journal of dentistry 34 (2006) 523524

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Guest editorial
This special edition of the Journal of Dentistry is the outcome
of the Second European Conference on Glass Ionomer
Cements {GIC} which was held in May 2004 at Warwick
University. This is the second occasion at which scientists and
clinicians from academia, industry and dental practice have
come together to share their ideas on the development and
clinical applications of these materials.

1.

Basic materials research

The topics covered were wide ranging and addressed the

potential changes which might be made to both the glasses
and the acid forming material. Culbertsons paper on alternative acids and those by Hill, Stamboulis and HurrellGillingham on the glasses provided a springboard for discussion on the important phenomenon of fluoride release and
control and interactions between the tooth tissue and the
restorative and visa versa. An elegant presentation by van
Meerbeek et al. demonstrated the factors which influence the
bonding of these materials to dentine. The biocompatibility of
these materials both in the dental area and more widely in
other medical applications was examined the paper by Hatton
and Hurrell-Gillingham clarifying the reasons for the adverse
effects occurring with the use of GICs, including death in skull
base surgery, These related to improper surgical technique but
highlighted the potential dangers of aluminium. This paper
was complemented by one from the same group on the
replacement of Al by Fe in the glass component of GIC. It
was a pleasant change to hear of a novel glass which did
indeed contain something new; as contrasted with different
proportions of same half dozen elements.

2.

Improvements in GIC properties

In addition to the information on potential improvements,

two manufacturers presented details of the properties
achievable with the latest materials. Peez showed important
early properties of hand-mixed material which had
addressed difficulty in mixing. This area had contributed to
problems found in general clinical use since the introduction
of the first commercial material ASPA in 1975. Woodfine
presented results indicating two materials that passed the
stringent requirements of the ISO amalgam specification and

contrasted this improvement with the reduction in minimum

strength requirement introduced recently into the latest ISO
specification for glass ionomers.
These presentations provided a major link to the reports
which demonstrated the wide range of applications for which
these materials may be used. There was particular interest in
the behaviour of the material and their potential for interacting with the oral environment. These may be divided into
effect of the GIC on the tooth and then the effects of the oral
environment on the GICs.

3.

Effects of GIC on tooth tissue

Hengtrakool reported on the effect of glass ionomers on a

biofilm containing S mutans demonstrating the significant
effect of fluoride ion release on biofilm inihibition. This
laboratory based study correlated well with the reports by
many of the speakers who demonstrated that the use of
glass ionomer cements in procedures such as the ART
technique performed well with longevity in excess of six
years. This was comparable with conventional preparations
with conventional restoratives after six years. There was
strong evidence that the use of GICs as sealants proved to be
therapeutic. Despite retention studies indicating GIC loss,
the caries incidence after five years was less than that found
with resin sealants. In fact at a microscopic level, although
not present in bulk, small volumes of GIC were found in the
depth of the fissures after five years. Frencken cited his
own studies showing the beneficial effects of GIC in the
prevention of secondary caries and also those of Qvist et al.1
showing primary cariostatic action on the tissue of adjacent
tooth surfaces. This was supported by the evidence from Ngo
on the benefits of fluoride releasing GICs in applications where
not all carious dentine could be unambiguously removed.

4.

Effect of the environment on GIC

Probably the most novel aspect of the performance of the GIC

in dental applications was the evidence from two groups of
the surface changes effected by exposure to saliva (natural or
artificial). This can be seen in the abstract from van Duinen
where an apparent mineral surface is depositing on the GIC.
This has now been reported in greater depth.2 The presentation

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journal of dentistry 34 (2006) 523524

by Tosaki from GC Dental provided a reference to a recent

paper indicating a similar effect with artificial saliva,3 the
surface deposition of Ca and P producing improved properties
in the GIC. In addition, the ambivalent interaction with
F ion was reviewed by Billington: it clearly can enhance
subsequent F release but can have adverse effect on the
glass-ionomer surface.
These materials appear to provide significant benefits for
many clinical applications. The reports from this conference
emphasise the importance of clinicians, industrialists and
academics collaborating to provide the appropriate material
suitable for the appropriate application.
Finally we would like to express our thanks to the sponsors,
3M ESPE, GC, Dentsply, Schottlander, Advanced Healthcare
and James Kent for their help without which this conference
would not have been possible.

references

1. Qvist V, Laurberg L, Poulsen A, Teglers PT. Eight year study

on conventional glass ionomer and amalgam restorations

in primary teeth. Acta Odontologica Scandinavica 2004;62:

3745.
2. Van Duinen RN, Davidson CL, De Gee SJ, Feilzer AJ. In situ
transformation of glass ionomer into enamel-like material.
American Journal of Dentistry 2004;17:2237.
3. Okada K, Tosaki S, Hirota K, Hume WR. Surface hardness
change of restorative filling materials stored in saliva. Dental
Materials 2001;17:349.

G. Pearson*
R.W. Billington
Queen Mary, University of London, Medical Science Building,
Mile End Road, London E1 4NS,
United Kingdom
*Tel.: +44 207 882 7977
E-mail address: g.j.pearson@qmul.ac.uk
(G. Pearson)
14 November 2005
0300-5712/$ see front matter # 2006 Elsevier Ltd. All rights
reserved.
doi:10.1016/j.jdent.2006.01.007