RECENT ADVANCES IN:

GLASS IONOMER CEMENT

The early conventional glass-ionomer materials were technique- _ •
sensitive, slow setting, opaque when set and sensitive to both
desiccation and hydration during setting. This led to premature
surface deterioration. Most of these problems have (more or less)
been solved in newer generations of glass-ionomer cement. Setting
has been accelerated and hydration problems have been reduced.
However, unlike composites, their use in stressed situations is still
questionable. The most common indication of the newer, heavily
filled, reduced particle size glass-ionomer cements is in non-stress
bearing build-ups, root caries, tunnel restorations and long term
.provisional restorations in primary and adult dentitions
The cement is formed as a result of poly-acidic attack of the outer •
shell of fluoride containing soluble aluminum-glasses. Dissimilar to
resin- based composites that have no chemical reactivity after setting,
glass ionomer cements remain reactive for a prolonged time. Also
quite the opposite to resin-based composites, bond formation of glass
ionomer cements to mineralized tissue is no problem. Although the
bond strength reaches only 25% of that can be obtained with
resinbased bonding systems, the bond is reliable and far more
degeneration resistant than the resin systems, where the hybrid layer
can break up with time 6 . Glass-ionomer cements do not require
extra provisions for consistent retention or adhesion, as they adhere
directly to, even humid, dental hard tissues
As filling material, glass-ionomer cement mimics tooth colour not as •
good as composites do and show faster surface loss by wear, but
since it is less technique demanding it may serve in many ways more
successfully than resin-based composites. Dependant on tradition, in
some countries (e.g. Australia, UK) full glass-ionomer Class III
restorations are generally accepted, while the material is merely used
as only dentine replacement in sandwich restorations. For the time
being resin-based composites possesses superior surface
.characteristics
The resin-modification of glass-ionomer cements, introduced to obtain •
command set glassionomer cements, did not contribute to higher wear
resistance 9 . Resin modified glass-ionomer cements are materials in
which a hydrophilic polymerizing resin is added to the glass-ionomer
matrix. The admixed resin improves initial aesthetics and tensile strength
and fracture toughness. Also desiccation and hydration problems are
reduced. Resin-modified glass-ionomer cements set partly through an
acidbase reaction and a polymerization of the resin component of the
matrix. The resin component can be lightcured. Another portion of the
setting process involves the typical acidbase process between the filler
and the poly-acid matrix. The latter reaction does not progress as
complete as is the case with traditional glass-ionomers. The hydrophilic
.character of the resin component also contributes to osmotic swelling
Another step in merging the characteristics of resin-based composites •
with those of traditional glass-ionomer cements was the introduction of
the poly-acrylic acid modified composite resins, also called compomers.
Compomers were intended as to optimally combine the properties of
glass-ionomers and resin-based composites. If regarded as a more or less
temporary restorative, compomers can replace resin-based composite in
anterior proximal restorations and have become in many countries the
material of first choice in paediatric dentistry. In almost all other
applications, traditional composites and glass-ionomer cements are
preferred because of greater strength and wear resistance and better
dimensional stability. As a matter of fact, a disadvantage of compomers is
that ease of handling was obtained at the cost the established specific
properties of hybrid resin-based composites and a proper glass-ionomer
.reaction
Within the framework of mixing resins with inorganic materials, it •
has to be realized that conventional glass-ionomer is a pure inorganic
material and thus is predisposed to acid erosion. Figure 2 shows how
decreasing pH affects wear significantly. This acid susceptibility is
less present for the resin-modified glass-ionomers. Note that wear as
such for the resinmodified types is considerably faster than for
conventional ones. Figure 3 shows how conventional glassionomers
.seriously can erode when used interdentally in risk patients
Also excessive consumption of soft drinks might put conventional •
glassionomer restorations at risk
For direct restorative
dentistry, the slow setting
of conventional
glassionomer cements is
felt as an inconvenience.
Apart from the nuisance of
waiting for finishing the
restoration, a drawback of
the slow setting is that the
water content of the freshly
placed cement can easily
be altered either by
dehydration or water
.uptake from the saliva
The loosely bound water may have a
negative effect on initial solidity of
glass-ionomer, but is at the same
time responsible for positive
characteristics such as curing
shrinkage relieve and continuing
chemistry throughout the bulk
material, which reinforces the
material and facilitates fluoride
release. A, yet not fully customary
technique, by which the cements’
hardening is substantially
accelerated with ultrasonic or heat
treatment may solve many problems
related to the slow setting of
glassionomers 10 . Figure 4 shows
that accelerated hardening prevents
the glass-ionomer for dye
penetration. Mechanical properties
are also significantly enhanced by
.heat or ultra-sound treatment
: ADVANCED GIC TYPES
Condensable / Self Hardening GIC – _1 •
These are basically, purely chemically activated RMGIC with no
light activation at all.Developed mainly for luting purposes, they
contain monomers and chemical initiatiors such a the benzoyl
peroxide and tamines to allow self polymerization.It is used mainly
in paediatric dentistry for cementation of stainless steel crowns,space
maintainers, bands and brackets Advantages over conventional
GIC‟sare Packable + Condensable, Easy placement , Non sticky,
Rapid finishing can be carried out, Improved wear resistance and
Solubility in oral fluids is very low
The Bioactive Glass _2 •
This idea was developed by Hench and co in 1973. It takes into
account the fact that on acid dissolution of glass, there is formation
of a layer rich in Ca and PO4 around the glass, such a glass can form
intimate bioactive bonds with bone cells and get fully integrated with
the bone. It is being used experimentally asBone cement, Retrograde
filling material, For perforation repair, Augmentation of alveolar
ridges in edentulous ridges , implant cementation, Infra- bony pocket
correction
Fiber Reinforced GIC _3 •
Incorporation of alumina fibres into the glass powder to improve upon its
flexural strength.This technology called the Polymeric Rigid Inorganic Matrix
Material It involves incorporation of a continuous network / scaffold of alumina
and SiO2 ceramic fibres It has increased depth of cure, reduced polymerization
shrinkage improved wear resistance and increase in flexural strength.
4_Giomer
Giomer utilizes the hybridization of GIC and composite by using a unique
technology called the prereacted glass
ionomertechnology.Thefluoroaluminosilicate glass is reacted with polyalkenoic
acid to yield a stable phase of GIC this pre reacted glass is then mixed with the
resin.Depending on the amount of glass which is reacted, the PRG technology
can be 2 types: F- PRG = reaction of Full / entire glass S- PRG = Surface of
glass Eg: Beautiful, Reactmer
Amalgomers_5 •
These are restoratives which are glass ionomer based but with the strength of
amalgam. They also provide Frelease, natural adhesion to tooth structure, good
compatibility and prevent shrinkage, creep, corrosion or thermal conductivity
problems associated with other filling materials.They have been found to have
exceptional wear characteristics, along with other advantages of GIC
6_Hainomers
These are newer bioactive materials developed by incorporating hydroxyapatite
within glass ionomerpowder.These are mainly being used as bone cements in
oral maxillofacial surgery and may a future role as retrograde filling material.
They have a role in bonding directly to bone and affect its growth and
development
7_Chlorhexidine impregnated GIC
It is developed to increase the anticariogenic action of GIC.Still under
experimental stage. Experiments conducted on cariogenic organisms
Proline Containing Glass Ionomer Cement _8 •
It is an amino acid-containing GIC had better surface hardness
properties than commercial Fuji IX GIC. This formulation of fast-set
glass ionomer showed increased water sorption without adversely
affecting the amount of fluoride release.Considering its biocompatibility,
this material shows promise not only as a dental restorative material but
also as a bone cement with low cytotoxicity 9_CPP – ACP Containing
GIC
Here casein phosphopeptide-amorphous calcium phosphate incorporated
into a glass-ionomer cement. Incorporation of 1.56% w/w CPP-ACP into
the GIC significantly increased microtensile bond strength (33%) and
compressive strength (23%) and significantly enhanced the release of
.calcium, phosphate, and fluoride ions at neutral and acidic pH
Zirconia Containing GIC _10 •
Zirconia containing GIC – A potential substitute for miracle
mix.Thediametral tensile strength of zirconia containing GIC significantly
Greater than that of Miracle mix due to better interfacial bonding Between
the particles and matrix.
11_NANO Bioceramic Modified GIC
Nano hydroxyapaptite / fluorapatite particles added to FUJI II GC, The
glass ionomer cements containing nanobioceramics are promising
restorative dental materials with both improved mechanical properties and
improved bond strength to dentin.Nanohydroxyapatite/fluoroapatite added
cements exhibited higher compressive strength (177–179 MPa), higher
diametral tensile strength (19–20 MPa) andhigher biaxial flexural strength
(26–28 MPa) as compared with the control group (160 MPa in CS, 14 MPa
.in DTS and 18 MPa in biaxial flexural strength)
Calcium Aluminate GIC _12 •
A hybrid product with a composition between that of calcium
aluminate and GIC, designed for luting fixed prosthesis.The calcium
aluminate component is made by sintering a mixture of high-purity
Al2O3 and CaO (approximately 1 : 1 molar ratio) to create
monocalciumaluminate.The main ingredients in the powder of this
hybrid cementare calcium aluminate, polyacrylic acid, tartaric
acid,strontium-fluoro-alumino-glass, and strontium fluoride. The
liquid component contains 99.6% water and 0.4% additivesfor
controlling setting.The calcium aluminate contributesto a basic pH
during curing, reduction in microleakage,excellent biocompatibility,
.and long-term stability andstrength
Thank you
 Presentation made by :
Rana Sayed Farghaly
Bassma Hassan Abdelaleem