 GLASS IONOMER

CEMENT

GUIDED BY: PRESENTED BY:

DR. SAUJANYA JYOTSNA VAISHNAV
DR. DEEPIKA BDS 4TH YEAR

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 GIC
[ GLASS IONOMER CEMENT]

 CONTENTS:
1. Introduction
2. Composition
3. Classification
4. Setting reaction
5. General clinical steps for GIC restorations
6. Properties
7. Application
8. Advantages & Disadvantages
9. Modifications

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 INTRODUCTION:

 GIC was first introduced by Wilson and Kent in 1972.

 Glass Ionomers are materials consisting of ion cross

linked polymer matrices surrounding glass reinforcing
filler particles

 GIC is hybrid formulation of Silicate and

polycarboxylate cement.

 SYNONYMS:

1. ASPA [Aluminosilicate phosphate cement]

2. Poly alkenoate cement

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 Composition:- Conventional GIC
 Powder:
Content Percentage Function
 Silica (SiO2) 29.0% -Forms skeletal
structure of the
glass.
-Increases the
transparency of
glass.
 Alumina(AlO2) 16.6% -Forms skeletal
structure of glass.
-Increases the
opacity of glass.
 CaF2 34.3% -Acts as flux .
-Provides opacity.
 AlF3 5.3% -Partially replaces
silicon in glass
network providing
cement potential.
 AlPO4 3.8% -Provide body to
cement.
-Improve
translucency to
cement.
 Na3AlF6 5%

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  Liquid:
Content Percentage Function
Polyacrylic acid in 40-50% -Copolymerizing
the form of with itacoic. Maleic
copolymer with acid etc. tends to
Itacoic acid, increase reactivity
Maleic acid & of liquid , decrease
Tricarballylic acid viscosity and reduce
tendency for
gelation.
Tartaric acid 5-15% -Improves handling
characteristics.
-Increase working
time.
-Shortens setting
time.
Water 30% -Medium of
reaction and
hydrates the
reaction products.

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 Classification:
1. Mount,s classification:
 Type 1 - Luting
 Type 2 -
a. Restorative esthetic
b. Restorative reinforced
 Type 3 - Lining or base
a. Autocure
b. Resin-modified

2. Based on Application (FUJI’s classification):

 Type 1 - Luting cements
 Type 2 - Restorative cements
 Type 3 - liners and bases
 Type 4 - Fissure sealent
 Type 5 - Orthodontic cements
 Type 6 - For core build up
 Type 7 - Fluoride releasing cements
 Type 8 & 9 - For Atraumatic Restorative Technique [ART]

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3.Mc Lean and Nicholson classification:
a. Glass ionomer cement:
-Poly alkeonates
-Poly phosphonates
b.Resin-modified GIC
c.Polyacid modified GIC

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 Setting Reaction:- Conventional GIC
Stage 1 : Dissolution
Stage 2 : Precipitation of salts; gelation and hardening
Stage 3 : Hydration of salts

Stage 1 : Dissolution-
 At the beginning of the reaction the surface of the glass
particles is attacked by the polyacid.
 This result in dissolution of the surface of the glass
particles releasing Ca and Al ions leading to the formation
of a cement sol.

Stage 2 : Precipitation of salts; gelation and hardening -

 Ca and Al ions bind to the polycarboxylate groups. The
initial clinical set is due to the cross linking of the more
readily available Ca ions.
 This reaction is complete within 4-10 minutes after mixing.
 MATURATION occurs over the next 24 hours when Al ions
get bound within the cement matrix to form a more rigid
cross linking between the polyacid chains.
 Na and Fluoride ions do not take part in cross linking.
 Na ions replace the Hydrogen ion in carboxylic group.
 Residual Na and Fluoride ion combine to form NaF. Which
leads to Anticariogenic property of cement.

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Stage 3 : Hydration of salts-
 During the maturation phase, there is progressive
hydration of the matrix salts which leads to a sharp
improvement in the physical properties of the cement.

Structure of set cement:

 Set cement consist of unreacted powder particles
surrounded by silica gel sheath and embedded in an matrix
of hydrated Ca and Al cross linked polyacrylic gel.

Bonding mechanism:
 Carboxylic groups have ability of chelating surface ions
that is calcium ions from the tooth structure that
generates chemical bond.
 Bond to enamel is higher than dentin due to greater
inorganic content and its greater homogeneity.

 Sensitivity to Air and Moisture:

 Exposure of cement to water before the hardening leads
to loss of anions and cations which form the matrix as they
can be dissolved.
 It can be protected by use of varnish, petroleum jelly or
cocoa butter.

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Structure of set conventional GIC – Ca
polyacrylate chains form first, followed by
aluminium polyacrylate chanins.

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 CLINICAL STEPS:
 Isolation
 Tooth preparation:
1. Cavity preparation
2. Prophylaxis
3. Surface conditioning
 Cement manipulation
 Finishing & polishing
 Protection

1. Isolation : GIC is highly sensitive to moisture

contamination during placement. so care should be taken
to isolate the tooth surface properly using rubber dam,
cotton rolls, retraction cords and saliva ejectors.

2. Tooth preparation: Tooth surface should be

prepared properly to enhance adhesion of glass ionomer
cement.

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 a) Cavity preparation:
I. Required while restoring class III or class V carious
lesion.
II. No mechanical retentive features are necessary.
b) Prophylaxis: This is done using pumice slurry carried in a
bristle brush. This will remove plaque or salivary pellicle from
the tooth surface.
c) Surface conditioning:
 For good adhesion of GIC.
 Agents :
10% Citric acid
3% H2O2
10% EDTA
25% Tannic acid
10% Polyacrylic acid
* 10% polyarylic acid is most widely accepted.

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3. Manipulation :
 P/L ratio : For luting : 1.5:1
For base : 3:1
 Powder and liquid is dispensed just prior to mixing. A non
absorbent paper pad is used.
 The powder should be rapidly incorporated into the liquid
using a stiff spatula.
 Normally half of the powder is mixed into the liquid for 5-15
seconds. The rest of the powder is quickly added and mixed
by folding the cement until a uniform glossy appearance is
achieved.
 Mixing time: 45 seconds
 Glossy appearance indicates the presence of unreacted
polyacid, which is critical for bonding to the tooth.
 A dull appearance indicates that the acid has reacted too
much with the glass particles for good bonding.

 Setting time For luting Restorative

type
 Initial 5-7 minutes 4-5 minutes

 Final 24 hours 24hours

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4) Finishing and polishing: Gross excess should be
trimmed using Bard Parker blade or sharp carvers.
*Final finishing and polishing is done after 24 hours. Finishing
diamond points are used to contour the restoration and Sof-Lex
discs from coarse to fine are used for final finishing.
* The finishing has to be done under moist conditions as dry
finishing will dehydrate the cement making it chalky and
porous, damaging its properties.

5) Surface protection: Surface has to be protected with

the resin bonding agent.
 A special varnish supplied by manufacturer .
 Cocoa butter or petroleum jelly.

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 PROPERTIES OF GIC:

 Mechanical properties:

Strengths after 7 days (glass ionomer cement)

Compressive Tensile strength Flexural
Type strength (MPa) (MPa) strength
(MPa)
Type II.1(esthetic) 70-220 12-20 8-40
Type 140-220 13-16 22-30
II.2(reinforced)
Type I (luting) 70-150 6-15 4-18

 Solubility:
* Due to leaching of intermediate products.
- For luting type : 1.25%
- For restorative type: 0.4%

 Adhesion: - Adhere well to enamel and dentin.

- Mechanism of adhesion : chemical

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ADHESION OF GLASS IONOMER CEMENT TO
TOOTH STRUCTURE

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  Biocompatibility: Pulpal response is mild.

* Pulpal response is greater than ZOE cements but less than

ZnPo4 cement.
* In small cavities smear layer should not be removed as it
acts as barrier to acid penetration. Deep areas are protected
by thin layer of Ca(OH)2.

 Anticariogenic properties:
- The cement contains fluoride which is released into the
surrounding tooth structure after placement.
- It prevents development of recurrent caries and also
prevents plaque accumulation on the surface of GIC
restorations.

 Acceptable esthetics:
- GIC is available in various shades.
- Both chemically cured and light cured restorative GIC
exhibit good color matching and translucency.

 Less technique sensitive:

- GIC is less technique sensitive than composite resins.
- Simple and easy to handle.

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APPLICATIONS OR INDICATIONS:

 As pit and fissure sealant.

 As a Liner or Base.
 Restoration of deciduous teeth. In Class I, Class II,
Class III and Class V.
 Anterior esthetic material for class III.
 Restoration material for erosion and class V
restorations.
 Luting agent for restorative materials or orthodontic
brackets.
 For core build up.
 Intermediate restorative material.
 In Atraumatic Restorative Technique.
 In Sandwich technique.

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 ADVANTAGES:
 Chemical adhesion to enamel and dentin.
 Anticariogenic effect due to presence of fluoride.
 Acceptable esthetics.
 Low Solubility.
 Biocompatible.
 Less technique sensitive.
 Less mixing time required.

 DISADVANTAGES:
 Low fracture resistance.
 Low wear resistance.
 Not esthetic as composite resin.
 May stain with time.
 Sensitive to moisture during setting .
 No control on working time.
 Expensive.

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 MODIFICATIONS:
I. Metal Modified Glass Ionomer Cement
A.Silver alloy admixed(Miracle Mix)
B. Cermet
II. Resin Modified Glass Ionomer Cement (RMGIC)
III. Compomer
IV. Giomer

I. Metal Modified Glass Ionomer Cement:

Metal reinforced glass ionomer cements were first introduces in
1977 to improve the strength, fracture toughness & resistance to
wear & yet maintain the potential for adhesion & anticariogenic
property.

TYPES:
A.Silver Alloy Admixed(Miracle Mix): Spherical amalgam
alloy powder is mixed with restorative type GIC powder.

B.Cermet: Silver particles are bonded to glass particles. This is

done by sintering a mixture of the two powders at a high
temperature.

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 USES:
- Restoration of small class I cavities as an alternative to amalgam
or composite resins. They are particularly useful in young patients
who are prone to caries.
- Post core build up of grossly destructed teeth.

ADVANTAGES:
- High strenghth.
- Fracture resistance.
- Resistance to wear.

DISADVANTAGES:
- Poor esthetics.
- Poor physical properties in comparison to amalgam.

II. RESIN MODIFIED GIC (RMGIC):

- Categorized by RMGIC or HYBRID.
-Usually light cured and less technique sensitive and may be
finished at the time of placement.

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COMPOSITION:
POWDER LIQUID
Ion leachable glasses Polyacrylic acid
(silica,alumina)
Photoinhibitors or chemical Water
initiators or both
Polymerizable resin Methacrylate monomer
Hydroxyethyl methacrylate
monomers

USES:
- Recommended for class V restorations.
-Can be used for class I and II restorations in primary teeth.
-As bases and liners.

ADVANTAGE:
- Stronger than traditional GIC.
- Improved moisture strength.
- High initial strength.
- Increase working time.
- Better adhesion than composite resin.

DISADVANTAGE:
- Biocompatibility is low.
- More setting shrinkage leading to increase microleakage.
- Poor marginal adaption.

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Structure of set resin-modified glass ionomer
cement – The same acid-base reaction occurs, but
resin (HEMA) will set upon light activation and
protect the autocure system from immediate
water uptake.

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III. COMPOMER:
- Poly acid modified resin composites.
- Combination of characteristics of composite and GIC.
- These materials are essentially polymer based composites that
have been slightly modified to permit fluoride release from the
glass or special matrix phases.
- Mechanical properties are superior to the properties of
traditional and RMGICs.

COMPOSITION:
POWDER LIQUID
Strontium aluminium Polymerizable
fluorosilicate glass particles methacrylate/Carboxylic acid
monomer
Metal oxides Water
Initiators

INDICATIONS:
- Pit & fissure sealant.
- Restorations of primary teeth.
- Liners & bases.
- For class III & class V lesions.
- Retrograde filling material.
- Repair of defective margins.

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 ADVANTAGES:
- Ease of use.
- Easy adaptation to tooth.
- Good esthetics.
- More working time than resin modified GIC.

IV. GIOMER:
- In order to retain some traditional properties of GIC , giomer
include procured and pulverized particles of GIC as an
additional dispersed phase within a compomer.
- Early clinical trials seem to indicate that they are not truly
competitive with composites as permanent filling materials in
posterior locations.

COMPOSITION:

Hybrid of GIC & Composite.

TYPES: Based on PRE REACTIVE GLASS technique.

S-PRG-I: Reaction of entire glass.

S-PRG-II: Reaction with glass surface.

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 INDICATIONS:
- Restoration of class I, II, III, IV, V cavities.
- Laminates and core build up.
- Restoration of cervical abrasion and root caries.
- Restoration of primary teeth.
- Repair of fracture of porcelain and composites.

ADVANTAGES:
- Increase wear resistance.
- Increase radiopacity.
- Better esthetics.
- High fluoride release.
- Inhibit demineralization.
- Highly Biocompatible.
- Provides complete seal against bacterial microleakage.

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