraction cord! rbber dam (#bber
dam can create conditions which may dehydrate the cement!
reslting in loss of water re;ired for cement formation."
b" 0 coat of light-cring bonding agent shold be applied to cement
immediately after removal of the matri4"
c" Jse of proprietary varnishes"
1*
Ths! a critical water balance at the interface! between water needed
for cement formation and water absorbed from saliva which will wea:en
the cement mst be maintained"
1=
Set structure of ce+ent
The set cement consists of an agglomeration of nreacted powder
particles srronded by a silica gel (that develop dring the removal of
cations from the srface of the particles.! in an amorphos matri4 of
hydrated calcim and alminim polysalts"
&actors affecting setting reaction$
a" $hemical factors"
b" ?hysical factors"
%0e+ica- factors
a" 9loride delays gelation and prolongs the wor:ing time"
b" Tartaric acid increases wor:ing time"
?roportion of glass and water
 1ecreased water content! faster the set and shorter the wor:ing time"
P0ysica- factors
a" 0lmina>silica ratio i"e" glass composition 5 @igher the ratio! faster
the set and shorter the wor:ing time"
b" ?article si3e of glass powder8 9iner the powder! faster the set and
shorter the wor:ing time"
c" Temperatre of mi4ing8 @igher the temperatre! faster the set and
shorter the wor:ing time"
1-
%HARA%TERISTI%S O& I% 62uis Int7 899:;
a" @ard sbstance on setting"
b" <ow-reaction e4otherm"
c" ,o polymeri3ation shrin:age"
d" ,o free monomer present"
e" 1imensional stability at high hmidity"
f" 9iller-matri4 interaction"
g" 0dhesion to enamel and dentine"
h" 9loride release"
i" 7arly moistre sensitivity re;iring protection (e"g"! with varnish.
immediately after placement"
PROPERTIES
The GI$ possess a nmber of very sefl properties! some of which
are ni;e in a restorative material"
?roperties of GI$ can be divided into two grop8
a" ?hysical properties"
b" 6iological properties"
PHYSI%AL PROPERTIES
1. STRENGTH
a" $ompressive strength - 1+' m?a > **!'''?si after *- hrs"
- becomes doble in a year
b" Wea: fle4ral strength - 6"6m?a or 96' psi after *- hors"
1+
2. FRACTURE TOUGHNESS
0 measre of energy re;ired to prodce fractre"
Type II GI$ are mch inferior to composites in this respect"
=" 27TTI,G TI%7 =-/ %I,JT72
-" T#0,2<J$7,T
The set cement has a translcency that matches with the tooth
enamel"
+" GI$ cements are the most resistant to erosion in the acidic
stagnation regions of moth (Wilson et al 19/6."
6" #esistant to staining and maintain their color match better
than composite resins"
&" @ardens 5 -/ :@,
/" 2olbility 5 '"- which is less than that of silicate cements
('"&."
9" ?oor wear resistance"
1'" If conditions of moistre control are followed there is no
change in dimensions of GI$"
11" 01@72IO,
- The precise mechanism of adhesion of GI$ is
based on both diffsion and adsorption phenomena"
16
- The natre of adhesion is physico-chemical"
Mec0anis+ of ad0esion 6OP7 Dents 8999;
The polyal:enoic acid of the glass-ionomer will penetrate the tooth
strctre releasing phosphate ions each of which will ta:e with it a calcim
ion from the tooth srface to maintain electrical netrality"
These ions will combine with srface layer of new material which is
firmly attached to the tooth srface (Geigger and Weiner 199=." This has
been described as a D1iffsion based adhesionE" (0chinmade and
,icholson in 199=."
There is also a degree of adhesion available to the collagen of
dentine throgh either hydrogen bonding or metallic ion bridging between
the carbo4yl grops on the polyacid and the collagen molecles
(0:inmade! 199-."
The bond to enamel is always higher than that to dentine probably
becase the greater inorganic content of enamel and its greater
homogenicity in morphology"
This ion-e4change system is ni;e in dentistry and is of
considerable significance"
The type of failre of adhesion leading to loss of restoration is
cohesive i"e" within the cement itself and not adhesive between cement and
1&
tooth strctre" There! even after loss of cement from tooth srface a layer
is left intact ths sealing the srface and preventing microlea:age"
S3R&A%E %ONDITIONIN < As a +ec0anis+ of 5onding7
The ;estion of conditioning the tooth srface in preparation for
adhesion is widely debated"
#etreatment of srface was first introdced by %clean and Wilson
in 19&& and they termed it as srface conditioning"
1ifferent acids sed are8
a" +'A citric acid"
b" 2rface active microbicidal soltions sch as
- Tblicid contains 5 '"1A chlorhe4idine
glconate"
- '"'/A dodicin
- =A ,a9 5 strengthens bond to enamel
and dentine"
c" Tannic acid *+A (for dentine."
d" 9erric chloride (by ?owis et al. *A a;eos alcholic soltions"
- ?rovides metal lin:ages between GI$ and
collagen"
- Gets incorporated into GI$ and apatite"
e" %inerali3ing soltions 5 1eveloped by $aston and Kohnson in
(19&9! 19/*."
74amples 8 <evine et al soltion 5 IT2 2oltion
f" 71T0
g" 1'A a;eos soltion of polyacrylic acid (?owis et al 19/*."
Advantages of Po-yacry-ic acid$
1/
i. ?art of cement forming system"
ii. $leans the srface with in 1' seconds"
iii. 0lters the srface energy of tooth ths encoraging
adaptation of cement to the cavity walls"
'IOLOI% PROPERTIES
The two main biologic properties of GI$ are8
1" 0nticariogenic potential de to release of floride"
*" 6iocompatibility"
I, &-uoride Re-ease
- One of the important properties GI$ shares with
silicate cement is the release of floride ions throghot the life
of the restoration (9orsten 199-."
- This floride release provides for the cariostatic
effect of GI$"
- The inflence of floride is fond in a 3one of
resistance to deminerali3ation which is at least =mm thic:
arond a GI$ restoration (Kidd et al 19&/."
- The spread of caries is arrested at the restoration
or cavity wall margins"
- The glass powder of both the silicate and GI$ is
prepared in a 9loride 9l4" 9loride ions are released from the
set material and ta:en p by the srronding tooth strctre"
19
- 7namel solbility is redced by this process of
floride release and pta:e"
- $onse;ently! the incidence and severity of
recrrent caries are redced"
Fluoride contributes to caries inhibition by to !rocesses"
1. ?hysico-chemical 9 ions released from
restorative material become incorporated in hydro4yapatite crystals of
adLacent tooth strctre to form florapatite which is more resistant to
acid decalcification"
- 0lso the formation of this acid resistant phase
enhances reminerali3ation of deminerali3ed enamel"
- $arios enamel is more poros than sond
enamel! this porosity allows increased penetration of
floride which contribtes to formation of acid-resistant
crystals and redces caries ris:"
*. 6iologic %echanism
- 9loride inhibits carbohydrate metabolism by the
acidogenic pla;e microflora"
- 9loride enters microorganism against a
concentration gradient and accmlation intracelllarly as the
e4tracelllar p@ redces"
*'
- This intracelllar @9 brea:s into @
I
and 9
-
ions
which cases en3yme inhibition and leads to slower rate of acid
prodction"
- GI$ also acts as a floride reservoir within the
oral environment GI$ pta:es floride ions on application of
topical florides and increased the rate of release for a short
period"
II, 'IO%OMPATI'ILITY
6iocompatibility is defined as the ability of a material to perform
with an appropriate host response in a specific application"
GI$ are generally biocompatible with oral tisses and as restorative
materials! reslt in only mild plpal irritation at a level similar to that
prodced by 3inc polycarbo4ylate or 3inc phosphate cements"
This can be attribted to polyal:enoic acid which is a wea: acid and
also has high moleclar weight of li;id and larger molecle si3e of acid!
ths it is not able to penetrate the dentinal tbles"
Their adhesion to tooth strctre ensres that they provide an
e4cellent marginal seal and prevent microlea:age"
GI$ is well-tolerated even by the healthy e4posed plp tisse"
When lesion is close to plp! it is better to place $a(O@.
*
as a sb-
base! avoided if plpitis is apparent > sspected"
*1
Thogh glass ionomers have become increasingly poplar as a
lting agent! post-operative sensitivity has been reported with these cement
at times"
**
T0eories = Reasons$
a. 9irst relates to powder-li;id ratio"
b. 0nother case for post-operative sensitivity may be
related to the manner in which the prepared srface of the
dentine is dried before the cementation process" Overdessication
of dentine may reslt in aspiration of the odontoblastic processes
which then cases necrosis"
c. Overfilling of crown before the seating process
which may lead to e4cessive hydralic pressre"
Indications
I, As a Restorative Materia-
a" #estoration of erosion > abrasion lesion 5 $lass B lesion"
b" 0nterior restorations"
c" 2ealing and filling of occlsal pits and fissres"
d" #estoration of $lass III carios lesions! preferably sing a lingal
approach"
e" #estoration of decidos teeth $lass I and $lass II"
f" #epair of defective margins in restoration or temporary coverage of
fractred teeth"
g" %inimal cavity preparation 5 appro4imal lesions! bccal and
occlsal approach (Tnnel preparation."
h" $ore bild-p"
*=
i" ?rovision restorations where ftre veneer crowns are contemplated"
L" 2ealing of root srfaces for overdentres"
II, &ast Setting -ining ce+ents and 5ase
a" <ining of all types of cavities where a biological seal and cariostatic
action are re;ired"
b" 1entine sbstitte in laminate techni;es"
c" 2ealing and filling of occlsal fissres showing early signs of caries"
III, Luting %e+ents 6&ine grain version of I%;
a" Jsefl in patients with rampant caries and as well as mltiple
carios lesions"
b" In e4posed porcelain margins sed for cosmetic reasons! becase of
its increased translcency"
c" $rown and prosthesis cementation" 6ecase8
i. Its ability to release 9 ions into nderlying dentine" This is
of great vale as secondary caries is a common case of
failre for cementation prosthesis"
ii. $hemical bonding"
%ontraindications
1" $lass IB carios lesions or fractred incisors"
*-
*" <esions involved large areas of labial enamel where
esthetics is of maLor importance"
=" $lass II carios lesions where conventional cavities
are preparedF replacement of e4isting amalgam"
-" <ost csp area"
Advantages$ 62I 89>>;
1" 0nticariogenic 5 6ecase of floride ions they can alleviate
sensitivity and redces recrrent caries"
*" 6iocompatible 5 <east irritant to plp"
=" $hemical bond to enamel > dentine 5 ths provide good
marginal seal"
-" %inimal setting shrin:age"
+" $oefficient of thermal e4pansion similar to tooth strctre
(i"e" dentine. ths it prevents microlea:age becase as the
coefficient of thermal e4pansion increases! microlea:age
increases (K010 vol" 1*-! 2ept" 199=."
6" #elatively resistant to acid and wear"
Disadvantages$
1" 6rittle material"
*" <ow tensile strength ths sed in bl: and low stress 5
bearing area"
*+
=" 7sthetically less pleasing than composite restorations"
-" #elatively opa;e and lac: polishability ths poor srface
finish"
+" Techni;e sensitive (6t lesser than composite."
6" <ac: of toghness"
&" 6ecase of powder li;id! formlations alterations"
- ?ost operative sensitivity"
- #edced physical and mechanical properties"
- 1ecreased bond strength"
- ?rone to porosity a frther case of wea:ness"
Water contamination dring early stages of setting reaction (1+
seconds to 1 minte. can case porosity! ga3ing and later staining and
solbility" Ths! GI$ shold be covered with varnish > 160"
/" ?oor edge strength! GI$ do not perform well in sacer
shaped lesions ()I vol" 19! ,o" 1*F 19//."
MANIP3LATION
The ?8 < ratio recommended by the manfactrer shold be
followed becase any redction in the ratio of set cement adversely affects
the properties of set cement"
- 9or mi4ing! a paper pad or a cool-dry glass slab
is re;ired" 0s stated earlier! high temperatre may alter the
*6
wor:ing time" 0lso temperatre shold not be below the dew
point as it may alter acid water balance"
- The powder and li;id shold not be dispensed
onto the slab ntil Lst before the mi4ing procedre is started"
74posre to air may alter the acid water ratio" The powder
shold be incorporated rapidly into the li;id sing a stiff plastic
spatla sing folding techni;e" ?lastic spatla is sed becase
cement stic:s to stainless steel instrments"
- %i4ing time shold not e4ceed -+ seconds"
- The mi4 shold have a glossy srface that
indicates the presence of nreacted polyacid which ensres
adhesive bonding to the tooth"
- If mi4ing is prolonged a dll srface will develop
and adhesion will not be achieved"
- Type II GI$s are also spplied in capsles
containing proportioned powder and li;id"
- The mi4ing is accomplished in an amalgamation
after the seal that separates the powder and li;id is bro:en"
Advantages of ca*su-es$
a" $onvenient"
b" $onsistent control of ?8< ratio"
c" 7limination of variation associated with hand spatlation"
*&
RE%ENT ADVAN%ES
The GI$ has come a long way since it was first introdced its
properties have improved and there are now many versions for varios
applications"
0mongst the recent development are8
1" %etal reinforced ionomer cements"
*" ,ew fast setting lining cements"
=" Water hardening lting agents"
-" 1al cre system which inclde8
- #esin modified GI$"
- ?oly acid modified resin > compomer"
+" ?ac:able GI$"
6" 2elf hardening resin GI$"
&" 2mart materials > floride charged materials"
/" 6ioactive GI$"
1) Metal Modified GIC
The metal modified GI$ were introdced in an attempt to improve
the strength! fractre toghness and resistance to wear and yet maintain the
potential for adhesion and anticariogenic property"
*/
Two methods were employed8
a" %iracle mi4 8 2pherical silver alloy" ?owder is mi4ed with type II
GI$ powder (in the ratio of &81 GI$ and silver alloy."1eveloped by
2I%%O,2 in 19/=(61K 19//.
b" $ement 8 9sion of glass particles to silver elemental particles
throgh high temperatre sintering of a mi4tre of two powders"
- 1eveloped by %clean and Gasser in 19/+"
Pro*erties of Meta- Modified I%
a) Mechanical properties:
i. The strength of miracle mi4 GI$ is higher than that of
conventional GI$"
ii. Increased fle4ral strength"
iii. Increased resistance to abrasion"
iv. Increased fractre resistance"
v. <ow thermal condctivity"
vi. $oefficient of thermal e4pansion same as dentine"
vii. ?asses anticariogenic property de to decrease of
florides"
viii. $hemical adhesion to tooth srface"
*9
Uses:
1" 0s an alternative to amalgam in conservative $lass
II cavities! mainly in primary teeth"
*" $ore bild p material"
=" <ining of $lass II 209 restoration > composite
restoration"
-" #oot caps for teeth sed nder overdentre"
+" %aterial sed in conLnction with ortho tramati3ed
or mobile posterior teeth (1ental Jpdate ,ov" 1991."
Contraindication:
1" 0nterior teeth becase of esthetics and where strong a4ial wall
spport is needed"
Disadvantages:
1" 9loride release is less than conventional GI$ becase the portion
of original Glass particles is metal coated"
*" 7sthetically poor"
=" #ogh srface"
-" #edced setting time"
Advantages:
1" 7ase of preparation and placement"
*" 0dhesion to tooth strctre"
=" $rown ctting can be done immediately"
='
2) Fast Setting Lining Ceents !"D# 1$%%) & 'hese
faster setting GIC (ere discovered )* +ilson and Crisp in 1$,2-
They fond that optically active d-tactaric acid modified the cement
forming reaction ths improving"
i. @andling characteristics"
ii. Increases the wor:ing time"
iii. 2hortens the setting time"
iv. 7nabled the floride contents of glasses to be redced"
v. Increases cement strength"
.) +ater /ardening Ceents 0 Anh*dro1s Ceents
!"D# 1$%%)
To solve the problems associated with the instability of polyacrylic
acid! copolymer of acids were introdced which althogh stable in water
might not yield the best cements"
Ths in 19&= Wilson and Kent described the se of polyacrylic acid
in dry form blended with Glass powder" <i;id consisted of water or an
a;eos soltion of tartaric acid"
This was termed as 02?0 B by ?rosser et al 19/-"
Advantages:
1" 1eveloped very low viscosity in early mi4ing stages"
*" #apid set at minimal temperatre"
=" 7asy maniplation"
-" 74cellent shelf life"
=1
2) D1al C1re 0 3hotoc1red GIC
A; Resin Modified I%
%oistre sensitivity and low early strength of GI$ are the reslts of
slow acid base setting reaction" @ence to overcome these two inherent
drawbac:s! some polymeri3able resin fnctional grops have been added to
GI$ to impart additional cring process and allow the bl: of material to
matre throgh acid base reaction"
1" 0ccording to ,icholson ()I 19&&.
#esin modified GI$ are those Glass ionomer materials that
are modified by the inclsion of resin! generally to ma:e them partly
photo crable"
*" 0ccording to W% Tay (1ental Jpdate 2ept" 9+.
These are hybrid materials that certain significant acid base
reaction as a part of their overall cring process"
=" 0ccording to %ont (Op" 1ent" 199-.
The term Ddal creE has been sggested becase these
cements ndergo the original acid base setting reaction
sperimposed over that"
-" 0ccording to $hristensen (K010 199&.
=*
These materials are termed as Tricre as the #%GI$ sets by
= phenomena"
a" 0cid base reaction between the components of conventional
GI$"
b" <ight cre reaction stimlated by light application activates
the initiated catalyst resin cre system"
c" 0to cre reaction when the powder and the li;id
components are mi4ed together the initiation catalyst system
for resin gets activated and ensres that over time these will
be a complete cre throghot the entire restoration with no
free resin remaining"
0 featre of these material is that they will set in the dar:"
1ar: setting althogh the process is slower than the conventional
GI$ and prodce a material that is inferior to the prodct obtained
by light cring"
Coposition:
- ?olyacrylic acid > modified polyacrylic acid with a light
activated polymeri3able side chain  app" +A"
- ?hoto polymeri3able monomer 5 @7%0 app" +wtA"
- Ioni3able glasses app" &'wtA"
- Water app" /A! e4amples 8 9Li II <$ (G$.! ?hotac 9il
(72?7.! Bitremer =%"
==
3roperties:
1- Strength
1ie material vales are higher than conventional GI$
Type II GI$ #% GI$
$omposite strength *- hors 1+'m?a 1'+m?a
@ardness strength *- hors -/ -'
1iamaterial strength *- hors 6"6m?a *'m?a
2- 'ransl1cenc*:
There is a decrease of translcency as a significant difference
between the refraction inde4 of the GI powder and set resin matri4
is present"
=" Fl1oride release 8 0ccording to 2:inners 5 There is increased
floride release as compared to GI$"
 $onventional GI$  --'Hg9 in 1- days"
 6+'Hg9 in =' days
 <-$ GI$  1*'' in 1- days"
 16'' in =' days"
2- Adhesion to tooth str1ct1re:
- 6ond strength is higher than conventional GI$ to tooth
strctre and also to other restorative material sch as
composites"
4- Marginal adaptation:
=-
- #% GI$ e4hibit a greater degree of shrin:age on setting as a
reslt of polymeri3ation ths e4hibit greater microle:age"
6" +ater sensitivit* 8 #esins are added to GI$Ms to redce the water
sensitivity of GI$" 2tdies show that GI$ liners are still ssceptible
to dehydration and that this material can also absorb water which
can reslt in dimensional change"
&" "iocopati)ilit* 8 6iocompatibility of #%GI$Ms is controversial
certain stdies sggests that precation sch as $a(O@.* for deep
preparation are recommended as there is a transient rise in
temperatre associated with polymeri3ation process"
Advantages: !DM Sept- 1$$4)-
1" 2fficiently long wor:ing time controlled in command to a snap set
by photo-cring"
*" Improved setting characteristics"
=" ?rotects the acid base reaction from problem of water balance"
-" #apid deviation of early strength"
+" $an be finished and polished immediately after set"
6" #epairs can be easily carried ot as the bond between old and new
material is strong"
&" 74hibits increased adhesion to composite when as a base"
=+
/" 9loride release is present which is greater conventional GI$"
9" Increased tensile strength (*'m?a."
Disadvantages !DM 1$$4)
1" 6iocompatibility is controversial"
*" 2etting shrin:age is higher 5 microlea:age is more! poor marginal
adaptation (abot 1A."
=" <ow wear resistance compared to composite (K010 9&."
-" 1epth of cre can be a problem 8 Incremental placement techni;e
necessary" 1epth of cre 5 =--mm"
Uses: !DM Fe) 1$$5)
a" <iners and bases"
b" $lass B! III restorations"
c" $ervical abrasion > 7rosion lesion! root
caries"
d" $ore bild ps where sfficient tooth
strctre remains"
e" $lass I and II restorations in decidos
teeth"
f" %icrocavity > Tnnel preparation"
=6
g" Temporary repairs of N teeth"
h" Temporary repairs of deflection crown
margins"
'; Po-yacid Modified Resin %o+*osite
Definition 8 0ccording to %clean and ,icholson 5 %aterials that may
contain either or both of the essential components of GI$ bt at levels
insfficient to promote the acid base cring reaction in the Ddar:E"
This material is essentially a resin composite in which the filler is
Glass and variable ;antity of dehydrated polyal:enoic acid which reacts
only if water is available"
- @ere there is a limited degrees of acid base reaction" The
adhesion system is based on the resin to dentine method
becase ion-e4change method cannot arise at any stage"
@ence photoactivation is necessary for type of materials"
Indications:
1" ?it and fissre sealants"
*" #estoration of decidos teeth"
=" %inimal cavity preparation > tnnel preparation"
-" <ining of all types of cavities where a biological seal and cariostatic
action is re;ired"
=&
+" $ore bild p"
6" 1entine sbstittes as in sandwich techni;es"
&" #epair of defective restoration margins"
/" $lass III and IB lesions"
9" 0brasion > 7rosion"
1'" 2ealing of root srfaces for overdentres"
11" ?otential root canal sealers"
1*" #etrograde filling materials in endo emergencies"
1=" <ting agents"
Advantages :
1" 2perior wor:ing characteristics to #%GI$"
*" 7ase of se"
=" 7asily adapts to tooth"
-" Good esthetics"
+" 9loride release! which is less than that of #%GI$"
Contraindications:
1" $lass IB carios lesion"
*" <esions involving large areas of labial srface where esthetics is of
prime concern"
=/
=" $lass II carios lesions where conventional cavities are prepared!
replacement of old amalgam restoration"
-" $sp coverage"
+" Jnderneath metal >?9% crowns where light cannot penetrate" 748
1yract (1entsply.! $ompoglass (Ivoclar.! Bariglass ($al:."
Pac(a5-e 6%ondensa5-e; I% 6&u?i I@ I% = Aetac Mo-ar;
This is a new high viscosity GI$ lanched in early 199'Ms" This
material was developed largely as a need for filling materials in the
atomatic > atramatic restoration therapy D0#TE" 0#T refers to the
restoration of teeth nder conditions of minimal instrmentation! especially
carried ot in the third world nations"
Advantages:
1" ?ac:able and condensable"
*" 7asy placement"
=" ,on-stic:y"
-" 7arly moistre sensitivity is redced"
+" #apid finishing can be carried ot"
6" Improved wear resistance"
&" 2olbility in oral flids is very low"
Indications:
1" Ideal material for molar restoration in decidos teeth"
*" Intermediate treatment restoration for permanent teeth"
=" $ore bild p"
=9
Se-f Hardening Resin I%
This is another recent development in resin modified GI lting
cements" These materials are not light activated bt certain monomers with
initiators are added to allow self polymeri3ation"
Coposition :
- 6en3oyl pero4ide and amine accelerators are added to GI$"
Advantages:
1" 7asily handled"
*" ,o significant post cementation sensitivity"
=" 2ignificant floride release"
-" @igh compressive and fractre strength"
+" ,o length activation re;ired"
Uses :
1" Jsed for lting stainless steel crowns! space maintainers!
orthodontic brac:ets! bands in pediatric cases"
S+art Mat = & %0arged Materia-s 6Denta- 3*date 899> Nov7;
The development of floride releasing material was made in order to
overcome the shortcomings faced by floride releasing materials"
-'
a" Increases the floride release more open
is the strctre of the material" This is associated with low
strength"
b" In order to improve the strength of these
floride containing materials! if they are made more dense and
strong the efficiency of ion release is redced only after
placement of restoration there is a sdden brst of floride
release followed by a rapid decline in ion release rate"
- @ence to overcome these shortcomings and improve the
therapetic potential of these floride releasing materials two
approaches were developed"
a) Fl1oride Charge Materials:
This is a modified GI$ and has two parts material system 8
#estoration part! $harge part"
The restorative part of the material is sed in the sal way" When
the 1
st
brst of floride is e4panded and the therapetic potential of the
restoration is spent" The material is given a second" 9loride change sing
a gel material that replenishes the floride sites in the restoration by ion
e4change and recovers the floride release and therapetic potential of the
restoration" This is achieved withot replacing the material provided the
-1
restoration materials the normal standards of anatomical sfficiently" This
approach is still in the e4perimental stage"
)) Lo( p/ sart aterials
The second approach is to optimi3e the efficacy of floride
materials" This material is based on the fact that floride shold be released
at a low p@ i"e" when caries attac: may be most threatening" @ence! these
materials are developed to release floride at a low oral p@" @ence termed
as smart materials" @ence in these florides is not released all the time the
episodic release prolongs the seflness of the material"
'ioactive -ass
The idea of bioactive glasses were developed by @ench and $o-
wor:ers in 19&=" 2tdies show that on dissoltion of the glass by acid there
is stimlation to formation of a layer rich in calcim and phosphate! arond
the glass that can bond with intimate bioactive bonds with the bone cells
and hence the material gets flly integrated into the bone" These bioactive
glasses grow calcim phophate rich layers in the presence of calcim and
phosphate satrated saliva"
This is an e4cellent material for se in ma4illofacial craniofacial
srgeries as it performs better than hydro4yapatite"
Uses:
1. 0gmentation of alveolar ridges in edentlos patients"
*. $ementation of cstom made present implants into place"
-*
%onc-usion$
- 1ring the relatively short time in which GI have been
clinically 5 available they have ndergone maLor
improvements"
- $onse;ently! their poplarity and range of ses have been
e4tended considerably"
- Jndobtedly this class of restorative materials will be
important part of dental restorations for a long time to come"
LASS IONOMER %EMENT
%ONTENTS
1" I,T#O1J$TIO,
*" @I2TO#O
- Invention
- 7arly 1evelopment
=" 179I,ITIO,
- $lassification
-" $O%?O2ITIO,
+" $@0#0$T7#I2TI$2 O9 GI$
6" $@7%I2T#O O9 27TTI,G
&" ?#O?7#TI72
/" I,1I$0TIO,2
9" $O,T#0I,1I$0TIO,2
-=
1'" 01B0,T0G72
11" 1I201B0,T0G72
1*" %0,I?J<0TIO,
1=" #7$7,T 01B0,$72
1-" 2J%%0#O P $O,$<J2IO,
--