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CEMENT
DR. ABHIJIT. PALLEWAR
1) Dentin substitute
3) Artificial dentin
Mc Lean
The glass is then ground to a fine powder, size ranging between 20µ
- Increase strength
- MALEICACID
- TRICARBOXYLICACID
- TARTARICACID
- WATER
- Increases WT
- Increases translucency
- Improves manipulability
- Increases strength
• Type I – Luting
• Type II – Restorative
• Type III – Liner/base
• Type IV – Pit & fissure sealant
• Type V – Luting for orthodontic purpose
• Type VI – Core buildup material
• Type VII – High fluoride releasing command set
• Type VIII – Atraumatic restorative treatment
• Type IX − Pediatric Glass Ionomer cements
F. NEWER CLASSIFICATION
• Powder, liquid
ANHYDROUS CEMENT
• Anhydrous cement was introduced in order to avoid increased viscosity
due to Increasing molecular weight of polyacids.
• In this freeze dried polyacid powder and glass powder are
placed in the same bottle
• Liquid is water or water with tartaric acid
• Also called as water settable cement
• Facilitates mixing and extends shelf life
INDICATIONS
1. Restorative materials:
• Core build-up
• Provisional restorations where future veneer
4. Finishing
2. Isolate the tooth with rubber dam where there is any risk of gingival
seepage or bleeding.
5.Apply a surface conditioner to the cavity to remove the smear layer and
improve the adhesion.
6. Dispense the cement on a cooled glass slab and mix quickly (30 secs for
hand mixing and 10 secs for machine mixing). Alternatively a paper
pad can be used. The mix should have a glossy appearance
Hand dispensing
9. Allow to set.
13. The final polishing should be delayed till the next appointment or at least
24hours.
The glass particles are attacked at the surface by poly acid which leads to
withdrawal of the cations thus the glass network breaks down to silicic acid.
Principally Al3+, Ca2+, F-, are released and migrate into aqueous phaseof
cement and form complexes
• Role of fluoride
• Glass composition
• Particle size
• Temperature of mixing
THE ROLE OF WATER
acrylate salts.
Early contamination
• Loss of translucency
Dehydration
• Softening of surface
CRACK IN UNPROTECTED GIC
• Loss of matrix-forming ions
• Water present in set cement can be classified in to two forms:
:
LOOSELY BOUND WATER
Water is easily lost and gained by the cement as the loosely bound water is
labile.
TIGHTLY BOUND WATER
• Petroleum jelly, cocoa butter, waterproof varnishes, and even nail varnishes
have been recommended as suitable surface coating agents.
• Coatings are lost by oral masticative wear, but by this time the cements
become more resistant to variations in water balance due to their post-
hardening.
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
• Among the coating strategies, light-polymerized resin coatings have been
considered the optimal surface protecting agent.
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
LINEAR ELASTICMECHANICAL
PROPERTIES
WEARANDFATIGUE
THERMALCOMPATIBILITY
PROPERTIES
ADHESION
ANTICARIOGENIC PROPERTIES
BIOCOMPATIBILTY
AESTHETICS
Linear-Elastic Mechanical Properties
• The compressive strength of GIC is commonly measured after 24 hours wet
storage.
• Compressive strength ranges between 60 and 300 Mpa and flexural
strength up to 50 Mpa .
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ULRICHLOHBAUERet al Materials2010,3,76-96
Properties Of Restorative Gic
PROPERTY GLASS CERMET HYBRI
IONOMERII D
IONOMER
1.Compressi 150 150 105
ve
strength(Mpa)
2.Diametrcal 6.6 6.7 20
tensile
strength(Mpa
)
3.Knoop 48 39 40
hardness(KH
N)
4.Solubility(AN 0.4 - -
SI/ ADA Test)
5.Pulp response mild mild mild
Properties Of Luting Gic
PROPERTY VALUES
• The number of occlusal contacts per day at medium chewing forces was
estimated to range between 300 to 700 cycles.
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
• Occlusal contact area (OCA) wear has been designated as material loss by
direct interaction of an antagonist with the restorative material.
• GIC exhibit a CFA wear five times higher than amalgam and three times
higher than resin composite materials.
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
THERMAL COMPATIBILITY
• The tooth structure and restorative materials in the mouth will expand upon
heating by hot foods and beverages but will contract when exposed to cold
substances.
• Such expansions and contractions may break the marginal seal of an inlay
or other fillings in the tooth, particularly if the difference in coefficient of
thermal expansion (CTE) is great between the tooth and the restorative
material.
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
• practically relevant temperature range between 20 °C and 60 °C, materials
such as resinous composites and amalgam expand more than the tooth
tissue, whereas porcelain and glass ionomer cements are well adapted to the
tooth tissue.
ANTICARIOGENIC PROPERTIES
Dental Glass Ionomer Cements As Permanent Filling Materials – Properties ,Limitations And
Future Tends – ulrich lohbauer Materials 2010,3,76-96
FLUORIDE RELEASE
• Thickly mixed cements release more flouride than thinly mixed ones.
themselves by fluorides.
• From saliva there is an ion exchange of fluoride ions diffusing from GIC
applications , tooth pastes and mouth rinses can recharge the GIC restoration
with fluoride.
.
AESTHETICS
Glass ionomer cement has got a degree of translucency because of its glass
filler .
Unlike composite resins, glass ionomer cement will not be affected by oral
fluids.
Because of slow hydration reactions glass ionomer cements take at least 24
hrs to fully mature & develop translucency.
• 2. particle size
• Glass ionomers bond permanently to tooth structure and also to other polar
substrates such as base metals.
• Barriers of adhesion 1) water
2) dynamic nature of tooth material.
Mechanism Of Adhesion According To Different Authors:
.
1.Chelation (Smith)
carboxylic groups
polyacrylates is formed.
IMPROVING ADHESION
Surface Conditioning
• Smoothing of surface irregularities
Surface-active solution 60
Dodicin, 0.9% aq 60
Na2EDTA, 2% aq 30
Na2EDTA, 15% aq 30
Sodium flouride, 3% aq 30
• Acid erosion –glass ionomer < silicate < zinc phosphate < poly
carboxylate
Marginal
seal
No
secondary
caries GIC Fluoride
release
Bioactive
• Glass ionomer cement showed greater inflammatory response than ZOE
but less than Zn phosphate cement, other cements but it resolved in 30 days
Reference book :Glass Ionomer Cement :Alan D Wilson/ john w.McLean chapter 8 page
no.126
SANDWICH TECHNIQUE
CLASSIII RESTORATIONS
SANDWICH TECHNIQUE
• Etching with 37% phosphoric acid for 1 min causes surface roughness
• The size of the fissure should allow sharp explorer tip to enter the crevice
which should be > 100 µ wide. Otherwise, GIC can get lost through erosion
due to its low wear resistance and solubility.
CORE BUILD UP
• The metal reinforced glass ionomer cements are used for this purpose
• Glass ionomer cements reinforce the teeth &prevent root fracture when root
canals are over widened.
TUNNEL PREPARATION
• First described in 1963
DEFINITION: RMGIC can be defined as a hybrid cement that sets via an acid
base reaction and partly via a photo- chemical polymerization reaction.
Eg: Fuji II LC, Vitrebond, Photac –Fil, Vitremer, FujiV
• Fluoride release: is same as that of the conventional but the lining version
shows higher F release
• Strength: The diametrical tensile strength is much higher but compressive
strength and hardness is lesser.
• Adhesion: to tooth is reduced. This is expected because of reduction in
carboxylic acid in the liquid and interruption of chemical bonding due to
the resin matrix.
• Due to reduced water and carboxylic acid content , reduces its wetting
capacity.
• Water sensitivity is considerably reduced.
Ca (OH)2 in deep preparations should be taken and the transient t0 rise during
setting is also a concern.
INDICATIONS:-
Luting cement in orthodontics
Powder
• Glass –17.5%
• Silver –82.5%
Particle size of silver is 3 – 4µm
Liquid
• Aqueous solution of copolymer of acrylic acid and
or maleic acid—37%
• Tartaric acid 9%
Disadvantages
• Poor resistance to abrasion
• Resistant to burnishing
• Poor aesthetics
• Also called as cermet ionomer cements
Contraindications
Anterior restorations.
Strength-
• Both tensile and compressive strength is greater
than conventional glass ionomer cement
Modulus of elasticity-
• Tends to be relatively lower than conventional gic
Abrasion resistance-
• Greater than conventional gic due to silver particle incorporartion
Radiopacity:
• In this study cermet glass ionomer showed the least microleakage and the
best sealing ability among other retrograde filling materials.
IMPROVED TRADITIONAL GIC :
B) LOW PH ‘SMART’MATERIALS
BIOACTIVE GLASS
FIBRE-REINFORCED GIC
GIOMER
ZIRCONOMER
HAINOMER
AMALGOMER
SIGNIFICANT FACTORS
Adhesion is stronger.
Radioopacity - adequate
- Intermediate restoration
- core build- up materials Eg.
• They concluded that Ketac Molar Easymix and Fuji IX presented the best
performance in all the tests.
• The found that among all Fuji IX presented the best results after 1hour.
• Following 24-hour storage, Fuji IX, Ketac Molar, and Vitro Molar had similar
performance.
• Except for Fuji IX, all materials presented higher compressive strength values after
24 hours than after 1 hour.
• endodontic sealers
eg: Fuji lining LC, Fuji III and IV, Ketac – Endo.
POLYACID MODIFIED GIC /COMPOMER
FLUORIDE
DURABILITY
RELEASING
OF COMPOMER
CAPABILITY
COMPOSITES
OFGIC
• Definition: Compomer can be defined as a material that contains both the
essential components of GIC but at levels insufficient to promote the acid –
base curing reaction in the dark .
• NaF and some other fillers are also present for additional F release and
Radio opacity.
• Stage II : occurs over 2-3 months when the water from the saliva gets
absorbed and initiates a slow acid base reaction with formation of hydro
gels within the resin and low level fluoride release.
PROPERTIES
• ADHESION: to tooth requires acid –etching because acid base reaction for
ion exchange requires water which does not occur for some time after
placement.
1. P& F sealant
2. Restoration of 10 teeth, class III and V lesions along with cervical
abrasions and erosions and intermediate restorations.
ADVANTAGES
Ease of use
Good esthetics
• Recently, a 2 component compomer is being marketed as a P: L system or
2 paste system meant exclusively for luting.
• These are self adhesive due to the presence of water which starts off the
acid base reaction.
• The powder contains the glasses, fluoride & chemical / light initiators.
• liquid contains the monomers, Polyacrylic acid, water and activators. These
set via light chemical polymer as well acid base reaction.
SELF HARDENING RMGIC
• Ease of handling
• Fluoride release
• Bioactive glass can form intimate bioactive bonds with the bone cells and
get fully integrated with the bone.
• Bio-active glass (BAG) can act as a source of a large amount of CaO and
P2O5 in a Na2O–SiO2 matrix with a rapid dissolution rate and high ionic
concentration.
• BAG 45S5 exhibits a high bioactivity index (IB = 12.5) compared to other
bio-active materials such as hydroxyapatite (IB = 3), and therefore it has
the potential to remineralise enamel white spot lesions with an increased
rate of HA formation.
Enamel white spot lesions can remineralise using bio-active glass and polyacrylic
acid-modified bio-active glass powders hussam mily et al JCD 2014;14
It is being used experimentally as
• Bone cement
• implant cementation
• Incorporation of alumina fibres into the glass powder to improve upon its
flexural strength
• Giomers are available in market as one paste form and these are light
polymerizing and require bonding agents for adhesion to tooth structure..
ADVANTAGES
• Fluoride release
• Fluoride recharging
• Biocompatibility
• Smooth surface finish & esthetics
• Excellent bonding
• Clinical stability
• Beautifil II is a second generation giomer introduced into market claiming
better optical properties than RMGIC.
Clinical evaluation of giomer and resin modified glass ionomer cement in class V noncarious
Lesions: An in vivo study jyothi et alJCD2011;14(4)
ZIRCONOMER
• Easy mixing and handling characteristics minimize chair time and enables
ease of bulk placement
• These are restoratives which are glass ionomer based but with the strength
of amalgam.
• They have been found to have exceptional wear characteristics, along with
other advantages of GIC
• According to bahadure et al conducted a study to estimate fluoride release
of six different dental restorative materials namely Amalgomer CR, Fuji II,
Fuji IX, Beautifil II, Dyract extra, and Coltene Synergy.
An estimation of fluoride release from various dental restorative materials at different pH:
In vitro study Bahadure, et al JOURNALOF INDIAN SOCIETYOFPEDODONTICSAND PREVENTIVEDENTISTRY2012 ;30(2)
HAINOMERS
• These are mainly being used as bone cements in ora maxillofacial surgery
and may have a future role as retrograde filling material.
• Studies have shown that they have a role in bonding directly to bone and
affect its growth and developement
New Fluoride Releasing GIC’s
organisms
GIC’s have come a long ways since its modest beginning in 1969.
Even though research can boast of substantial improvements, certain
essential properties still seem to be wanting and further clinical trials are
warranted for a majority of these developments.
At this point of time, we are left wondering if GIC will ever be able to
dominate tomorrow’s restorative scene or will it go into total oblivion.
Let us wish GIC all the best for the coming years
REFERENCES