A glass ionomer cement is a dental restorative material used in dentistry as a filling

material and luting cement,[1] including for orthodontic bracket attachment.[2][needs update] Glass-ionomer
cements are based on the reaction of silicate glass-powder (calciumaluminofluorosilicate glass[3])
and polyacrylic acid, an ionomer. Occasionally water is used instead of an acid,[2] altering the
properties of the material and its uses.[4] This reaction produces a powdered cement of glass
particles surrounded by matrix of fluoride elements and is known chemically as glass
polyalkenoate.[5] There are other forms of similar reactions which can take place, for example, when
using an aqueous solution of acrylic/itaconic copolymer with tartaric acid, this results in a glass-
ionomer in liquid form. An aqueous solution of maleic acid polymer or maleic/acrylic copolymer with
tartaric acid can also be used to form a glass-ionomer in liquid form. Tartaric acid plays a significant
part in controlling the setting characteristics of the material.[5] Glass-ionomer based hybrids
incorporate another dental material, for example resin-modified glass ionomer cements (RMGIC)
and compomers (or modified composites).[5]
Glass ionomer cement is primarily used in the prevention of dental caries. This dental material has
good adhesive bond properties to tooth structure,[6] allowing it to form a tight seal between the
internal structures of the tooth and the surrounding environment. Dental caries is caused by bacterial
production of acid during their metabolic actions. The acid produced from this metabolism results in
the breakdown of tooth enamel and subsequent inner structures of the tooth, if the disease is not
intervened by a dental professional, or if the carious lesion does not arrest and/or the enamel re-
mineralises by itself. Glass ionomer cements act as sealants when pits and fissures in the tooth
occur and release fluoride to prevent further enamel demineralisation and promote remineralisation.
Fluoride can also hinder bacterial growth, by inhibiting their metabolism of ingested sugars in the
diet. It does this by inhibiting various metabolic enzymes within the bacteria. This leads to a
reduction in the acid produced during the bacteria's digestion of food, preventing a further drop in pH
and therefore preventing caries.
The application of glass ionomer sealants to occlusal surfaces of the posterior teeth, reduce dental
caries in comparison to not using sealants at all.[7][needs update] There is evidence that when using
sealants, only 6% of people develop tooth decay over a 2-year period, in comparison to 40% of
people when not using a sealant.[7] However, it is recommended that the use of fluoride
varnish alongside glass ionomer sealants should be applied in practice to further reduce the risk of
secondary dental caries.[8]
However, the addition of resin to glass ionomers, improves properties significantly, allowing it to be
more easily mixed and placed.[3] Resin-modified glass ionomers allow equal or higher fluoride
release and there is evidence of higher retention, higher strength and lower solubility.[3] Resin-based
glass ionomers have two setting reactions: an acid-base setting and a free-radical polymerisation.
The free-radical polymerisation is the predominant mode of setting, as it occurs more rapidly than
the acid-base setting, which is comparatively slower. Only the material properly activated by light will
be optimally cured. The presence of resin protects the cement from water contamination. Due to the
shortened working time, it is recommended that placement and shaping of the material occurs as
soon as possible after mixing.[5]