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Lecture Outline
What is glass inomer? Classification of glass inomer. Advantages & disadvantages of using glass inomer. Development & use of glass inomer. The fluoride releasing material continuum.
Dental Cements
Powder Zinc Oxide
Zinc Phosphate cement
Aluminosilicate Glass
Silicate cement
Polycarboxylate cement
Ionomer
Glass
Basic ion-leachable calcium fluoroionfluoroaluminoalumino-silicate glass powder
Acrylic acid Maleic acid Itaconic acid Butene dicarboxylic acid Vinyl phosphonic acid
Liquid acid attacks glass. Glass decomposition, metal ion release (Calcium, Aluminum, Fluoride). Migration of metal ions into liquid. Gelation of matrix by metal ions. PostPost-set hardening by continued binding of metal ions. Slow maturation (cross-linking, hydration, silica matrix). (cross-
H+
Silica gel core
Anions
Aluminosilicate glass
Ca2+,Al3+,Na+, F-
Role of Water
Transport media for fluoride. Stabilizes the set matrix (25 - 50% water). Solvation of ionomers/polymers and metal
ions.
Early moisture contamination leads to increased solubility and poor esthetics, (protect for first 7 minutes). Later desiccation causes shrinkage and crazing, crazing, (maybe even months later).
Fluoride
How fluoride works:
Inhibits demineralization. Enhances remineralization. Improves enamel crystal structure (fluorapatite). More readily taken up in demineralized enamel. Inhibits the process by which cariogenic bacteria metabolize carbohydrates (inhibits acid production). Interferes with ionic bonding during pellicle and plaque formation on tooth surface.
Level around restoration ~ 10 ppm. Level in saliva of average patient ~ 0.08 ppm. Fluorine release from GIC does not lead to restoration breakdown.
Recharging.
Classification
ADA Classification
= tooth-colored (Ketac-Fil, Fuji IX) tooth(Ketac= reinforced (Ketac-Silver, Miracle Mix) (Ketacliners and bases (Ketac-Bond) (Ketac-
Type III:
fast-set fast-
Classification
Usage Classification Restorative material
Traditional (Fuji II, Ketac-Fil) KetacHighly viscous (Fuji IX, Ketac-Molar) IX, KetacMetal reinforced (Miracle Mix, Ketac-Silver) Ketac-
Base/liner GC lining cement, Ketac-Bond KetacRoot surface sealing Cervical Cement Root canal sealing KetacKetac-Endo
Strengths:
GIC Indications
High caries risk patient Atrumatic Restorative Treatment (ART) Pediatric dentistry Class V lesions Liners & bases & sandwich technique Luting agents Core buildups ??? Maybe if > 2/3 of tooth structure remains Orthopedics (bone substitute material)
Steps of Clinical Use of Glass Inomer 1. Mechanical retention in preparation advised (no bevels).
Steps of Clinical Use of Glass Inomer 2. Dentin conditioning (10 % polyacrylic acid for 1010-20 seconds). 3. Inject into preparation. Overfill the preparation.
References