GLASS IONOMERS

The many faces of glass ionomers

•GI -- what are they ?

•GI categories ?

•GI setting reactions ?

•GI release of F and recharging ?

•GI applications ?
DEVELOPMENT
Timeline for “direct restorative materials” usage

First GIC in 1972

Dentsply A.S.P.A

A.S. = Alumino luminos silicate glass ilicate

glass

P.A. = Polyacrylic olyacrylica acid in water

 GLASS IONOMER
Today, the two major applications for glass ionomers are as:

• 1. resin-modified glass ionomer cements

for luting fixed appliances and

• 2. as ART restorations..
 Glass ionomer

a versatile material

with peceuliar chemical properties

Used as:

1. a restorative material,
2. liner,
3. bonding agent, and
4. permanent cement.
Indications for Using Glass Ionomers
• Primary teeth.
• Final restorations in non-stress areas.
• Intermediate restorations.
• Core material for a buildups.
• Long-term temporary restorations.
 TERMINOLOGY
Don’t be confused by some of the strange language.

Glass Ionomer:
“glass” refers to the glassy ceramic particles and the glassy matrix

(non-crystalline) of the set material,

while “ionomer” refers to ion-crosslinked polymer.
 TERMINOLOGY
Don’t be confused by some of the strange language.

Polyalkenoic or Polyalkenoate:
refers to polymer chain which incorporates alkenoic monomers
such as:

acrylic acid, tartaric acid, maleic acid, etc.

 TERMINOLOGY
Don’t be confused by some of the strange language.

F-Release GIC:

refers to release of fluoride ions

All glass ionomers are capable of fluoride

ion release
 TERMINOLOGY
Don’t be confused by some of the strange language.

Multiple-Cure:
refers to multiple curing mechanisms possible with resin-modified systems –

the terminology was first introduced in 1992 by 3M for their Vitremer product

because it underwent the:

(1) traditional GI chemical setting reactions,

(2) a self-cured polymerization reaction,

(3) light-cured polymerization reaction.

 GLASS IONOMERS
• Glass ionomers are a “hybrid” formed
from two earlier dental cement products

“Silicate cement powder” and “Polycarboxylate cement liquid”

The hybrid was created to combine

the best properties of the two materials.

However,
such marriages are never really truly
perfect.
 Silicate cement:

silicate glass powder particles

react with phosphoric acid solution.

• A composite structure results that is a

complex matrix of reaction products
surrounding mostly unreacted silicate
glass filler particles.
 Polycarboxylate cement
• Zinc oxide powder is mixed
• with polyacrlic acid
 GLASS IONOMERS
HYBRID = SC [Powder] and PCC [Liquid] = A.S.P.A.

Silicate Cement

C
a
+
2 G
l
a
ss
pa
r
t
i
c
le
S
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,
Na
,
H
O
2, A
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+
3 E
t
c
he
dp
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r
i
ph
e
ry
F
,
Ca
, + H
+
F
-
A
l H
P
O
3,
4
A
l
,
Zn S
i
+
4

C
a
,A
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,N
a
,Z
n
P
h
o
sp
ha
t
es
a
n
d
F
l
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or
i
de
s

R
E
A
C
TA
N
T
S P
RO
DU
CTS
Polycarboxylate Cement

H
O
O
C -
O
O
C
Z
i
n
c
po
l
ya
c
r
y
l
at
e
g
el
C
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--
OO
C Re
s
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d
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a
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Z
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H
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Z
n
O C
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H Z
n
+
+ Z
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P
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- C
OO
-
CO
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CZ
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+ C
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H
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 GLASS IONOMERS
HYBRID = SC [Powder] and PCC [Liquid] = A.S.P.A.

H2O Si+4
PAA
SiO2, in Al+3
SiO2,
Al2O3, H2O Na+
Al2O3,
Na, Ca, Ca+2
Na, Ca,
F F-
F
PAA

Residual Glass Particle

SiO2,
POLYACRYLATE HYDROGEL
Al2O3, (initially Ca polyacrylate gel
Na, Ca, and later Al polyacrylate gel)
F
Si+4, Al+3, Ca+2, Na+, F- Ions
 Ingredients of Glass Ionomer Cements

• Powder: • Liquid:
-Calcium flouro alumino - Copolymer of PAA,
silicate glass. Itaconic, Maleic,
- Tartaric acid (to
improve setting
- Radio-pacifier to allow properties)
detection of 2ry caries
Glass ionomers exist as an aqueous solution
• The set product is a hydrogel.

• It is hydrophilic.

• It requires a certain amount of water to

be stable---- critical amount of water

• Removing the water, destabilizes the

chelation.
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.
 Critical amount of water in GIC
Water in GIC are:
• advantages in wetting and chelating tooth structure

• disadvantage for strength and esthetics.

• the hydrogel can not be made to be as strong as a typical hydrophobic

composite system.

• The water also refracts light making the colors of glass ionomers more
opaque in appearance.

• They never achieve the excellent translucency of composites or

ceramics.

• Water should not exceeds the critical amount of water

GI SETTING REACTIONS
Ca+2 Al+3
H-O-H
F- Si+4

F-Al-SiO2 --O-Si+4(OH)2
¯OOC COO¯ CaF2 H-O-H
COO¯
Ca+
H-O-H
¯OOC COO¯
COO¯

¯OOC

COO¯ H-O-H
Ca++
¯OOC
Ca+ ¯OOC
COO¯
¯OOC
¯OOC
¯OOC COO¯
Al+3
COO¯
H-O-H
TWO STAGES OF SETTING REACTIONS

At first stage:
Calcium ions----divalent crosslinks between
chains.

At 2nd stage:(These are replaced gradually over 1-3 days )

By Aluminium ion---- trivalent crosslinks
between chains

As result:
the siliceous network develops within the
hydrogel.
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.
Fluoride Release from Glass
Ionomers
 High early release, then drops.
 Release continues over a long time
 Dynamic release and uptake mechanisms
 Strong evidence that this inhibits caries
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.
3. Protection of cement during setting :-
• Glass ionomer cement is extremely sensitive to
air & water during setting.
• Immediately after placement into cavity,
preshaped matrix is applied to it.
4. Finishing :-
Excess material should be trimmed from margins.
Hand instruments are preferred to rotary tools to
avoid ditching.
Further finishing is done after 24hrs.
5.Protection of cement after setting :-

• Before dismissing the patient ,restoration is

again coated with the protective agent to protect
trimmed area.
• Failure to protect for first 24hrs results in
weaken cement.
Advantages:-
♣ Inherent adhesion 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.
Features of GIC:

• Bond adhesively to enamel & dentin

• Release fluoride ions over a prolonged

• period of time

• Biocompatible

• Have approximately same coefficient of

thermal expansion as that of tooth structure.
 Glass ionomer cement
(Polyalkenoate)
Presentation forms:
- Traditional form: Powder/ Liquid.
- Pre-proportioned capsules: for mech. Mixing.
- Water settable cement (Anhydrous cement)
Preparation of the tooth surface
 Chemical adhesion requires a clean tooth surface

 10% polyacrylic acid is applied to ‘condition’ the tooth

surface or remove smear layer

 use polyacrylic acid as any remaining acid will not

compromise the setting reaction

 Do not etch prior to application of GI

 etching removes the mineral content from the dentine,
reducing capacity for ion exchange
PROBLEMS WITH CONVENTIONAL
GLASS IONOMERS
Poor Strength Properties
Poor Esthetic Qualities
Low Abrasion Resistance
Moisture Sensitivity
Short Working Time
Modifications of G.I.C
*Aim:-
a- Improves mechanical properties.
b- Improves abrasion (wear) resistance.
c- Improves optical properties.
 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
 Glass ionomers
RECENT ADVANCES

IN

Glass ionomer
History of glass ionmer
 Conventional glass ionomer
 Metal modified glass ionomer
 Resin modified glass ionomer
 Nanofilled glass ionomer
 Hydrophobic POLYMER

GIOMER COMPOMER COMPOSITE

 Light Cure Composite and  LC Composite and
 Pre-reacted GIC powder  F source Universal
CEMENTS CEMENTS
FILLING MATERIALS FILLING MATERIALS FILLING MATERIALS

Resin Modified-GI
 GI and
 LC Hydrophilic
monomer and polymer

CEMENTS

Metal modified-GI GI Resin Reinforced-GI

 GI and  GI and
 Metallic fillers  Resin-Fillers
 Cermet fillers
A.R.T. and
CORES TEMPORARIES
HYDROGEL
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.
1- Metal modified glass ionomer.
- Idea and aim:
incorporate amalgam alloy powder with the glass powder
in order to increase wear resistance and flexural
strength.
- E.g. Miracle mixture.
- Dis advantages:
Did not increase the wear resistance
(Not successful).
 METAL - REINFORCEMENT OF GLASS IONOMARS

Glass Cermets
(Ketac Silver)

Amalgam
Alloy
(Miracle Mix)
3- Light cured glass ionomers
(resin modified G.I or Hybrid ionomers)
* Form:
Powder/Liquid.
* Composition:
A-Powder:
- Radiopaque ion leachable glass
B- Liquid (Kept in a dark bottle):
- Modified polyacid with methacrylate end group.
- HEMA hydrophilic monomer
- Photoinitiator.
* Setting reaction:
- Two mechanisms
a- Dual cure:
*Two reactions
- Conventional acid- base Rx.
- Polymerization Rx of the resin component (free
radical Rx) when light is applied to the cement.
*Problem:
Limited depth of cure
* How to improve?
1- Incremental placement.
2- Triple cure.
b- Triple cure (redox reaction containing
systems)
* Idea:
The resin part was modified to allow self curing
reaction→ Ensure effective polymerization of the
resin part in deep cavity.
* Three reactions
-
* Advantages:
1- Incremental placement is not necessary.
2- The redox reaction ensure full depth of cure.
Resin-Modified Glass Ionomers

Liners were
developed first

Restoratives
came later

Involve two
setting
mechanisms
Resin Modified Glass Ionomer
Cement “RMGI”
 RMGI
 The benefits of light curing glass ionomers are well
recognized, the most obvious being the cure-on-
demand feature. (controled working time)

 Resin modified glass Ionomer incorporating the

benefits of nanotechnology has now been developed
 NANO FILLED GLASS
IONOMERS
KETAC NANO
Bonded-nano fillers in GIC
Paste-paste system
 indications for Nano Light
Curing Glass Ionomer
Restorative
 • Primary teeth restorations
 • Small Class I restorations
 • Class III and V restorations
 • Laminate/Sandwich technique
 • Core build-up where at least 50% of coronal tooth
structure is remaining for support
 Precaution
 Ketac Nano restorative contains reactive Methacrylate
monomers, must be cured in 2mm or less increments
to minimize residual unreached monomers and
because there is no “redox” reaction that allows for
continuing polymerization in the absence of light
activation.
 Generally, coronal tooth structure that is exposed to
high stress factors, i.e. cusps, should not be restored
with any glass ionomer type restorative materials
 PRIMING
Applied to both enamel and dentinal surfaces for 15 seconds.

The primed surface will appear shiny after drying and light curing.

Using Primer is critical for achieving adhesion of Ketac Nano to tooth

structure. Primer use must not be eliminated from the procedure
 CURING
 Ketac™ Nano restorative should be placed in 2mm
increments or less, and light cured after each
increment.
 An LED curing light will cure all shades with a 20
second light exposure.
 Halogen lights are the same with the exception of the
darker A3.5 and A4 shades which require a 30
second exposure.
THANK YOU
 PROGLASS ™ TWO LC
Radiopaque Light Cured Reinforced GI Cement
ProGlass Two LC is specially formulated with smaller particles that
make it ideal for restorative fillings & other secondary indications
such as liner and base.
Features
Type II a : Aesthetic restorative cements
Type II b : Reinforced restorative cements
Type III : Lining cements, Base.
* High Polishability * Excellent chemical adhesion
* Exceptional mechanical properties * Fluoride release
Indications
•Class III & V restorations, particularly restoration of cervical
erosions & root surface caries
•Restoration of deciduous teeth
•Small Class I & III restorations
•Pit & Fissure sealant
•Good results in areas where rubber dam is difficult to use
Packaging
•Box of 50 capsules * Sample box * Powder (15g) / Liquid (6.8ml) Kit
 PROGLASS ™ NINE
Radiopaque Packable Glass Ionomer Cement
The high translucency of ProGlass™ Nine ensures use in anterior restorations
without compromising aesthetics.
Features
Type II a : Aesthetic restorative cements

* Condensable viscosity * High wear resistance

* Early resistance to water uptake permitting one visit treatment
* Excellent chemical bonding, no etching & excellent marginal seal
Indications
• Final restorative for Class I, II, III & V deciduous teeth
•Long-term restorative in non load-bearing areas of Class I & II
•Intermediate restorative and sandwich material for heavy stress bearing Class I and
II cavities
Packaging
•Box of 50 capsules * Sample box * Powder (16g) / Liquid (6.4ml) Kit
 Soon to Come…
Innovative Capsule Design

Premeasured capsules that offer consistent mixes

Capsule Activation
A.R.T. RESTORATIONS
ART = Atraumatic Restorative Technique

Developed as temporary restorations for 3rd world countries.

First tested in African countries.
Now used widely in Asian countries.

Original technique = scoop, finger mix, finger insertion.

Current technique = P/L or precapsulated mixture.

Fuji IX

Now being used as permanent restoration in pedodontics.

A.R.T. RESTORATIONS
ART = Atraumatic Restorative Technique

Developed as temporary restorations for 3rd world countries.

First tested in African countries.
Now used widely in Asian countries.

Original technique = scoop, finger mix, finger insertion.

Current technique = P/L or precapsulated mixture.

Fuji IX

Now being used as permanent restoration in pedodontics.

 SANDWICH TECHNIQUE
Devolped by Mclean,
To combine the beneficial properties of GIC
& composite.
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. Apply a thin layer of low
This will improve viscosity enamel bonding
micromechanical bond to agent & finally place the
composite resin. 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.
♣ Anticariogenic property.
♣ Better strength,finishing,esthetics of overlying
composite resin.