GLASS IONOMER CEMENTS

 Glass-ionomer cement was developed by Wilson and Kent in England in the year

1972.

 This material has been in general clinical use in dentistry in Europe since 1975
and was introduced in the U.S. as ASPA (Alumino Silicate Poly Acrylate) in 1977.

 The glass-ionomer cement has been evolved as a hybrid from the Silicate cement

and the polycarboxylate cement.

 The term glass-ionomer cement was coined by Wilson and Kent though the ISO
terminology for the cement was Polyalkenoate Cement

CLASSIFICATION OF GLASS IONOMER CEMENTS-

Traditional classification (based on application):
• Type I—Luting cements
• Type II—Restorative cements
– Type II.1—Restorative esthetic
– Type II.2—Restorative reinforced
• Type III—Liner or Base

Classification of GICs according to their use:

• Type I—For luting cements
• Type II—For restorations
• Type III—Liners and bases
• Type IV—Fissure sealants
• Type V—Orthodontic cements
• Type VI—Core build up.

COMPOSITION
Conventional GIC Powder
Powder Liquid

• Silica 41.9 percent • Polyacrylic acid (Itaconic acid, maleic

acid) 40–55 percent
• Alumina 28.6 percent
• Tartaric acid 6–15 percent
• Calcium fluoride 15.7 percent
• Water 30 percent
• Aluminum fluride 1.6%

• Sodium fluoride 9.3 percent

• Aluminum phosphate 3.8 percent

Setting Reaction of Autocure Glass Ionomer Cement

Three stages of GIC setting reaction:
1. Ion-leaching phase
2. Hydrogel phase
3. Polysalt gel phase.

Two clinically important results of setting reaction are:

1. Physical properties of glass ionomer cements take long time to fully develop
because of cement’s long-setting reaction.
2. Cement is sensitive to desiccation and moisture contamination.
INDICATIONS -
• Restoration of permanent teeth
– Class V, Class III, small class I tooth preparations
– Abrasion/Erosion
– Root caries.
• Restoration of deciduous teeth
– Class I to Class VI tooth preparations
– Rampant and nursing bottle caries
• Luting or cementing
– Metal restorations (Inlay, onlay, crowns)
– Nonmetal restorations (composite inlays and onlays)
– Veneers
– Pins and posts
– Orthodontic bondsand brackets.
• Preventive restorations – Tunnel preparation – Pit and fissure sealants
• Protective liner and base: Under composite, amalgam and cast restorations
because of its adhesive nature and biocompatibility.
• Repair material: To repair marginal gaps in inlays, onlays and crowns.
• Core build up: As core build up before full coverage restorations.
• Splinting of teeth
• As interim restoration: For long-term temporary restoration of teeth with
questionable pulpal status.
• Endodontics
– For restoration of access cavity
– As root canal sealer
– Repair of external root resorption
– Repair of perforation.
• Other restorative technique
– Sandwich technique
– Atraumatic restorative treatment
– Bonded restorations.

CONTRAINDICATIONS
• In stress-bearing areas like class I, class II and class IV preparations
• In cuspal replacement cases
• In patients with xerostomia
• In mouth breathers because restoration may become opaque, brittle and
fracture over time
• In areas requiring esthetics like veneering of anterior teeth.

GIC - Advantages
• Adhesion: Inherent adhesion to tooth structure because of chemical bonding to
enamel and dentin through ion exchange
• Biocompatible: GIC is biocompatible because large sized polyacrylic acid
molecules prevent the acid from producing pulpal response.
• Anticariogenic: GIC is anticariogenic because of fluoride release.
• Conservative tooth preparation: Because of its adhesive nature, GIC requires
minimal tooth preparation.
• Esthetic: Good color matching and translucency makes it esthetic.
• Less technique sensitive: are less technique sensitive than composite
• Little shrinkage and good marginal seal.
• Low solubility: show less solubility than other cements.

Disadvantages
• Brittle and low fracture resistance: Glass ionomers are brittle and have low
fracture resistance when compared to composite restorations. They have low
modulus of elasticity.
• Low wear resistance: Glass ionomers show low wear resistance when compared
to composite restorations.
• Water sensitivity during setting phase: Glass ionomer is sensitive to moisture
contamination and desiccation soon after placement, which can affect physical
properties and esthetics. Therefore, it requires moisture control during
manipulation and placement.
• Opaque in nature: Opacity of glass ionomer cement makes it less esthetic than
composites.
• Radiolucent: Conventional glass ionomer is not inherently radiopaque.

Steps for Placement of GIC

• Isolation
• Tooth preparation
• Mixing of GIC
• Restoration
• Finishing and polishing
• Surface protection.

Isolation

If moisture contaminates the cement during manipulation and setting, the gel will
weaken and wash out prematurely. Commonly used methods for isolation are
rubber dam, retraction cords, cotton rolls and saliva ejectors.

Tooth Preparation
Tooth preparation for glass ionomer cement is done in two ways:
1. Mechanical preparation
2. Chemical preparation (conditioning).

Class I Tooth Preparation

• Small pit and fissure lesions, which do not have high occlusal stresses.
Indications
• Deep pits and fissures
• Recently erupted teeth in patients with high caries index