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GLASS IONOMER CEMENT

UNDER THE GUIDANCE OF DR . Shalan kaul DR. Tallia DR. Harsheen DR. Divya

GLASS IONOMER CEMENT

INTRODUCTION
Glass Ionomer is the generic name of a group of materials based on the reaction of silicate glass powder and polyacrylic acid . This material acquires its name from its formulation of a glass powder and an ionomer that contains carboxylic acids . Originally , the cement was intended for the aesthetic restoration of anterior teeth

and it was recommended for use in restoring teeth with class III and class V cavity preparations . Because of its adhesive bond to tooth structure and its caries prevention potential , the types of glass ionomers have expanded to include their use as luting agents , orthodontic bracket adhesives , pit and fissure sealants , liners and bases , core

buildups , and intermediate restorations. Type of application depends upon the consistency of the cement which ranges from low viscosity to very high viscosity.

DEVELOPMENT
First developed by A.D Wilson and

B.E Kent in 1969.

ALTERNATIVE NAMES
ASPA Cement
Glass Polyalkeonates Glass ionomer cement

CLASSIFICATION
I According to Philips - Type I Luting - Type II-Restorative - Type III-Liner and Base II According to Davidson and Major Conventional /traditional

a) Glass ionomer for direct restorations b) Metal reinforced GIC c) High viscosity GIC d) Low viscosity GIC e) Base/Liner f)

Luting According to Gj mount

1. Glass ionomer cements a) I Glass polyalkeonates

II Glass polyphosphonates b) Resin modified GIC c) Polyacid modified composite resin 2) a) Auto cure b) Dual cure c) Tri cure

a) Type I- Luting b) TypeII-(I)-Restorative

(II)-Restorative esthetic (III)-Restorative reinforced (MMGIC) c) Type III-Lining or base IV According to Sturdvent : 1. Traditional or conventional 2. Metal modified GIC

a) Ceremets

b) Miracle mix
3) Light cured GIC 4) Hybrid(resin modified GIC ) 5) Polyacid modified resin composites

or compomer V According to Wilson and Mc Lean

1) Type I-Luting 2) Type II- a) esthetic filling material

b ) Bis- reinforced filling material C ) Type III Lining base and fissure sealant VI-According to intended applications 1)Type I Luting 2)Type II-Restorative

3) Type

III- Fast setting lining 4) Type IV-Fissure sealants 5) Type V- Orthodontic cements 6) Type VI-Core build up material 7) Type VII-High fluoride releasing command set GIC 8) Type VIII-GIC for Atraumatic Restorative Treatment ( ART ) 9) Type IX-Geriatric and Pediatric GIC

VII According to Mc Lean , Nicholson and Wilson(1994) 1) Glass ionomer cement a) Glass polyalkeonates b) Glass polyphosphonates 2) Resin modified GIC 3) Polyacid modified GIC

VIII Based on chemical constituents of

cement 1 ) Consentional 2 ) Metal reinforced a ) Miracle mix b ) Ceremets 3) Resin modified

Composition
Liquid
Polyacid (Acrylic, Maleic, Itaconic Water Comonomer-D-Tartaric- accelerates

set,increases working time, traslucency strength Recently added-poly vinlyphosphoric acid

Powder
It is basically an acid soluble calcium aluminosilicate glass containing flouride. It consist of Alumina(AI2)-I6.6% Skeletal structure Increase opacity

Silica (SiO2)-29%

Increase Transluency Fluoride Decrease fusion Anticariogenecity Increase working time Increase strength

Calcium flouride (CaF2) 34.2%

Increase opacity Acts as flux Aluminium phosphates(AIPO4) 9.9% Decrease melting temperature Increase transluency

Cryolite (Na3 AIF6) -5%

Increase opacity Acts as flux Other ions NA+ , K+ , Ca+,Sr+3

Chemistry of setting
When the powder and liquid are mixed to form a paste , the acid etches the surface of the glass partices and calcium , aluminium , sodium and fluorine ions are leached into the aqueous medium . The polyacid chains are crossed linked by the calcium ions that are replaced by aluminium ions with in the next 24 hours

Sodium and flourine ions do not

participate in the cross- linking of a cement . Some of the sodium ions may replace the hydrogen ions of carboxylic groups , whereas the remaining ions are dispersed uniformly within the set cement along with flourine ions .The cross linked phase becomes hydrated over time with the same water used for mixing . This process is called Maturation.

The unreacted portion of glass particle are sheathed by a silica gel that develop during removal of cations from the surface of the particles . Thus the set cement consists of an agglomeration of unreacted powder particles surrounded by a silica gel in a amorphous matrix of hydrated calcium and aluminium polysalts .

Water plays a critical role in the setting of GIC. It serves as reaction medium initially and then slowly hydrates the cross linked matrix , thereby yielding a stable gel structure that is stronger and less susceptible to moisture .

Indications
Non-stress bearing areas
Class III and V restorations in adults Class I and II restoration in primary

dentition Temporary or caries control restorations Crown margin repairs

Cement base under amalgam , resin ,

ceramics , direct and indirect gold Core buildups when atleast 3 walls of tooth are remaining ( after crown preparation)

Contraindications
High stress applications
Class IV and class II restorations Cups replacement Core build ups with less than 3 sound

wall remaining

ADVANTAGES
Chemical adhesion to tooth structure . Excellent biocompatibility with pulp . Coefficient to thermal expansion similar to

tooth structure Porcelain like translucency . Anticariogenic property due to release of flouride ions from restoration . Favourable bioactive properties .

Disadvantages
Low wear resistance . Low fracture resistance and Low tensile

strength Moisture sensitivity , susceptibility to moisture uptake . Initial slow setting .

PROPERTIES
BIOLOGICAL PROPERTIES
Biocompatibility with pulp -The effect of GIC on soft and calcified tissues is found to be mild . CAUSES FOR MILDNESS Polyacrylic acid is a weak acid initially and it becomes even weaker with time
1.

Larger size of polyacrylic acid molecules may limit its diffusion through dentinal tubules. 2. Anticariogenic property Flourides contributes to the caries inhibition in the oral environment by two mechanisms.

Physiochemical mechanism

GIC releases flouride ions . These ions incorporate in to the hydroxyapetite crystal of adjacent tooth structure to form fluoroapetite which is more resistant to acid mediated decalcification.

Biological mechanism -

Flouride ions inhibit or alter the carbohydrate metabolism of acidogenic bacteria which are responsible for caries formation . 3. Bioactive property 4. Direct bonding to tooth structureSince it directy binds to tooth enamel and dentin , it minimises marginal leakage

b/w tooth and restoration , reduces risk of secondary caries and pulpal injuries, improves retention to the restorative materials instrumentation is minimised . Hence more tooth material can be conserved .

MECHANICAL PROPERTIES
COMPRESSIVE STRENGTH TYPE I - 90-140 TYPE II - 140-150 TYPE III - 70-100 2. TENSILE STRENGTH TYPE I - 6-7 TYPE II 6.6 TYPE III - 6- 9
1.

MODULUS OF ELASTICITY

TYPE I 7-8 TYPE II 8-9 TYPE III 7-8 THERMAL PROPERTY Similar to dentin AESTHETICS Good aesthetic , used as anterior restorative material.

MANIPULATION
POWDER LIQUID RATIO

Type I 1.25 -1.5 gm/ml Type II- 3 gm/ ml Type III- 1.5 gm / ml PROPORTIONING Take required amount of powder on one side of the glass slab , and divide the

Powder into one bulk and two small increments .place 2 -3 drops of liquid for luting , or one drop for restoration, on the same side , near the bulk . MIXING Each portion of the powder is mixed in to the liquid with a plastic spatula followed by smaller increments. Mixing is done in folding and tapping motion.

The total mixing time is 30- 45 seconds.The Luting cement is a fluid similar to ZnPO4 Cement mix . The restorative mix should have a putty like consistency and a glossy surface. The glossy surface indicates the p/o unreacted polyacrylic acid which can bond with the tooth surface.

DISPENSING OF GIC

MIXING OF GIC

INSERTION OF GIC

MODIFICATIONS
METAL MODIFIED GIC Two types of

metal modified cements. 1) SILVER ALLOY ADMIX 2) CERMET [ glass sintered with silver ]
SILVER ALLOY ADMIX

The addition of metal powders to glass ionomer cements can improve strength;

Sced and Wilson found that metal fibres were best for increasing flexural strength. Simmons suggested mixing amalgam alloy powders into the cements and developed this system clinically under the name Miracle mix. He used this alloy / glass ionomer mix for core building and for the treatment of mouths with high caries incidence. However , their esthetics are poor and they do not take burnish.

MIRACLE MIX

MIRACLE MIX

CERMET
Solution to the problem of improving resistance to abrasion was the development of cermet ionomer cements by McLean and Gasser.By sintering the metal and glass powders together strong bonding of the metal to the glass was achieved. Ion leachable calcium aluminiumflourosilicate glasses powder and a number of metal powders were tried including alloys of silver and tin ionomer cements have greatly

improved resistance to abrasion when compared with glass ionomer cements and their flexural strength is also higher . However their strength is still insufficient to replace amalgam alloys and their use should be confined to low stress bearing cavity preparations.

RESIN MODIFIED GLASS IONOMER


Despite all the improvements , the two problems of conventional glass ionomer still remained : Moisture sensitivity and lack of command cure. To overcome these problems , attempts have been made to combine glass Ionomer chemistry with the well known chemistry of composite resins.

So , resin modification of glass ionomer cement was designed to produce favorable physical properties similar to those of resin composites while maintaining the basic features of the conventional glass ionomer cement.these products are considered to be Dual cure cements if only one polymerization mechanism is used ;

If both mechanisms are used , they are considered to be tri cure cements. These new materials are called as resin modified glass ionomer cements or hybrid ionomers. In their simplest form, these are GICs with the addition of a small quantity of a resin such as hydroxyethyl methacrylate ( HEMA) or Bis GMA in the liquid.

More complex materials have been developed by modifications of the polyacid with side chains that can be polymerized by a light curing mechanism . They remain GIC s by their ability to set without light activation ,although this reaction takes place more slowly than for the traditional cements . The first

Commercial RM GICs available were Liners , Vitrebond being the first introduced.

Composition
LIQUID

Polyacrylic acid copolymer 2) Tartaric acid


1)

3 ) Methacrylate groups

(HEMA)

4) Photoinitiator POWDER 1) Same powder as chemical cure glass ionomer 2) Photosensitizer

Resin modified glass ionomer cement

Ist resin modified glass ionomer cement .

High quality resin modified glass ionomer cement .

COMPARISON TO CONVENTIONAL

GLASS IONOMER generally improved physical properties Improved shades and transtucency Can be dual or tri-cure Water sensitivity reduced

ADVANTAGES

Greater working time


Good adaptation and adhesion Acceptable flouride release DISADVANTAGES setting shrinkage Limited depth of cure

High Strength, Packableor High Viscosity Glass Ionomers :


These glass ionomers are particularly useful for atraumatic restorative treatment technique . They were designed as an alternative to amalgam for posterior preventive restorations. EXAMPLE- Fuji IX and Ketac Molar. These cements set only by conventional neutralization reaction but have

Properties that exceed those of the resin modified systems. Setting is rapid , early moisture sensitivity is considerably reduced and solubility in oral fluids is very low.

Fuji IX ( HIGH VISCOSITY GIC )

PRESENTED BY SUKRITI SHARMA ROLL NO 90

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