Volume: 1: Issue-1: March-May -2011 www.ijpaes.

com ISSN 2231-4490

GLASS IONOMER CEMENTS (GIC) IN DENTISTRY: A REVIEW
TR. Mahesh Singh*, P .Suresh**, J .Sandhyarani***, J .Sravanthi****
*Government Medical College, Jagdalpur.
** Resident, Conservative and Endodontics.
*** entist, Sandhya ental Clinic, Jagdalpur.
**** entist, !ir "orce #a$impeth, #ydera%ad.
Abstract: G&C 'G(!SS &)*)MER CEME*TS+ is the versatile material used in dentistry
since ,-.,, %ut it/s use resurged recently as an ideal cementing material. &n vie0 o1 it/s 0ide
use in dental practice, the discussion o1 G&C is important to the dental practitioners.
Key wors: G&C 'Glass &onomer Cements+, ental Cement Material.
INTROD!CTION
2*ecessity is the mother o1 invention3. &t 0as the late ,456/s. #istory had already 0itnessed a
host o1 restorative materials including amalgam, composite, cast alloys etc. %ut all had 1allen
short o1 that certain per1ection that the dental researches and clinician yearned 1or7..that o1 a
material that 0ould %e esthetic, adhesive, %iocompati%le, anticariogenic and relatively
economical. &t 0as during this time that cement came into the picture and created 8uite a
sensation %y not only possessing a ma9ority o1 the desira%le properties %ut also providing
much scope 1or modi1ication and improvement. This 0as the Glass &onomer Cement.
Glass ionomer is a com%ination o1 :Glass/po0der and :ionomer/;ic acid G&C can %e de1ined
as a 0ater; %ased material that hardens 1ollo0ing an acid;%ase reaction %et0een the %asic
1luoro aluminosilicate glass po0der and an acidic solution o1 polyacrylic acid.
Co"#os$t$o%
&ower < &s %asically an acid solu%le calcium aluminosilicate glass containing 1luoride. &t is
1ormed %y 1using silica = alumina = calcium 1luorite, metal o>ides and metal phosphates at
,,66
6
;,?66
6
C and then pouring the melt onto a metal plate @ into 0ater. The glass 1ormed is
crushed, milled and ground to a 1orm po0der o1 A6 B ?6C siDe depending on 0hat it/s going
to %e used 1or. They get decomposed %y acids due to the presence !l
=E
ions 0hich can easily
enter the silica net0or$. &t is this property that ena%les cement 1ormation.
"unctions o1 componentsF
Alumia '!l
A
)
E
+
; &ncrease opacity
Silica 'Si)
A
+
; &ncrease Translucency
!luori"eF &ts has ? 1unctions
; ecrease 1usion t
)

; !nticariogenecity
; &ncrease translucency
; &ncrease 0or$ing time
; &ncrease strength
#alcium $luori"e 'Ca "
A
+
; &ncrease opacity
; !cts as 1lu>
Alumiium phospha%es
; ecrease melting t
o
; &ncrease translucency
#ryoli%e '*a
E
!l "
5
+
; &ncrease translucency
; !cts as 1lu>
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Na.( /.( #a.2( Sr.3
; &nclude high reactivity o1 glass 0ith polyacid.
!l
A
)
E
F Si)
A
ratio is crucial and should %e G ,FA 1or cement 1ormation to occur. Cement
1ormation 0ill occur only 0hen there 0ill there %e su11icient replacement o1 Si %y !l to
render the net0or$ suscepti%le to acid attac$.
The glass can %e modi1ied %y several 0ays to enhance the physical properties o1 the cement.
,. Ca can %e replaced %y Sr, Ha or (a to give a R@) glass
A. Iashing glasses 0ith organic acids to remove sur1ace concentration o1 Ca 0hich 0ill
help prolong IT
E. Corundum, Rutile, Haddelyte disperse phases can %e added to increase 1le>ural
strength
J. Metals, resins, 1i%ers are added to increase the strength.
L$'($F )riginally, the li8uid 1or G&C 0as an a8ueous solution o1 P!! in a concentration o1
a%out ?6K. This 0as 8uite viscous and tended to gel over time. Thus, P!! 0as co;
polymeriDed 0ith other acids such as itaconic, maleic and tricar%o>ylic acids. This
polyelectrolytic li8uid o1 G&C is, thus, also called as polyal$enoic acids. Recently polyvinyl
phosphoric acid has also %een introduced to this system.
! typical li8uid o1 G&C contains J6;??K o1 AF, polyacrylic F itaconic acid co; polymer and
0ater.
The %asic 1unctions o1 these coBpolymers includeF
; the co; polymeric acids are more irregularly arranged than the homo polymer. This
reduces #; %onding %et0een acid molecules and reduces degree o1 gelling
; decrease the viscosity
; reduce tendency 1or gelation,hence, improves storage.
; &ncrease the reactivity o1 li8uid
The rest o1 the li8uid comprises o1 0ater, 0hich is an important constituent o1 G&C. &t is
the reaction medium and helps in hydrating the matri>.
A$t$)es:
,. Tartaric acid
; &ncreases IT
; &ncreases translucency
; &mproves manipu%ality
; &ncreases strength
?;,?K o1 optically active isomer o1 T! is added.
A. PolyphosphatesF e>tends Ior$ing Time.
E. Metal o>idesF accelerates Setting Time.
The reactivity o1 the polyacid depends onF
; ingredients< malec acid is a more reactive acid than P!!
; Mol .0t and concentration< increase reactivity
&ro#ert$es o* GIC
G&C sho0 a variety o1 properties and are clearly very diverse materials
AD+ESIONF
!dhesion o1 G&C helps inF
; Providing a conservative approach to restorations
; Providing a per1ect seal
i11erent Conditioners used are F
,. P)(L !CRL(&C !C& F &s the conditioner o1 choice as it is a part o1 the cement
1orming acid. &t alters the sur1ace energy, e>posing highly mineraliDed tooth sur1ace
to di11usion o1 acid and ion e>change. This enhances adaptation o1 cement ',6K,
,6sec+
A. ?6K citric acid, ? sec.
E. A?K tannic acid, E6 s
J. AK "erric chloride
?. *a"
5. ET!
.. Mineralising solution B(evine solution
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,IOCOM&ATI,ILITYF
!dverse a11ect o1 G&C on living tissues are minimal. !ny in1lammatory response o1 pulp
to0ards G&C due to its high initial p# o1 6.4 to ,.5 resolves 0ithin A6;E6 days. *o ill e11ects
are caused %y P!! %ecauseF
; P!! is a 0ea$ acid, 0hich %ecomes 0ea$er 0hen partly neutraliDed
; &ts di11usion into the tu%ular dentin is unli$ely due to its high molecular 0eight and
heavy chain entanglement
; &t gets readily precipitated %y the calcium ions in the tu%ules.
; issociated #
=
ions remain near the chain due to electrostatic attraction
The occasional post insertions sensitivity encountered on luting 1ull cro0ns is due to
; The high initial p# MA.EE 'P!!+ li8uid and ,..5 '0ater setta%le+N0hich persists 1or
a%out ? mins.
; (o0er PF ( ratio
; Pre;e>isting pulpitis
; Minimal thic$ness to prevent this, certain precautions should %e ta$en.
; on/t remove smear layer
; Protect deep areas o1 cavities 0ith Ca ')#+
A
ANTICARIOGENECITYF
G&C has the uni8ue property o1 %eing cariostatic due to the sustained release o1
1luoride, 0hich con1ers resistance to caries not only on the restored tooth %ut also on the
ad9acent tooth. The in1luence o1 1luoride is 1ound in a Done o1 resistance to demineraliDation,
0hich is at least Emm thic$ around a G&C restoration.
"luoride contri%utes to carious inhi%ition in the oral environment %y means o1 %oth
; Physicochemical mechanism
; Hiologic mechanism

AEST+ETICSF
! degree o1 translucency e>ists 1or G&C due to the glass 1illers. &ts translucency
depends on its 1ormation. &t is important to note that %ecause o1 slo0 hydration reactions,
Glass ionomer ta$es at least AJhrs to 1ully mature and develop translucency. Translucency
increases as the cement ages. Resistance to stain is largely dependent on o%taining a good
sur1ace 1inish. The colour seems to %e una11ected %y oral 1luids as compared to composites
0hich tend to stain.
DIMENSIONAL STA,ILITY:
! correctly manipulated and protected G&C sho0s a volumetric setting contraction o1
O EK. !t higher humidities, the cement tends to a%sor% 0ater and e>pand so much so that a
net e>pansion occurs 0hile at lo0er humidities, a lo0 shrin$age occur.
DISSOL!TION AND DISINTEGRATION:
The loss o1 solu%le matri> 1orming species 1rom the cement can lead to disintegration o1
the cement. This can %e caused %yF
; Early 0ater contamination
; Chemical attac$ such as pla8ue acids @ !P" gel application
; Mechanical 0ear
&t is mandatory to protect the G&C in its 1irst P hour o1 li1e. ! solu%ility o1 only 6.JK '0t+ is
seen as compared to other cements
D!RA,ILITY AND LONGEVITY:
!ccording to one study, the G&C restoration evaluated in erosion;a%rasion lesions,
-EK sho0ed retention even a1ter ,6yrs. "ailure rate ranges 1rom 6;.6K, 0hich is more o1 a
measure o1 the clinicians s$ill than o1 the inherent 8uality o1 the material
STRENGT+F
)ne o1 the ma9or limitations o1 G&C is their suscepti%ility to %rittle 1racture. !s
compared to composite and amalgam, G&C/s are 0ea$ and lac$ rigidity. The 0ea$ness
appears to %e in the matri>, 0hich is prone to crac$ propagation. ! certain degree o1 porosity
also develops as it is a A part material, 0hich needs to %e mi>ed prior to placement
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RADIO&ACITYF
G&C are 1airly R@) due to inclusion o1 radio opaci1ies li$e HaS)
J
. Most G&C/s are slightly
more radiopa8ue than dentin and can %e di11erentiated in radiograph.
C-$%$ca- !ses: Accor$%. to &/$-$#0s c-ass$*$cat$o%
L(t$%. ce"e%ts (TY&E 1):
The ideal properties o1 a luting cement according to Mc (ean and Iilson are F
(o0 viscosity and 1ilm thic$ness
(ong 0or$ing time and rapid set at mouth temperature
Good resistance to a8ueous acid attac$
#igh compression and tensile strength
Resistance to plastic
!dhesion to tooth structure
Cariostatic properties
Hiological compati%ility 0ith the pulp
Translucency
Radiopacity
Restorative Cement 'Type &&+ F
&ndicationsF
o The erosion@a%rasion lesion
o Class Q lesion
o Restoration o1 primary teeth
o Class &&& lesion
o (aminate restoration
o Microcavity preparation < %o>,slot,tunnel
o !traumatic Restorative Treatment '!RT+
o Patients prone to rampant caries
o Small medium siDed class & lesion
o Repair o1 open margins around cro0ns and inlays.
The Po0derF(i8uid 'PF(+ < EF, !s mentioned %e1ore, correct sur1ace treatment, manipulation
and protection are essential 1or a long lasting restoration.
L$%er a% base (TY&E III):
! lining cement is %asically used to protect the pulp 1rom temperature change, %y
sealing dentinal tu%ules. &t needs to %e only 6.?mm thic$. They have lo0 physical properties
and are used to 1ill voids in cavity preparation. The PF( < ,.? F ,
! %ase is used as a dentin su%stitute. !ccording to Mount, the entire cavity should %e
1illed 0ith G&C and then cut %ac$ to ma$e room 1or amalgam @composite.
Ot/er !ses:
)rthodontic luting cements:
(uting cements are needed to e11ect a sta%le attachment o1 %ands and %rac$ets during
tooth movement. ! common clinical pro%lem is
o demineraliDation and caries under %rac$ets and %ands
o detachment causing schedule disruption and R> delay.
Hoth these pro%lems can %e solved %y using G&C as " release reduces demineraliDation under
%rac$ets and %ands. Conventional G&C has sho0n proven %ene1it over Rn P)
J
1or %and
cementation 0ith regard to retention and decreased demineraliDation.
Core %uild up:
The construction o1 a core is o1ten necessary prior to cro0n preparation in order to give the
1inal cro0n appropriate resistance and retention. Traditional G&C lac$ the necessary tensile
and 1le>ural strengths 1or anything other than small core %uild ups or %loc$ing out under cuts
in preparations.
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GIC $% e%oo%t$cs:
They are used 1orF
o Sealing root canals orthogradely and retrogradely
o Restoring pulps cham%er
o Per1oration repair
o Sometimes 1or repairing vertical 1racture.
G&C 0as used %ecause o1F
&ts capacity to %ond 0hich enhances seal and rein1orces the tooth
&ts good %iocompati%ility, 0hich 0ould minimiDe irritation to
periradicular tissues
&ts " release, 0hich imparts an anti; micro%ial e11ect to com%at root
canal in1ection
CONCL!SION
&n spite o1 su%stantial improvement G&C/s have short comings 0ith regard to moisture
sensitivity, 0ear resistance, 1le>ural strength and 1inal 1inish. Even though chemical adhesion
and 1luoride release are ma9or %ene1its, conventional G&C/s are restricted to special
indications li$e class &&& or class Q cavities. !dvancements have occurred to overcome these
pro%lems %ut most are still a0aiting clinical trials.
RE2ERENCES
,. Graham J Mount S !n !tlas )1 Glass &onomer Cements ClinicianTs GuideS Erd
Edition
A. Graham J MountS Preservation !nd Restoration )1 Tooth Structure
E. !lan Iilson @ John I McleanS Glass &onomer Cements
J. StrurdventS !rtTs !nd Science )1 )perative
entistryS Jth Edition
?. !nusavice U.JF Phillips Science o1 ental Material
5. Iilson !, Mc(ean JI. Glass Ionomer Cement. ChicagoF Vuintessence Pu%lishing
CoS ,4--F,J.
.. Iilson !, Uent HE. The glass ionomer cementF ! ne0 translucent dental 1illing
material. J Appl Chem Biotechnol. ,4.,SA,FE,E.
-. Iilson !, Uent HE. ! ne0 translucent cement 1or dentistryF The glass ionomer
cement. Brit Dent J.,4.AS,EAF,EE;,E?.
4. Mc(ean JI, *icholson JI, Iilson !. Suggested nomenclature 1or glass ionomer
cements and related materials 'editorial+. Quintessence Int. ,44JSA?F?-.;?-4.
,6. *icholson JI, Croll TP. Glass ionomers in restorative dentistry. Quintessence Int.
,44.SA-F.6?;.,J.
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