GLASS IONOMER CEMENTS & COMPOSITES

TOOTH COLOURED RESTORATIVE MATERIALS

By Afeefa c Roll no;2

 RESTORATION

Filling material or prosthesis used to restore or replace a tooth, a

portion of tooth ,multiple teeth, or other oral tissues

Requirement of ideal restorative materials

Esthetic Maintenance of physical strength of crown Preserving anatomy of occlusal surface thus preventing inter relation ship with opposing and adjacent tooth long term adhesion between restoration and tooth to ensure complete isolation

GLASS IONOMER CEMENT

DEFINITION An aqueous based material that hardens following acid based reaction between fluro alumino silicate glass powder and poly acrylic acid solution

 HISTORY
It was developed byWILSON and KENT in the early 1970s The design of earliest glass ionomer cement was hybrid formulation of silicate and poly carboxylate cement Earliest commercial product-Acronym for hybrid formulation Alumino silicate poly acrylic acid(ASPA) The original poly acrylic acid in the liquid component was modified by copolymerisation with Itaconic acid,maliec acid &tartaric acid Ag-Sn particle is admixed to produce amalgam substitutes combination -MIRACLE MIXTURE

 In early 1990s original glass Ionomer formulations with alternate filler particle categorised as resin modified glass Ionomer Continued evolution polyacid modified resin composite - compomers

 Advantages
It is a tooth colored material It will adhere directly to enamel &dentin through ion exchange mechanism Biologically active releasing fluorides

 Disadvantages Its physical properties are not sufficient to enable it to withstand Heavy occlusal forces in large restorations

 CLASSIFICATION According to WILSON & KENT Type 1-LUTING

Cementation of crowns, bridges, orthodontic devices p:l ratio 1.5:1 Type2 RESTORATIVE type2.1- restorative esthetic auto cure or resin modified P:l ratio-3:1 type2.2-restoration under high occlusal load auto cure or resin modified P:l ratio-3:1

 Type 3 lining or base

Simple lining under metallic restoration P:l ratio-1.5:1

According to Intented application Type1 luting Type2-restorative Type3- lining &base Type4-fissure sealant Type 5-orthodontic cement

Type 6-core build up Type 7-fluoride releasing Type 8-GIC for ART Type 9-gediatric &pediatric GIC

Composition Powder fluoro alumino silicate glass silica-increase translucency alumina-Skeletal structure & increase opacity calcium fluoride-increase opacity &act as flux Aluminium fluoride Sodium flouride Aluminium phosphate Liquid 40-55% soln of poly acrylic or itaconic acid copolymer in water or Copolymer of maleic acid & poly acrylic acid-improve storage Tartaric acid-maintain working time

 SETTING REACTION Acid base reaction When powder &liquid are mixed to form paste, the acid etches surface of glass particle and calcium ,aluminium, sodium & fluorine ions are released in to aqueous medium. The poly acrylic acid chains are cross linked by the calcium ions that are replaced by aluminium ions in next 24 hours. The remaining ions are dispersed uniformly within the set cement with fluorine ions . The cross linked phase hydrated over time with the same water used for mixing .the process is called MATURATION

Setting reaction depends on Temperature of mixing slablower temperature of mixing slab , longer working time P:L Ratio Higher powder content , higher physical properties
Water plays critical role in GIC. If freshly mixed cement are exposed to ambient air with out protective covering the surface will crack as a result of desication Contamination by water dissolution of matrix

GIC must protected against desiccation and water changes

 Manipulation Hand mixing divide powder in to two equal

compartment

gently spread liquid drop over the glass slab roll first half of the powder in to liquid incorporate two together rapidly , this is completed in 10 sec rest of powder is brought in to mix Mixing time 25-30 sec setting time type 1 4 to5 type2 7sec

 Conditioning the cavity After cavity preparation there will be smear layer on surface of floor and walls To remove smear layer 10% polyacrylic acid is applied followed to remain in place for10 sec The cavity should be washed thoroughly and dried lightly ,cement followed in to place immediately Do not over dry the cavity

 Physical properties
Compressive strength150Mpa Tensile strength-6.6Mpa Hardness-48KHN Solubility-0.4

 Biological

Ion exchange adhesion

Properties

The union b/n glass Ionomer and tooth structure arises as a

result of an exchange of ions Because of low ph of poly alkanioc acid it will attack tooth surface and release ca & phosphate ions which will be free to mix with matrix of cement ,further release of ion buffer the reaction and anew material containing ions from both cement and tooth will begin to form and set at the interface .The new material will be firmly attached to both sides of the union will be stronger and more resistant to acid attack

 Anticariogenic properties GIC release fluoride which prevent formation of secondary caries Esthetics Inferior to silicate and composite Lack translucency

 Mechanism of adhesion
Chelation of carboxyl groups of polyacids with the apatite of enamel and dentin

 Biocompatibility
Glass Ionomer show high degree of biocompatibility with living tissues Poly acrylic acid are mild acids with high molecular wt and long complex chain formation .this make difficult for acid to penetrate through dentinal tubules even it does not produce vigorous action Due to presence of Free fluoride ion ,bacteria such as
streptococcus can not thrive in presence of fluoride

 Uses
Esthetic restoration of anterior teeth Restoration of class 3&class 5 cavity Luting Orthodontic bracket Pit& , and fissure Liner &base Core build up Intermediate restoration

modifications
Anhydrous
Freeze dried poly acid powder and glass powder are placed in same bottle as powder Liquid-water or water with tartaric acid Powder mixed with water the acid powder dissolves to re constitute the liquid acid process followed by acid base reaction

 Metal modified GIC

To improve strength &fracture toughness of GIC Two methods are employed Silver alloy admixed spherical amalgam alloy powder+type2 GIC Cermet -silver particle Are bonded to glass powder particle by fusion this s achieved by sintering of particle at too high temperature

 Properties Compressive strength-150 Mpa Esthetics-poor esthetics

 Resin modified
To over come moisture sensitivity& low early strength Powder-ion leachable fluoro alumino silicate glass Initiator-light curing or chemical curing Liquid-water & poly acid or poly acid modified with methacrylate & HEMA monomer

 Properties
Improved translucency Increased strength Compressive strength-105Mpa Tensile stregth-20Mpa Hardness -39KHN

 Highly viscous GIC USED IN ART

 Properties
Less fluoride than conventional GIC Restoration of low stress bearing areas Fluoride release similar to that of conventional GIC

composites
Definition
A HIGHLY CROSS LINKED POLY MERIC MATERIAL REINFORCED BY DISPERSION OF AMORPHOUS SILICA GLASS.CRYSTALINE OR ORGANIC RESIN FILLER PARTICLE AND OR SHORT FIBERS BONDED TO MATRIX BY COUPLING AGENTS

 History
1930s first mention of methyl methacrylate 1948-acrylic resin introduced Buonocore-micromechanical adhesion-acid etching Bowen introduced BIS GMA ,filled composite resin ,UV cured composite 1980s-light cured composite ,hybrid resin 1990-packable composite 1996-flowable
2000-nano fill introduced

 Advantages Good esthetics

CLASS Traditional composite Hybrid large particle Hybrid midifiller Hybrid minifiller packable

PARTICLE SIZE 1-50micro glass 1-20 micro meter glass 0.04 micro meter silica 0.1-10 micro meter glass .04 micro meter silica 0.1-2 micro meter glass .04 micro meter silica
Midifiller /mini filler hybrid

flowable
homogenous microfill Heterogenous microfill

Midifiller hybrid

0.04 micron silica

0.04micron silica Prepolymerised particle-0.04 micro

 Composition

An organic resin component that forms the matrix Eg ; Bis GMA Inorganic filler these may be A)macro filler with particle size of about 5-10 mm eg; glass ,quartz ,ceramic etc B)Micro filler with particle size of 0.04mm eg;amorphous silica Coupling agent applied to filler to the resin silane -titanate or zirconate Initiator system to activate setting mechanism-light or chemical activation Inhibitors-BHT OPTICAL MODIFIERS-aluminium oxide

 Curing of resin based composite

Chemical activated systems Two paste One-benzoyl peroxide-initiator Aromatic tertiary amine-N-N dimethyl para toludine Two paste r mixed together result in polymerisation

 Light activated systems

Single paste containing in a light proof syringe Photosensitizer camphoroquinone Amine initiator-dimethyl aminoethyl methacrylate (DMAEMA) Light source of activation Exposure time-40 second to light cure a2mm thick layer

 Advantage
Mixing not required Control of working time

Disadvantage
Limited curing depth Poor accessibilty in posterior areas

Curing lamps LED LAMPS QTH LAMPS PAC LAMPS ARGON LASER LAMPS

 DEGREE OF CONVERSION
MEASURE OF PERCENTAGE OF CARBON CARBON DOUBLE BOND THAT HAVE BEEN CONVERTED TO SINGLE BOND TO FORM POLYMERIC RESIN Higher degree of conversion better strength degree of conversion depends on Transmission of light through the material Time of exposure Amount of photo initiator or inhibitor present

 Polymerisation shrinkage
Shrinkage of 1 -1.7% It leads to marginal leakage Chemically activated resin shrink towards center of bulk material Light cured material first polymerise at surface, contraction towards light source

 Incremental build up and cavity configuration

Limitation of depth of cure of photo initiated resin dictates, use of incremental build up of composite Over comes limited depth of cure& residual stress concentration

 Clinical steps Etching and bonding Acid etching -one of most efficient way to improve
bond and marginal seal between resin and enamel Mode of action- it creates micro porosities it increases surface area Most commonly used etchant-37% phosphoric acid

 Delivery and placement

The chemical cure and dual cure materials will be packaged as paste /paste system or a powder /liquid system Light activated material will always be delivered in light proof syringes Incremental build up-placement of composite in small quantities in selected areas of the cavities and direct the light source

 Depth of cure
Depth of cure of composite resin is quite significant activator light should be placed within 1-2 mm of surface of the newly placed restoration Factors considered during curing Degree of cure will decrease with in creasing depth Increased time of exposure to light will increase depth of cure

propert y Size Inorgan ic filler volume In organic filler Compre ssive strengt h Tensile strengt h Elastic modulu s Water sorptio n shrinka ge

Unfille d acrylic

traditio nal 8-12 60-70

Hybrid small particle 0.5-3 65-77

Hybrid all purpose 0.4-1 60-65

Micro filled 0.040.4 20-59

flowab le 0.6-1 30-55

packable

0 0

fibrous 48-67

70-80

80-90

75-80

35-67

40-60

65-81

70

250-300

350-400

300-350

250300

24

50-65

75-90

40-50

30-50

40-45

2.4

8-15

15-20

11-15

3-6

4-8

3-13

.5-1..7

05-.6

.5-.7

1.4-1.7

8-10

2-3

2-3

2-3

3-5

2-3

 Properties
Marginal leakage When gingival margins are of cavity are located in dentin
or, cementum or both; the resin is firmly anchored to etched enamel and other margins, ;material pull from margin due polymerization shrinkage; gap formation in interface

 Wear
Composite undergo occlusal wear Wear rate-10-20 micrometer/year posterior composite wear-0.1-2mm more than enamel over 10 year

 Radiopacty
Resins are radiolucent

Biocompatiblity
Composites are relatively biocompatible Composite resin affect pulp from two aspects 1-inherent chemical toxicity of the material 2-pulpal involvement due to microleakage

 Improperly cured or uncured composites enter dentinal tubules cause pulpal inflammation Pulp protection-GIC and Calcium Hydroxide

CLASS
traditional Hybrid large particle

CLINICAL USE
High stress areas High stress areas requiring improved polishability-classes 1,, 2, 34 high stress areas requiring improved polishability classes-3 ,4 Moderate stress areas requiring optimal polishability-classes-3 ,4

Hybrid midifiller Hybrid minifiller ,

Packable hybrid

situations in which improved condensability Needed(1&2)

flowable
microfill

Situations in which improved flow is needed(class2)

Low stress &sub gingival areas require high

 Limitations Pulpal irritation due to un reacted monomer Tissue cell response is less

 Compomer
POLY ACID MODIFIED COMPOSTE Acid base reaction presence of saliva

COMPOSITION
One paste-light curable material-silicate glass particle NaF2&poly acid modified monomer wit out water Setting-photopolymerisation of acidic monomer

 Limitations
Gic susceptible to dehydration through life span Resistance to fracture is one of d main use of limitations to the use of glass Ionomer Resistance to Abration and wear is little less than of composite

 Conclusion Tooth colored restorative material provide better esthetic, they are used widely in dentistry

 Thank u