GLASS IONOMER CEMENTS

Traditional form powder / liquid
Proportioned capsules Water settable cement Polycarboxylic acid freeze dried and in such a case the liquid may be distilled water or a diluted solution of tartaric acid Composition: Calcium fluoroaluminosilicate glass Glass are three components Silica(Sio2) , Alumina( mix in flux of sodium and calcium fluorides. The particle size of the powder depends upon the purpose for which is used.

Barium glass may be added to give radiopacity

Composition Liquid: Aqueous solution of polyacrylic acid,itaconic acid Copolymer with tartaric acid not more than 5%

Applications
1. 2. 3. 4. 5. 6. 7. Cement Liner / Base Core Retrograde Filling Material P/F Sealant Root Caries Cervical Restoration Temporary, or ART Restoration

8. They are recommended for high caries risk patients

9. Cervical class V restorations in adults

Benefits of Glass Ionomer
1.Direct Bond to tooth no bonding agent required 2.Bonds to moist tooth 3.Fluoride protection 4.Excellent marginal seal - no shrinkage 5.Thermal expansion = tooth 6.Biocompatible - ideal match for dentin

Setting Reactions
The following stages on mixing 1. Dissolution 2. Migration 3. Reaction and precipitation (Hardening) Dissolution of the surface glass by the acid H+ attack glass to

release cation (Ca++,AL+++) and fluoride ions between 20% to 30% of the glass is decomposed by acid attack. Migration of the surface ions (Ca++,AL+++) and fluoride ions complex into the liquid. The divalent Ca++ will migrate first and react with carboxylic group to form cross linked carboxylic acid gel leading to initial set ,followed by trivalent AL+++ the latter reaction takes longer time 24 H and results in stronger cements so the reaction protected from saliva with varnish. The sodium ions form silica gel on the surface of the particles.

Properties
Bond strength to dentin of 2 to 3 Mpa lower than composite. When the dentin etched, the glass-ionomer may use 4 years clinical data showed a retention rate for glass-ionomer. 1-Cervical restoration 75% pulp reaction was mild. 2-If the thickness of dentin is less than 1mm use calcium hydroxide Liner. The fluoride in glass-ionomer released over a period of two years.

Role of water in the setting reactions
1. It is serves as a reaction medium 2. It is loosely bond to the structure, 3. It is slowly hydrates the cross-link matrix and become tightly bond. 4. It is increase strength by producing stable gel structure if glass ionomer cement is subjected to dryness during the initial set. 5. The reaction will not complete and the surface crack.

Manipulation
G.I. packed in bottles and in capsules, mixing time 30 to 40 sec. is used with a typical setting time of 4 minutes. Placing the restorative and carving the correct contour should protect the surface from saliva by applications of varnish. Trimming and finishing had done after 24 H.

Modification of glass ionomers
It have been made in order to improve the mechanical properties, abrasion resistance and optical properties. 1. Metal modified glass-ionomers A. Miracile mixture. B. Cermet glass-ionomers. 2. Light cured (Hybrid glass-ionomers ) 3, Compomer. 4. Giomer (Hybrid glass- ionomers and composite) 5. Nano-ionomer

summary. Cements are popular applications for GI – to attach crowns and bridges to tooth structure. Cores or foundations for fixed prosthetics: are popular but not as durable as composite or amalgam. Tunnel restorations are MO or DO restorations formed under marginal ridges without breaking them. Sandwich restorations are composites bonded over GI with the GI exposed as surfaces in some cases for fluoride release. Retrograde filling materials are root canal fillings of teeth that are removed, filled, and replanted. Sealant applications have not fared well because GI tend to be brittle. Cervical restorations are hard to restore because of moisture control challenges – so traditional glass ionomers are often preferred because of the ability to work in wet fields. Temporary restorations in permanent teeth or ART restorations in primary teeth are extremely popular.

Three classifications of GIs a) Glass Ionomer Cements or traditional glass ionomer restorative products. Consist of an acid-decomposable glass and an acidic polymer that undergo an acid/base reaction when mixed. The reaction does not require light to occur - the mixed material sets in the dark. Examples of these products are Ketac-Fil (ESPE) and Fuji II (GC America).

b) Resin-Modified Glass-Ionomer Cements This group can be divided into 2 subgroups : Light Cured Resin Modified Glass Ionomer Base/Liners & Light Cured Resin Modified Glass Ionomer Restoratives. Resin has been added in one form or another. In addition to the GI acid/base reaction, they also undergo a resin polymerization reaction that is usually initiated by light exposure (these products require light exposure to harden.) Examples are Fuji II LC (GC America), Vitremer (3M), and Photac-Fil (ESPE).
c) Polyacid Modified Composite Resins These are more resin than glass ionomer. They contain one or both of the basic glass-ionomer components These products usually do not set without light exposure or set very slowly. Examples are VariGlass VLC (Caulk), Dyract (Caulk), and Geristore (Den-Mat).

Hytac and F2000 are compomers.
Dyract Flow is a flowable version of a resin-modified glass ionomer. Fuji I LC is a light-cured RMGI that has substantial quantities of glass ionomer Vitremer is a common RMGI that is extremely popular as a lining cement over calcium hydroxide for deep amalgam or composite restorations.

(RESINS MODIFIED GLASS IONOMER) COMPOMERS

Applications 1-Used for low stress bearing 2- High caries risk patients (civically eroded teeth)

Compositions
Supplied as one past system more related to glassionomer than composite, the liquid contains

monomers, polyacid and water reaction Advantages: 1.Better optical. 2.Less sensitivity to moisture after setting. 3. Superior mechanical properties. 4. They are used as anterior restorative.

Light cured (Hybrid Ionomer

They are used as lining materials under composite resin used as anterior restoration specially as class V cavities Set by acid base reaction and both light –cured and selfcured

Properties
Not need bonding agent the tooth has conditioned (etched) with polyacrylic acid or a primer before placement of the hybrid ionomer. More fluoride release than compomers and composite but less than glass ionomer recharge when exposed to fluoride treatment or fluoride dentifrices.

Manipulation
Packaged as powder/liquid or encapsulated forms Hybrid Ionomer set has immediately when light cured and can be finished immediately. Not need bonding agent.

RESIN CEMENTS There are two major groups of resin cements A-Unfilled acrylic resin cement B-Composite cements

Clinical applications
1.

2.

3.

Cements are recently used substituted the conventional resin They are also used for cementation of veneers, cast ceramic crowns , inlays, bridges composite inlays and orthodontic brackets .

Classification of resin cements

These are based on methyl methacrylate + compomers The accelerator initiator system is typically amine and peroxide Setting occurs As a result of free radical, polymerization characterized by heat liberation and shrinkage of polymer Supplied as powder + liquid Used for cementation of orthodontic brackets

II- Adhesive resin

2-Composite resin cements Replaced the unfilled resin due to their superior properties Classification according to bonding mechanism to tooth structure •Conventional cure. resin cement These types gain their retention to tooth structure through acid etching in conjunction with enamel and dentin bonding.

These divided into 3 types

1-Self – cured Powder + liquid or two paste systems. Composition Diacrylates oligomers Diluted with dimethaerylate monomer ( low molecular weight) Silanated silica or Glass filler. initiator – accelerator system Peroxide amine

2- Light – cured (micro filled )

Small particle (hybrid composites)

Composition:The other major past (Bis- GMA) or( urethane dimethaerylate) diluted with dimethacrylate monomer or TEGDMA Or Silica or glass fillers 20-75 (or) both

They are photo initiated in the presence of camphorquinine (amin system ) they are provided as a paste which requires no mixing .

3. Dual cured
Similar to the light – cure Polymerize by the mechanisms of light or Chemical supplied as base + catalyst paste must be mixed before use after mixing , self cure chemical reaction takes place slowly and provided extended working time until the cement is exposed to light at which the cement solidifies rapidly.

Adhesive Resin Cements Phosphonate Cements
These are self-cured powder / liquid systems. Composition: ( Methacryloxyethyl phenyl phosphate ) MAOEPH.PH (or) 4- Methacryloxyethyl trimellitican hybride ( 4 –META ) These cements are called ( phosphonate cements ) Recently formulated as a two paste system contains Composition: 1- Bis – GMA resin. 2- It is silanated quartz fillers.

The phosphate end of the phosphonate react with calcium of the tooth or with metal oxide. the phosphonate is very sensitive to oxygen so a gel has provided to coat the margins of a restoration until the setting has occurred.

Properties
The effect on the pulp: Irritating to the pulp so pulp protection via calcium hydroxide is very important or glass ionomer liner .If the bonding are a involves only enamel or if the remaining dentin thickness is sufficient, The irritation not significant . Film thickness: It is varies according to uses. Solubility: It is insoluble in the oral fluids.

4- Bonding 1- To enamel by acid etching. 2- To dentin by dentin bonding agents 3- To restoration previously treated with surface or chemical preparations. 5) Strength It has high compressive strength 180-260 MPA fracture toughness high. 6) Optical They are translucent radiopaque types are available to be used in the posterior teeth.

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