1

Good Morning
 2

GLASS IONOMER CEMENT

3
4
 5

INTRODUCTION
DEFINITION OF CEMENT:

A cement is a substance that hardens to act as a

base,liner,filling material or adhesive to bind
devices/prosthesis to the tooth structure or to each
other.
[Philips’ science of dental materials]
 6

DEFINITION OF GLASS IONOMER CEMENT

-’Glass ionomer is the generic name of a group of

materials that use silicate glass powder &
aqueous solution of polyacrylic acid’
[Kenneth J Anusavice]
 7

McLean 1994

Cement that consist of a basic glass and an

acidic polymer, which sets by an acid-base
reaction between these components.

ADA/ANSI sp. No.- 96

 8

HISTORY
-1971:Wilson and Kent first reported it[ASPA1]
-1972:Crisp and Wilson added tartaric acid
[ASPAII]
-Methyl alcohol was added-ASPAIII
-1973:First marketable material, ASPA IV
-1975:Crisp and Abel gave luting agent , ASPA IVa
-1977:Seed and Wilson gave metal reinforced
cements
-1978: Mc Lean and Glasser gave Cermet ionomer
cements
-1982:Prosser et al gave water activated cements ,
ASPA V
 9

OTHER NAMES-

ISO TERMINOLOGY-Poly alkenoate cement

In U.S-ASPA[Alumino Silicate Polyacrylate]

Dentin substitute

Man made dentin

Artificial dentin
 10

COMPOSITION-
 11

-AL2O3&SiO2:
Glass former
1:2/more by mass[ratio is crucial]

-CaF2:
Flux
Reduce temp-at which glass will fuse
Increase translucency of cement

-FLUORIDE:
Flux
Improves therapeutic value of the cement
 12

-AlPO4:
Improves translucency
Add body to cement paste

-CRYOLITE[Na3AlF6]
Flux
Increase translucency of set cements
 13

ROLE OF COMPONENTS IN LIQUID

-WATER:
Reaction medium
Slowly hydrates cross linked matrix
Hydrates the siliceous hydrogels-metal salts are
formed

-ITACONIC ACID,TARTARIC ACID&

MALEIC ACID
Improves handling characteristics
Increases working time
Shortens setting time
 14

INDICATIONS OF GIC

1. Erosive or abrasive lesion

2. Sealing and filling of occlusal pit and fissures
3. Restoration of primary teeth
4. Class V carious lesion
5. Class III carious lesion
 15

CONTRA-INDICATIONS

1. Class IV carious lesion

2. Lesion involving large areas of labial enamel
where esthetics is of major importance
3. Lost cusp areas
 16

CLASSIFICATION OF
GIC
 17

A.ACCORDING TO A.D. WILSON

AND J.W. McLEAN[1988]
-TYPE 1: Luting cements

-TYPE 2: Restorative cement

*a]restorative esthetic

*b]restorative reinforced

-TYPE 3-Liners and bases

 18

B.ACCORDING TO SKINNER

-TYPE 1:Luting

-TYPE 2:Restorative

-TYPE 3:Liners & Bases

 19

C.ACCORDING TO INTENDED APPLICATION

-TYPE 1:Luting

-TYPE 2:Restorative

-TYPE 3:Liner/Base

-TYPE 4:Pit & fissure sealant

-TYPE 5:Luting for orthodontic purpose

-TYPE 6:Core buildup material

-TYPE 7:High fluoride releasing/command set

-TYPE 8:Atraumatic restorative treatment [ART]

-TYPE 9:Pediatric use

20
21
22
23
 24

D.NEWER CLASSIFICATION
-TRADITIONAL GIC:

*a]Type 1:Luting
*b]Type 2:Restorative
*c]Type 3:Liners & bases

-METAL MODIFIED GIC:

*a]Miracle mix
*b]Cermet cement
25
 26

-LIGHT CURE GIC:

*a]HEMA added to liquid

-HYBRID GIC/RESIN MODIFIED GIC

*a]Composite resin in which fillers are substituted

with glass ionomer particles

*b]Precured glasses blended into composites

 27

SETTING REACTION
 28

ACID – BASE REACTION

-FLUORO ALUMINO SILICATE

glass powder

-POLYACRYLIC ACID

-WATER
 29

STAGES IN SETTING REACTION

 30

1.DECOMPOSITION OF GLASS/ION
LEACHING PHASE
Powder + Liquid mixed

Polyacid attacks the glass particles [k/a leaching] to

release Ca2+ & Al3+

Continuous increase in acidity

Because of which
 31

CaF2 dissociates

Reacts with acrylic

copolymer/polyacrylic acid

To form

A stable matrix
32
 33

APPERANCE OF THE
MIX:
-Glossy
-Adhere to tooth structure
 34

2.GELATION & VULNERABILITY TO

WATER:[Hydrogel phase]
CA2+ IONS are rapidly released

These ions cross links with polyacrylic acid ie.,Ca

bridges to form a Ca polycarboxylate gel in which
non reacted glass is embedded

INITIAL SETTING OF CEMENT IS BECZ OF

THIS RXN’
35
 36

APPERANCE OF THE
MIX

RIGID
OPAQUE
 37

3.HARDENING AND SLOW MATURATION

-Phase occurs when mix reaches its final set

-Continued attack of H+ ions causes delayed release of

Al3+ from silicate glass in form of AlF ions which are
deposited in the already preformed matrix to form a
water insoluble Ca-Al-Carboxylate gel

-Al ions are responsible for providing strenght to the

cement
 38

-This process continues for 24 hrs

-Undergoes slight expansion and increase in

translucency

-Cement becomes resistant to dessication and

strenght also increases for atleast a year

-Increase in strenght and rigidity are associated with

slow increase in cross linking
39
 40

STRUCTURE OF
SET CEMENT
41
 42

CEMENT
MANIPULATION
43
44
 45

-Full spoon of powder to be taken

-Liquid bottle is shooked and then tilted sideways and
then inverted completely
-Do not mix beyond 30s
-First ½ mixed with liquid for 10 s; second ½
incorporated in the 1st for 15s
-Area of mixing small
-Mixing time not to exceed 45-60s
-Mix should have ‘GLOSSY’ appearance; residual acid
on surface is critical for bonding
 46

LOSS OF GLOSS
TEST
47
 48

-TYPE I:Luting cement[forms string upto 3-

4cm+gloss]

-TYPE II-Restorative cement[string upto 1cm+gloss]

-TYPE III-Liners and bases[forms string upto 3-

4cm+gloss]
 49

WORKING AND
SETTING TIME
 50

-WORKING TIME[W.T]

*W.T:3-5 min

-SETTING TIME[S.T]

*S.T for Type 1 GIC---5-7 min

*S.T for Type 2 GIC---10 min
 51

FACTORS AFFECTING RATE OF

SETTING
1]Glass composition-increased Al/Si ratio-FASTER SET

2]Particle size-FINER THE PARTICLE SIZE FASTER THE

SET

3]Tartaric acid-SHARPENS SET WITHOUT SHORTENING

WT

4]Relative proportion of constituents-P/L RATIO

5]Temperature of mixing-INCREASE IN TEMPERATURE

CAUSES FASTER SET
 52

-Among these factors,those within the province of

clinician are:

1]Temperature of mixing
2]P/L ratio
 53

-FACTORS WITHIN THE PROVINCE OF CLINICIAN

1]TEMPERATURE OF MIXING:

-Chilling the powder and mixing pad-increases WT upto 25%

[McLean 1970]

-Increase in WT occurs without loss of physical properties

[Makinson 1978]

-WORD OF WARNING!!

*Chilling of liquid will cause gelation

*Increase in humidity and temperature below dew point-
weakens the cement
 54

2]POWDER-LIQUID RATIO

-Increase in powder-FASTER SET

-But insufficient liquid-DECREASE in translucency

of the set cement
 55

PROTECTION OF RESTORATION SUFACE

-Vaseline & petroleum jelly can be applied on restoration
surface

-Low viscosity resin cement

-Varnish

-Bonding agents are used for autocured/light cured GIC

 56

PROPERTIES OF
GIC
 57

1.BIOCOMPATIBILITY
-GIC is biocompatible because-
-Polyacrylic acid is a weak acid
-Long polymer chains tangle to each other which prevent their
penetration to dentinal tubule
-Freshly mixed cement has a pH of 0.9-1.6[acidic]
-This might result in mild inflammation that resolves within 10
– 20 days
-GIC showed greater inflammatory response than ZoE but less
than Zn phosphate cement & other cements[Garcia et al,1981]
-Pulp response to GIC is favourable
It is used to protect mechanical/traumatic exposure of healthy
pulp
 58

2.FLUORIDE RELEASE

-Contains 10-23% F- in the matrix

-Fluoride release peak in 1st 24 hrs after the mixing

-The influence of F- is seen at atleast 3mm around

the glass ionomer restoration

-It is released for a sustained period of 18

months[Wilson et al 1985]
 59

-F release can be sustained for a very long time &

shows a pattern of an INITIAL RAPID RELEASE
[EARLY BURST] followed by a SUSTAINED ,
LOWER LEVEL DIFFUSION BASED RELEASE

-F release increases in acidic conditions

-In addition these cements are able to counteract such

acidity , increasing the ph of the external medium-
process termed BUFFERING
 60

3.FLUORIDE RECHARGE

-Glass ionomers may have synergistic effects when used with

extrinsic fluorides

-In the presence of an inverse fluoride concentration gradient,

glass ionomer may absorb fluoride from the envioronment &
release it again under specific conditions

-Fluoride recharge takes place by

*application of topical APF[acidulated phosphate fluoride]
*fluoride rinses
*fluoridated dentrifices
 61

-The F uptake by GICs atleast in the early stages of

cement existence was originally proposed by
WALLS

-However this ability was found to be almost

completely lost on maturation
62
 63

4.THERMAL PROPERTIES

-The thermal diffusivity value of GIC is

CLOSE to that of dentin

-The material has an adequate thermal

insulating effect on the pulp & helps to protect
it from thermal trauma
 64

MATERIALS THERMAL DIFFUSIVITY

-GIC[CTE:10-14] 0.15-0.35

-TOOTH[CTE:11.4] ---

-ENAMEL 0.18

-DENTIN 0.47
 65

5.ESTHETICS
OVERVIEW:
-GIC has got a degree of translucency because of its glass filler
particles

-Unlike composite resins , GIC will not be affected by oral

fluids

-The ESTHETIC QUOTIENT depends on:

A]Refractive index of glass particles & matrix
B]Particle size
C]Translucency of glass particles

-Specification limits of GIC :0.35-0.90[for optimum esthetics it

is btw 0.35 to 0.90]
 66

TRANSLUCENCY
*GIC has a degree of translucency
*Because its filler is a glass[opaque]
*Because of slow hydration reactions , GIC take
atleast 24 hrs to fully mature
*Early contamination with water reduces translucency
*Dark shades are less translucent
*GIC remain unaffected by oral fluids
 67

-#OPACITY
*Also termed as CONTRAST RATIO[CR]
*If CR=1-MATERIAL IS OPAQUE
*If CR=0-PERFECTLY TRANSLUCENT
*To match ENAMEL CR<0.55
*GIC CR<0.9

#SCATTERING POWDER &

REFLECTANCE
*Opacity also depends on the scattering coefficient
*Light reflectance
 68

MISC. PROPERTIES

-Low exothermic rxn”

-Adheres chemically to the tooth structure
-Less shrinkage than polymerizing resins
-Dimensinally stable
-F release discourages microbial infiltration
-Poor abrasion resistance
-Avg.esthetics
 69

RECENT
ADVANCES
 70

1.WATER SOLUBLE GIC

-Liquid is delivered in a freeze dried form,which

is incorporated into the powder

-Liquid used:Water / Water with tartaric acid

 71

2.METAL MODIFIED GIC

i]MIRACLE MIX/SILVER ALLOY ADMIX GIC

-Seed & Wilson in 1980 incorporated spherical silver amalgam

alloy into Type 2 GIC POWDER in the ratio of 7:1

*POWDER
-Glass:17.5%
-SILVER:82.5%[Particle size of silver is 3-4 micron mtr

*LIQUID
-Aq. Soln of copolymer of acrylic acid & / maleic acid:37%
-Tartaric acid:9%
 72

-DISADVANTAGES:
*Poor resistance to abrasion
*Resistant to burnishing
*Poor esthetics
 73

GLASS CERMET

-Also called as CERMET IONOMER

CEMENT
-McLean & Grasser in 1985 frst
developed it fusing the glass glass
powders to silver particles through
sintering that can be made to react
with polyacid to form the cement
*INDICATIONS
A]Core build up material
B]Class 1 cavities in primary teeth
C]Preventive restoration
D]Temporary posterior restoration
 74

*CONTRAINDICATIONS:
A]Ant.restoration
B]Areas subjected to high occlusal
loadings

*PROPERTIES
#Strenght:
-Both tensile & compressive strength
is greater than conventional GIC

#MOE:
-Relatively lower than conv.GIC

#ABRASION RESISTANCE
-Greater than that of conventional
GIC due to silver particles
incorporation
75