RESIN MODIFIED GLASS

IONOMERS

INTRODUCTION
Resin modified glass ionomers were introduced in 1988
by Antonucci, Mc Kinney and Mitra with an objective to
combine some of the desirable properties of glassionomer (fluoride release and chemical adhesion) with
high strength and low solubility of resins.
Antonucci et al. originally used the term resin-modified
glass-ionomer as the trivial name and resin-modified
glass polyalkenoate as the systematic name.

NOTE: Although sometimes are referred to as visible light

curing GIC or hybrid GIC, such terms should be discouraged
as they are insufficiently specific and can be confused with
some of the compomer materials.

Like the name implies, Resin-modified glass-ionomer

(RMGI) is a hybrid material derived from adding water
soluble polymers or polymerizable resins to conventional
glass-ionomer cement.
These materials can be
1.

Chemically cured (chemical-cured, acid base reaction)

2.

Dual cured (light-cured and acidbase reaction)or

3.

Tri-cured (chemical-cured ,light-cured and acidbase

reaction).

RMGI is available as
1.

2.

Powder/liquid

Pre proportioned
encapsulated form

3.

Paste/Paste systems

NOTE: The powder liquid components are initially hand

mixed and loaded into the delivery system; which facilitates
the placement of the material directly into the cavity.
This minimizes the inclusion of air bubbles and voids. But,
the delivery system has been criticized for being fiddly and
cumbersome as it can be difficult to load the material into
syringe.

COMPOSITION

Resin-modified glass-ionomers are of the glass-ionomer

family, and they contain basic ion-leachable glass powder
and a water-soluble polymeric acid such as poly(acrylic acid).
In addition, they contain organic resin monomers, typically
2-hydroxyethyl methacrylate (HEMA), and an associated
initiator system.
NOTE: The choice of resin is limited by the fact that glass
ionomers are water-based materials and so the resin needs to
be water-soluble. HEMA is a very effective hydrophilic
monomer in this respect, as it readily dissolves in water.

In addition to HEMA, some brands of resin-modified

glass ionomers are modified by the inclusion of branches
grafted onto the parent poly(acrylic acid).
These branches end in vinyl groups, and are capable of
copolymerizing with HEMA, once initiation has occurred.
Which means, these particular RMGIs develop organic
cross links as they cure.

In powder liquid systems

PowderConsists of an ion-leachable glass and
initiators for chemical/light-curing.

LIQUIDCONTAINS FOUR MAIN INGREDIENTS

1
Bis-GMA
Bis-GMA

2
POLY
POLY
ACRYLIC
ACRYLIC
ACID
ACID

3
HEMA

Enables polymerization reaction.

Reacts with the ion-leachable glass to allow acidbase

reaction

HEMA a hydrophilic methacrylate, enables both the resin

and acid components to coexist in an aqueous solution; It
also takes part in the polymerization reaction.

4
WATER

Water allows ionization of the acid component so that acid

Other components include polymerization activators and stabilizers
base reaction can occur.

In chemically polymerized materials, an example of an

initiator/activator system would be hydrogen peroxide as
the initiator, ascorbic acid as the activator, and cupric
sulphate as coactivator.
In light activated materials, camphorquinone is used as a
visible-light photochemical initiator, sodium p-toluene
sulphinate as the activator, and ethyl 4-N N dimethyl amino
benzoate as the photoaccelerator.

NOTE: The role of HEMA is

1. To polymerize the materials and positively enhance the bond
strength to tooth and dentin.
2. To enhance penetration of dental adhesives to dentin.
3. Performs as a co solvent and comonomer, which will enhance
water solubility of vinyl containing polyacid.

Water is responsible for calcium and aluminum cation

transportation to the polyacid. If there is not enough water due to
desiccation, the above reaction will stop resulting in crazing. .

SETTING
REACTION

CHEMICALLY ACTIVATED SYSTEMS

The setting reaction comprises an acidbase reaction of
the glass ionomer components occurring without light
and chemical polymerization by a redox catalyst, without
the necessity of light.
Therefore, chemically-activated polymerization of the
resin-modified glass-ionomer cement is referred to as
Dark Cure, because the reaction occurs in absence of
light.

DUAL CURE SYSTEMS

The setting reaction comprises an acidbase reaction of
the glass ionomer and a light-activated free radical
polymerization initiated by visible light.

TRI CURE SYSTEMS

Firstly, an acid/base reaction identical to that of conventional
glass ionomer cements.
Secondly, a light-activated free radical polymerization of
methacrylate groups of the polymer and HEMA initiated by
visible light and occurs only where the light penetrates.
However, as depth of cure through irradiation will be limited
by the depth of penetration of the light there is a third setting
reaction included so that any remaining monomer that has
not set photo-chemically will undergo a chemical
polymerization.

In general, in the resin-modified glass ionomer, the

setting reaction is a dual mechanism.
1)

The usual glass ionomer acid-base reaction begins on

mixing the material, followed by

2)

Free radical polymerization reaction which may be

generated by either photoinitiators or by chemical
initiators or both. If chemical initiators are included,
then the polymerization reaction will begin on mixing
as well.

1. ACID-BASE
REACTION

From the start of mixing there will be the conventional

acid/base reaction with the poly acrylic acid protons
liberating metal ions and fluoride from the glass,
forming a silica hydrogel around the glass surface.
The rising aqueous phase pH causes poly salt
precipitates to form from the migrating ions, which act
as cross-links to the poly acrylic acid chains.

Acid-base reaction: Fluoro alumino silicate glass (base)

+ poly(acrylic acid) = calcium and aluminum poly salt
hydrogel.

NOTE: The final set structure is a complex composite of the

original glass particles , sheathed by a siliceous hydrogel and
bonded together by a matrix phase of hydrated fluoridated
calcium and aluminium polyacrylates.

ACID BASE REACTION

COOH
COOH
COOH

Poly acrylic acid

Fluoro aluminosilicate glass

Al+++

Ca++

FH+

Calcium and aluminum

polysalt hydrogel

COOH

The RMGI differs from convention glass ionomer in that the

acid/base reaction is much slower, giving a considerably
longer working time.
This is because the HEMA has replaced some of the normal
water content and water is an essential component of the
acid/base reaction.
NOTE : Acid/ base component will be partly set within 7 to 10
minutes but the gelation is relatively slow and the reaction will
continue for weeks or even months.

2. POLYMERIZATION

REACTION

The second reaction is the polymerization of HEMA to poly

HEMA.
Because of the incorporation of traces of camphorquinone
and a tertiary amine in the formula, irradiation of the
surface layer will initiate polymerization of the HEMA and
this will be complete in less than one minute, providing the
initial set.

NOTE: The polymerization reaction rate is much faster than

the acid base reaction.

POLYMERIZATION REACTION :
Free-radical or photochemical polymerization process is
similar to that used in composite resins.

HEMA in presence
of photochemical
initiators and activators

Poly HEMA Matrix

2 SEPARATE
MATRICES

COMBINATION OF REACTIONS

COO-

Poly HEMA

Ca++
Al+++

Ca++

COO-

FH+

Al+
++

COOH

C
a
+
+

F-

COO-

H+

CO
CO
O

Ca++
O-

COO-

H
CO
H O

Poly acrylate
salt

Therefore, in the simple water/HEMA system, two matrices

are formed;
1)

The ionomer salt hydrogel and

2)

Poly HEMA.
The initial set of the resin-modified glass ionomer cement is
the result of formation of polymer matrix and the acid-base
reaction serves to harden and strengthen the formed matrix.

NOTE : It is certain that, the two matrices for thermodynamic

reasons, will not interpenetrate but will form separate phases, which
is not a desirable situation.

To prevent phase separation, another version of resin glassionomer cement bas been formulated.
This is Vitrabond and is termed as a Class II material, where
poly(acrvlic acid) (PAA) is replaced by modified PAAs.
These are based on graft copolymers of poly(acrylic acid) in
which a minor proportion of the carboxylic acid functional
groups was replaced with cross-linkable branches that were
terminated in vinyl groups and are capable of
copolymerizing with HEMA once initiation has occurred.

These materials, too, required HEMA to retain all of the

components in a single phase.

CH=CH2

COOH
COOH

CH=CH2

COOH

CH=CH2

MODIFIED POLY ACRYLIC ACID

When a resin glass-ionomer cement containing a

modified PAA and HEMA is mixed with the glass powder
and activated by light, several types of polymerization can
take place.
The HEMA will polymerize to form poly HEMA.
The modified PAA, because it contains unsaturated
groups, will copolymerize with HEMA; thus, poly HEMA
will be chemically linked to the polyacrylate matrix and
phase separation will not occur.

CROSS LINKS
BETWEEN THE
MATRICES

Poly HEMA
COO-

Ca++
Al+++

Ca++

COO-

FAl+
++

C
a
+
+

F-

H+
COOH

H+

CO
O

COO-

CO
OH

Ca++
CO
H O

Poly acrylate
salt

COO-

Also, the modified PAA will further polymerize to form a

cross linked PAA, which should increase the strength of
the cement.

NOTE: The matrix of such a cement will contain both ionic

and covalent cross links.

CLINICAL
PROPERTIES

ADHESION
ADHESION TO TOOTH:
Bonding of RMGIC to tooth is due to dual mechanism of
adhesion.
As for conventional glass ionomer the mechanism of adhesion
is thought to be based on a dynamic ion exchange process, in
which the poly alkenoic acid softens and infiltrates the
hydroxyapatite structure and displaces calcium and phosphate
ions out of the substrate to form an intermediate adsorption
layer of calcium and aluminum phosphates and polyacrylates at
the glass ionomer - hydroxyapatite interface.

As for resin based adhesives, micro mechanical bonding

mechanism occurs.
Laboratory shear bond strength of the resin-modified
cement to dentine is significantly higher than that of
conventional glass ionomer cement.

NOTE: It may be because of the slowness of the acid-base

reaction in the modified cement that the polyacid is available for
a longer period, resulting in the formation of a stronger adhesive
bond.

To take advantage of resin content in RMGI, the use of

various adhesive systems has been tried to improve bond
strength to tooth, but these have yielded mixed results.
Some products are supplied with primers. These are
visible light cured liquids which are composed of HEMA,
ethanol, photo-initiators and a modified poly acrylic
acid.

These primers are acidic in nature and act by modifying the

smear layer and wetting the tooth surface to allow adhesion
of the RMGIC.
Commercially available primers are:
1.

Fuji dentin conditioner (GC)

2.

Vitremer primer (3M ESPE)

3.

Nano-ionomer primer (3 M ESPE)

NOTE: The disadvantage of these materials is that they

usually infiltrate the dentin and make alternative adhesive

restorations less successful.

ADHESION TO COMPOSITE RESIN:

Resin-modified glass ionomers have the advantage of being
able to directly bond to resin composite.
RMGIs produce a catalyst rich air-inhibited layer which can
polymerize with the composite, making them useful in glass
ionomer/composite laminate restoration.

NOTE: The bond strength between conventional GIC and

composite is limited by the low cohesive strength of glass ionomers
due to the lack of chemical bonding. This is because of difference in
setting reaction between composite resin and GIC.

NOTE: The clinical technique described by Mount suggests etching

the initially set GIC for 15 seconds prior to placing a layer of resin
bond to develop a mechanical bond between the two materials.
Bond strengths improve if the GIC is etched after 24 hours of
maturation. However, this procedure requires an additional clinical
visit to complete a restoration. Therefore, RMGIC shows an
advantage over conventional GIC in laminate technique.

ADHESION TO OTHER MATERIALS:

RMGIs are commonly used as sub-lining of calcium
hydroxide. There is no interaction or bonding between these
two materials.
It is therefore important that the RMGIC layer is extended
beyond the extent of calcium hydroxide to gain adhesion to
the surrounding dentin to form a seal.
When used for luting, they will form chemical bonds with
tooth and not to the cast restoration being cemented.

WATER SORPTION
Hydrophilic nature of the added resin results in a varied
degree of long-term water sorption leading to volumetric
expansion.
This may help to reduce these marginal discrepancies
and also relieves polymerization shrinkage stresses that
develop along cavity walls during the initial setting stage
of these materials.

But, water that is absorbed into resin matrices acts as a

plasticizer which weakens the physical properties of
these materials
Furthermore, excessive expansion can in itself create
stresses that may possibly result in undesirable cuspal
flexures and fracture of brittle, unsupported tooth
structures.
NOTE: The increased water absorption in RMGIs also
provides channels for rapid leaching of potentially cytotoxic
residual monomers and photoinitiators.

NOTE : Relatively long periods are required for hygroscopic

expansion to be effective, during which ingress of bacteria and
by-products could have already induced irreversible damage to
the pulpo-dentinal complex. Thus, the concept of rapid
compensation for polymerization contraction via hygroscopic
expansion should be viewed with caution.

POLYMERIZATION SHRINKAGE
The inclusion of resin phase brings with it the problem of
polymerization shrinkage, which is greater than that in resin
based composites.
The measured shrinkage is more akin to unfilled acrylic
resin, being in the region of 3-4%
This shrinkage can lead to loss of adhesion as stresses at the
interface between the tooth and the restorative are generated
with the onset of light activated polymerization reaction.

ESTHETICS
They are less translucent because of significant difference
in the refractive index between resin matrix and powder
particles.

MECHANICAL STRENGTH
Inclusion of the resin component into the conventional
glass ionomers allows rapid development of strength and
more resistance to early moisture contamination.
The set cement has improved diametral tensile strength,
compressive strength and elastic modulus, when compared
with its conventional counterparts.
The resinous component renders it tougher and less brittle.

Comparison of compressive and diametral tensile

strength of RMGIC and conventional GIC

Comparison of flexural strength among different

luting agents
Zinc phosphate (ZP) Flecks
Glass ionomer (GI) Fuji I luting cement
Resin-modified glass ionomer (RMGI)
RelyX Vitremer luting cement
Dual-polymerization resin (D-P R1),
photopolymerized (P) or
unphotopolymerized (U)
Dual-polymerization resin (D-P R2),
photopolymerized (P) or
unphotopolymerized (U)RelyX
Adhesive Resin Cement

Comparison of flexural strength among

different RMGI
t 24 Hrs

MODULUS OF ELASTICITY
RMGIs are twice as flexible as water-based glass
ionomers and have a lower modulus of elasticity.
A cement with high modulus of elasticity is important to
provide better resistance to deformation under occlusal
force and marginal gap formation.
Therefore a stiff material is required in regions of high
masticatory stress or in long span prostheses and also to
prevent micro leakage.

Comparison of modulus of elasticity among

different luting agents Zinc phosphate (ZP) Flecks
Glass ionomer (GI) Fuji I luting
cement.
Resin-modified glass ionomer (RMGI)
RelyX Vitremer luting cement.
Dual-polymerization resin (D-P R1),
photopolymerized (P) or
unphotopolymerized (U) Calibra.
Dual-polymerization resin (D-P R2),
photopolymerized (P) or
unphotopolymerized (U) RelyX
Adhesive Resin Cement.

NOTE: The low modulus of elasticity of RMGI can have

unfavorable consequences for long term success if there is a
thick layer of luting material remaining between the
restoration and the tooth.

pH
The resin-modified glass ionomer cement had a higher initial
pH (3.6) than the conventional glass ionomer and the zinc
phosphate cement and has a low reported incidence of pulpal
sensitivity.
Resin-modified glass ionomer products for luting therefore
have a low reported incidence of pulpal sensitivity.
NOTE: The low initial pH values for the zinc phosphate (2.2) and
conventional GIC (1.6) could contribute to the postoperative
sensitivity. Hence, the use of varnishes or resin-based dentin
desensitizing primers should be considered for pulp protection when
these low pH luting agents are used and when the remaining dentin
thickness is minimal.

pH values of different luting cements

FLUORIDE RELEASE
These materials provide a sustained release of fluoride,
which occurs in the same way as with conventional GIC.
Majority of the release occurs in the early life of the
cement, usually during the first 10-15 days, which is
slightly higher than conventional GIC.

The long term release with RMGIC is slightly greater,

which may be due to the slower setting of the glass
ionomer phase of the cement. It may also be because the
poly HEMA matrix could provide an easier pathway for
the ionic species to migrate through the cement.

NOTE: Though, the external fluoride concentration is

increased, this may be at the expense of the restoration as it
starts to degrade.

FILM THICKNESS
Current ISO standards require a film thickness at the time
of seating of no greater than 25 m for water-based luting
cements, and no greater than 50 m for resin-based
cements.

According to Andrew et als study, within 2 min after

mixing the film thickness of these luting cements is 25m
or less, which meets the relevant ISO standard.
If the restoration is luted within this time, it will not
interfere with seating.
NOTE:The film thickness increases at the 3-minute interval;
depicting that the resin-modified glass ionomer cement is likely to
produce incomplete seating of the restoration if placement is
delayed, so clinicians using this type of luting cement should
probably consider subdividing the cementation of a large number of
restorations.

NOTE: Setting time often extends several minutes after

working time for luting materials, so occlusal loading by the
patient should be prevented until it is certain the cement has
set.

BIOCOMPATIBILITY
The monomer HEMA, which is an essential component
of resin-modified glass-ionomers, and is released from
these materials under all cure conditions, has a variety of
adverse biological effects.
These include cytotoxicity, inducing of apoptosis,
persistent inflammation, respiratory problems, allergy
and contact dermatitis.
NOTE: HEMA release occurs mainly in the first 24h after
polymerization.

NOTE : Even in its polymerized form bound in RMGIC, if

HEMA is placed directly onto vital pulp tissue it may cause the
death of the pulpal tissue. For this reason their use in direct
contact with the pulp is contraindicated.

HEMA is volatile and may be inhaled, a hazard for

which face-masks do not provide protection.
The eyes may also be exposed to this monomer vapor.
Latex gloves are inadequate as protection for the skin,
because they have been found to be permeable to
HEMA and other monomers.
NOTE: Nitrile gloves, have been found to provide good
protection against the passage of HEMA, and are therefore
recommended.

In order to use resin-modified glass-ionomer cements

safely, the following precautions are recommended.
1)

Ensure that the work space is well ventilated.

2)

Avoid inhalation of HEMA vapor.

3)

Touch unset material only with instruments, never with

hands, even when wearing gloves;

4)

Avoid contact of resin-modified cement (set or unset)

with the oral mucosa of the patient; use with a liner to prevent
diffusion of HEMA to the pulp.

5) Build-up restorations in increments (optimum

thickness 1mm, maximum thickness 2mm) to enable
each increment to be properly cured, thereby reducing
the amount of HEMA available for release.
6) Light-cure unused remnants of cement before disposal,
to reduce the possibility of exposure to volatile HEMA
vapor.

ADVANTAGES
Compressive strength, diametral tensile strength, and
flexural strength are dramatically improved in
comparison to zinc phosphate, polycarboxylate, and
glass-ionomer cements but is less than resin composites.
Abrasion resistance and fracture resistance are greater
than GIC.
Fluoride release pattern is similar to glass ionomer
cements.

Less sensitive to early moisture contamination and

desiccation during setting and less soluble than the glassionomer cement because of covalent cross-linking of the
poly acrylate salt from free-radical polymerization.
Ease of mixing and use, because multiple bonding steps
are not required.
Minimal post-operative sensitivity as there is no etching
required.

Have adequately low film thickness.

They bond to resin composite.
High bond strength to moist dentin (14 MPa)
Retention of resin-modified glass ionomer cements is not
significantly affected by eugenol-containing provisional
materials, as long as the provisional cement is completely
removed with a thorough prophylaxis.

DISADVANTAGES
A significant disadvantage of the resin ionomers is the
hydrophilic nature of poly HEMA, which results in increased
water sorption and subsequent plasticity and hygroscopic
expansion in the order of 3%
Because the matrix of the material is a mixture of hydrogel salt
and polymer light scattering will be greater than in the
conventional material; especially zinc-containing glass of Class
II-type materials is opaque, making it difficult to formulate a
translucent material.

After the snap set of the cement, the hard bulk of the poses
problems in excess removal.
If one waits for a longer time during cementation in the
posterior area of the mouth where embrasures are small and
tooth contacts large, proper removal of the cement may be
extremely difficult without damage to tissues, which would
expose the early cement margin to blood, greatly reducing the
bond strength and accelerating erosion.
NOTE : A dilemma results in that removal of excess must occur
right after the initial set, which may pull unset material form
under the restoration margin.

Most RMGI come encapsulated, which simplifies mixing,

but a unit dose price can be up to 35 times that of zinc
phosphate cement.
Low flexural strength.
Resin ionomer cements present concerns regarding
biocompatibility due to the presence of free monomer in
the liquid.
Although rare, dimethacrylates may elicit an allergic
response in certain persons and careful handling by
dental personnel is recommended during mixing.

INDICATIONS
Originally formulated as liner/base materials, modern
RMGIs can be used as restorative materials, for core buildup and for luting.

PRODUCT GUIDE FOR LINERS/BASES

Vitrebond

GC Fuji lining LC

Their use for luting purposes is becoming more popular

because of their relatively high bond strength to dentin,
and their ability to form a very thin film layer.
They are recommended to be used for luting metal or
porcelain fused- to-metal crowns and FPDs to tooth,
amalgam, resin composite, or glass ionomer core
buildups.
They are highly retentive when used with high strength
alumina or zirconium core all-ceramic crowns.

PRODUCT GUIDE FOR LUTING CEMENTS

Rely X Luting

Fuji Plus

Rely X Luting Plus

Ultracem

Clinical reports for specific uses, such as Class V

restorations, have shown them to be reliable materials
that give good results in terms of both aesthetics and
durability.
They have found particular use in pediatric dentistry.

OCCLUSAL CLASS II, III AND V RESTORATIONS:

RESTORATIONS IN PEDIATRIC PATIENTS
RMGICs have compressive strengths to withstand
occlusal load and provide adequate wear properties for
the posterior primary dentition.
These are particularly useful in children less than the
age of 4, when cooperative behavior is not anticipated.
NOTE: The advantages of not needing to acid etch tooth structure
before restoration placement and knowing that the chemical setting
reaction will occur, even in the absence of light, makes the RMGIC
favorable for the pediatric patents, where speed is critical and
isolation of tooth is difficult.

In a study by Prabhakar et al, the composite showed

higher mean shear bond strength in permanent teeth as
compared to resin modified glass ionomer cement,
whereas in primary teeth it showed significantly lesser
shear bond strength compared to resin modified glass
ionomer cement.
NOTE :It may be due to thicker peritubular dentin in
primary teeth and relatively less intertubular dentin. Since
intertubular dentin is the major area where resin bonding
occurs, primary teeth dentin provides lower bond strength with
composite when compared to permanent teeth.

PRODUCT GUIDE FOR RESTORATIVE

MATERIALS
(LIGHT CURABLE)

Photac- Fil

Fuji II LC

Vitremer

ORTHODONTIC BONDING
The use of resin composites for orthodontic bonding requires
some loss of enamel during etching and debonding and the
debonding procedure is relatively laborious. But, as the bond
strength of RMGIC is lower than resin cement, the debonding
is easy.
The bond strength of RMGIC is higher than GIC. Therefore, it
doesnt show a cohesive failure as in GIC, and the orthodontic
bond is not expected to fail during the treatment.

Commercial product to cement orthodontic bands.

CONTRA-INDICATIONS
Their use for cementing posts in non vital teeth is
questionable because of the potential for expansioninduced root fracture.
Because of potential for substantial dimensional change
due to hygroscopic expansion, these cements are not
recommended for luting all-ceramic restorations that are
susceptible to etching(silicate ceramics)

NOTE :In-vitro studies have shown that ceramic crowns

crack between 3 and 12months after cementation with both
RMGIs and compomers.

CLINICAL
HANDLING

HANDLING OF RESTORATIVE MATERIALS

Prior to the placement of the material, the dentin
should not be dehydrated.
The recommended technique for using the
accompanying primer depends on the product so always
consult the specific manufacturers directions for use.
Generally , primers are applied for 20-30 s using a
brush and lightly air dried. This is critical as the ethanol
must evaporate.
The primer is then light cured for 20seconds.

Resin-modified glass ionomers have greater curing shrinkage

than the conventional chemically-cured cements.
Therefore, incremental placement techniques should always
be used to ensure complete curing at depth and to minimize
polymerization shrinkage.
The depth of cure is significantly higher than the average
composite resin, that has been shown to be 2.0- 2.5mm, and
the presence of the auto cure component is an added safety
factor in development of adhesion in the depths of a deep
cavity.

However, the material that has not been irradiated is not as

strong as that which has been irradiated. Hence, incremental
buildup of the restoration is recommended for any situation
where the light source is further than 3mm from the floor of
the cavity.
Caution: Clinicians seem to assume that depth of cure is not an
important consideration with these materials, because the acid-base
reaction can take place at any depth. In reality, any such glassionomer structure would set more sluggishly and be weaker than a
purely acid-base cement, in addition to which there would be free
HEMA monomer in that part of the restoration closest to the pulp.
Consequently, and contrary to clinical advice, depth of cure does
matter in these materials.

POLISHING
Most manufacturers state that immediate polishing can
be carried out after light-curing.
However, the setting reaction will continue slowly for at
least 24 hours and the best result can be obtained if
finishing is delayed.
When immediate polishing is required, care must be
taken not to overheat the restoration as this may cause
excessive drying and cracking and may prevent setting of
the ionomeric component.

Finishing of the RMGI may be carried out by removing

excess material (flash) using a sharp instrument.
Alternatively, rotary instruments with water spray and either
diamond or tungsten carbide finishing burs may be used.
Final polishing can be done using aluminum oxide polishing
discs or silicone polishers.

NOTE: Acid-base setting phase progresses for 24 hrs. So,

excessive finishing and polishing at the initial appointment
should be avoided.

Finishing glosses are available with some products.

These are light-cured, resin based solutions that contain
bis-GMA and tri(ethylene glycol) TEGDMA.
Their use is optional, but they provide a smoother
surface by filling any surface irregularities.
NOTE : The use of finishing glosses is not recommended
when the product is being used as a core build up material as
the oxygen inhibited surface may react with some of the
currently available impression materials.

HANDLING OF LUTING AGENTS:

Clinically, mixing and manipulation of RMGI is very
similar to conventional glass-ionomer cement, cleaning of
the tooth is the same (the smeared layer should not be
removed by heavy pumicing).
The cement should be mixed closely following the
manufacturers directions on a glass slab or mixing pad (if
not pre-encapsulated) and the restoration quickly seated
with firm finger pressure while the material has a glossy
appearance.

As soon as the cement begins to harden (snap set),

removal of excess should begin (especially in inter
proximal areas).
Excess removal must be done quickly (or removal can be
extremely difficult) and carefully so as not to pull material
out from under the restoration margins.
As for glass-ionomer, the tooth should be well isolated and
the material kept dry for 7 to 10 minutes to minimize loss
of cement at the margins due to early solubility.

REFERENCES

Introduction to Dental Materials By Richard Van Noot 4th edition

The biocompatibility of resin-modified glass-ionomer cements for
dentistry John W. Nicholsona, Beata Czarnecka dental materials 24
( 2008) 17021708
Tooth-colored Restoratives: Principles and Techniques By Harry F.
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