GLASS IONOMER

CEMENT

Jayalakshmi Preetha M
CRI

Dept o endodontics
 CONTENTS
• DEFINITION • ROLE OF WATER
• COMPOSITION • COATING MATERIALS
• CLASSIFICATION • PROPERTIES
• MODE OF SUPPLY • APPLICATIONS IN RESTORATIVE DENTISTRY
• INDICATIONS • APPLICATIONS IN ENDODONTICS
• CONTRAINDICATIONS • MODIFICATIONS OF GIC
• SETTING REACTION • RECENT ADVANCES OF GIC
DEFINITION
 DEFINITIONS

“Glass-ionomer is the generic name of a group of materials

that use silicate glass powder and aqueous solution of
polyacrylic acid” - Kenneth J Anusavice

“Glass ionomer cement is a basic glass and an acidic polymer

w•hich sets by an acid- base reaction between these
components”
JW McLean, LW Nicholson. AD Wilson
• GIC Acquired its name from its composition of glass particles and
an
ionomer that contains carboxylic acid.

• Extensive use of this cement to replace dentin , has given it

different names:

1) Dentin substitute

2) Man made dentin

3) Artificial dentin

4) Alumino Silicate Polyacrylic Acid(ASPA)

COMPOSITION
POWDER
SiO2 –30.1%
Al2O3 –19.9%
AlF3 –2.6%
CaF2 –34.5%
NaF2 –3.7%
AlPO4 –10.0%
 Basic component is a calcium alumino silicate containing fluoride.

 Glasses are prepared by fusing the components between 11000c - 15000 c

then pouring the melt onto a metal plate or into water.

 The glass is then ground to a fine powder, size ranging between

20µ for luting to 50µ for restoration.

 They get decomposed by acids due to the presence Al +3 ions which
can easily enter the silica network.
 It is this property that enables cement formation.
.
 Alumina (Al2
O3)  Calcium fluoride (Ca F2)
- Increase opacity
- Increase opacity
- Acts as flux
 Silica (SiO2)
Aluminium phosphates
- Increase Translucency
- Decrease melting temp.
 Fluoride:. Its has
- Increase translucency
5 functions
Cryolite (Na3 Al F6)
- Decrease fusion temp.
- Increase translucency
- Anticariogenecity
- Acts as flux
- Increase translucency

- Increase working time

- Increase strength
 LIQUID
- POLY ACRYLIC ACID
- 40% TO 50%
- ITACONIC ACID

- MALEIC ACID

- TRICARBOXYLIC ACID

- TARTARIC ACID

- WATER
• water is an important constituent of GIC, It is the reaction
medium

and helps in hydrating the matrix.

• The three acids itaconic ,maleic and tricarboxylic acid

decrease viscosity of liquid , Promote reactivity, prevent

gelation of liquid.
ACCORDING TO USES:

• Type I – Luting
• Type II – Restorative
• Type III – Liner/base
• Type IV – Pit & fissure sealant
• Type V – Luting for orthodontic purpose
• Type – Core buildup material
VI – High fluoride releasing command set
• Type – Atraumatic restorative treatment
VII − Pediatric Glass Ionomer cements
• Type VIII
• Type
MODE OF SUPPLY

• Powder, liquid

• Pre proportioned
capsules
 INDICATIONS

1. Restorative materials:

• Restoring of erosion/ abrasion lesions without cavity

preparation.
• Sealing and filling of occlusal pits and fissures
• Restoration of deciduous teeth.
• Restoration of class III lesions, preferably using a

lingual approach with labial plate intact.

• Repair of defective margins in restorations

• Minimal cavity preparations – Approximal Buccal and Occlusal

lesions, approach (tunnel preparation)

• Core build-up

• Provisional restorations where future

veneer crowns are contemplated

• Sealing of root surfaces for overdentures.

2. FAST SETTING LINING CEMENT
AND BASES:

• Lining of all types of cavities where a biological seal and cariostatic

action are required

• Replacement of carious dentin and the attachment of

composite
resins using the acid etch technique .

• Sealing and filling of occlusal fissures showing early signs

of
caries.
3. LUTING
CEMENT:

• Fine grain versions of the glass ionomer cement are

used.

• Useful in patients with high caries index

 CONTRAINDICATIONS

 Class IV carious lesions or fractured incisors.

 Lesions involving large areas of labial enamel
where esthetics is of major importance
 class II carious lesions where conventional
cavities are prepared.
 Replacement of existing amalgam
restorations.
 Lost cusp areas.
SETTING REACTION
• IT IS AN ACID BASE REACTION BETWEEN ACIDIC POLYELECTROLYTE
AND BASIC GLASS POWDER.

DECOMPOSITION ---DECOMPOSITION OF GLASS POWDER BY ACID RESULTING IN

RELEASE OF IONS.

MIGRATION ---THESE IONS MIGRATE INTO AQUEOUS MEDIUM

GELATION ---CAUSED BY MULTIVALENT ALUMINIUM AND CALCIUM IONS

DISPLACING VARIOUS SPHERES OF HYDRATION THAT INTERPOSE THEMSELVES
BETWEEN CATION-ANION ION PAIRS

POST SET HARDENING AND SLOW MATURATION ---HARDENING AND

PRECIPITATION CONTINUE FOR ABOUT 24 hrs ACCOMPANIED BY SLIGHT
EXPANSION UNDER CONDITIONS OF HIGH HUMIDITY AND DEVELOPMENT OF
TRANSLUCENCY.
STAGES OF SETTING REACTION
WORKING TIME AND SETTING TIME :

• It sets rapidly in the mouth that is within 3-5

min and hardens to form a body having
translucency that matches enamel
• Setting time for type I –GIC – 5 -7 min
• Setting time for type II–GIC --10 min
 THE ROLE OF WATER

 Plays an important role in setting reacton and structure

of
cement.
 Acts as reaction medium

 Hydrates the siliceous microgel and metal

poly acrylate salts.

 EARLY CONTAMINATION

• Loss of calcium polyacrylate chains

• Loss of translucency

• Loss of physical properties

• Leaves cement susceptible to erosion

DEHYDRATION

• Cracking & fissuring of cement

• Softening of surface

• Loss of matrix-forming ions

CRACK IN UNPROTECTED GIC

• Water present in set cement can be classified in to two forms:

a) loosely bound water

b) tightly bound water

:
LOOSELY BOUND WATER

 Its is the water which is readily removed by desiccation .

 Water is easily lost and gained by the cement as the loosely bound water
is
labile.
 TIGHTLY BOUND WATER

 Its is the water which cannot be removed .

 Its is associated with the hydration shell of cation-polyacrylate bond.

 As the cement ages the degree of of hydration ↑ that is the ratio of tightly
bound to loosely bound water increases which in turn increases strength
and modulus of elasticity and decrease plasticity (according to wilson et al
1981).
 COATING MATERIALS

• Water plays a key role for proper maturation of GIC.

• water contamination and dehydration during the initial setting stages

can compromise the physical properties of the restoration.
• It is recommended to strictly exclude water during the vulnerable
setting stage, which is reported to last for atleast one hour until even
two weeks after placement.
• Petroleum jelly, cocoa butter, waterproof varnishes, and even nail varnishes
have been recommended as suitable surface coating.
• Light polymerised resin coatings are also used.
LINEAR ELASTIC MECHANICAL
PROPERTIES

WEAR AND FATIGUE

THERMAL COMPATIBILITY
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 .
• GIC exhibit a significant increase (approximately 100%) in flexural as
well as in compressive strength when exposed to water in the period
between 24 hours and one year after mixing .
• When exposed to aqueous solutions of varying pH, GIC exhibited a high
acid erosion resistance compared to other restorative materials.
 WEAR AND FATIGUE

• Deterioration is described in general terms of wear, marginal breakdown

and fatigue fracture due to cyclic loading.
• Braem et al.proposed average human chewing stresses between 5 MPa
and 20 MPa at a chewing frequency of approximately 2 Hz.
• The number of occlusal contacts per day at medium chewing forces
was estimated to range between 300 to 700 cycles.
• In dentistry, the loss of material due to non-antagonistic contacts have
been
defined as occlusal contact free area (CFA).
• 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.
• Failure mechanisms such as void nucleation, crack propagation and
detachment of particles or sudden, subcritical failure are common
features in wear and fatigue.
 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.
• 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

• Fluoride is the most effective agent in caries prevention.

• The metabolism of the bacteria that cause caries is inhibited and the resistance
enamel and dentin is increased due to the remineralization of porous or softene
enamel and dentin.
• Sustained, long-term fluoride release especially in marginal gaps between fillin
material and tooth help prevent secondary caries of the dental tissues.
• For conventional GIC, an initial release of up to 10 ppm and a constant long-
term release of 1 to 3 ppm over 100 months was reported.
 FLUORIDE RELEASE

• The influence of fluoride action is seen of at least 3 mm around the glass

ionomer restoration and is released for a sustained period of 18 months (Wilson et a
1985)
• Thickly mixed cements release more flouride than thinly mixed ones.

• Fluoride release is restricted by sodium and to some,extent by calcium

content.
• Water plays a critical role in the fluoride release of GIC , the aqueous phases of the
set GIC exist in he form of hydrogels that allow chemical equilibrium with an ion
movement between GIC and the oral cavity & surrounding tooth structures.
• GIC is also described as ‘smart” restorative material because apart from

releasing fluoride to surrounding tooth structure, they can also

“recharge”

themselves by fluorides.

• This is also referred to “reservoir effect”.

• From saliva there is an ion exchange of fluoride ions diffusing from GIC

(area of high conc.) to the tooth (area of low fl conc.).

• Released fluoride is incorporated in to hydroxyapatite crystals of

the enamel and dentin over an area of approx. 1-3 mm surrounding

the restoration forming hydroxyfluorapatite.

• Fluoride containing oral care products including topical fluoride gel

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.
 Early contamination with water reduces translucency.
 Dark shades are less translucent .

 The esthetic quotient depends upon:-

• 1. Refractive index of glass particles and matrix

• 2. particle size

• 3. translucency of glass particles

 Specification limits of GIC 0.35 - 0.90 (for optimum aesthetics it is

between 0.35 – 0.90 )
 ADHESION

• 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)

2. Hydrogen Bonding Followed By Ionic Bond

(Wilson)

3. Hydroxyapatite & Polyacrylic Acid Interaction

(Beech)

4. Hydrogen Bonding With Dentin Collagen

(Akinmade )
Acc. to Wilson(1974)
• Initial adhesion is by hydrogen bonding from

free carboxylic groups

• Progressively these bonds are replaced by ionic
bonds
• Polymeric polar chains of acids bridge the

interface between cement and substrate

Acc. to Wilson, Prosser and Powis(1983)

• Polyacrylate displaces and replaces surface

phosphate and calcium from hydroxyapatite

•An intermediate layer of Ca and Al phosphates and

polyacrylates is formed.
 EROSION

• Erosion is as a result of chemical attack and mechanical wear

• Chemical erosion is due to acids generated by dental plaque,or contained
in food and beverages
• Acid erosion –glass ionomer < silicate < zinc phosphate < poly
carboxylate
BIOCOMPATABILITY

Marginal
seal

No
secondary
caries GIC Fluoride
release

Bio active
 SANDWICH TECHNIQUE

First described By Mc Lean & Wilson In 1977.

The procedure involves :-
• Placing GIC as base of cavity .

• Etching with 37% phosphoric acid for 1 min causes surface roughness

• Dentin bonding agent is applied.

• Placing composite restoration.

 ADVANTAGES
INCLUDED:

• GIC acts as a dentin substitute

• The high contraction stresses produced (2.8 – 3.9 Mpa) by the
polymerization shrinkage are reduced as the amount of composite
is reduced .
• Microleakage is reduced.
• Minimization of no. of composite increments, therefore time is
saved.
Open and close technique
 PIT AND FISSURE SEALANTS

• A cariostatic action is essential for caries ,preventive material GIC is

recommended as a P and F sealant where the orifices of the fissure
are patent .
• 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

• Conservative alternative cavity preparation in primary molars.

• Indication:- Small proximal caries with out involvement of

marginal ridges.
 GIC IN ENDODONTICS
They are used for:
• Root end fillngs
• Root canal sealer
• Perforation repair
• Intraorifice barriers
• Temporary coronal restorations
GIC is used because of :
• Its capacity to bond which enhances
seal & reinforce the tooth
• Its good biocompatibility, which would
minimize irritation to peri radicular tissues
• Its F release ability, which imparts an
antimicrobial effect
to combat root canal infection.
 RESIN
MODIFIED GIC
MODIFICATIONS OF
GIC
METAL
MODIFIED GIC
 RESIN MODIFIED GIC

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

• Developed by Antonucci, Mc Kinney and SB mitra.

• It was developed in between late 1980s and early 1990s .

• Resin modification of glass ionomer cement was designed to produce

favourable physical properties similar to those of resin composites
while maintaining basic features of conventional GIC.
• Addition of polymerizable resins to the formulation is done to
import additional curing process to the original acid base reactions.
• The HEMA content is around 15-25% and water content is low
to accommodate the polymerizable ingredients.
• It is a powder : liquid system with P:L = 3:1

• These products are considered to be dual –cure cements if only one

polymerization mechanism is used , if both mechanisms are used they
are considered to be tri-cure cements.
 METAL MODIFIED GIC
MIRACLE MIX / SILVER CERMET
• Silver cermet was introduced by Simmons in year 1983.
• Sced and Wilson in 1980 incorporated spherical silver amalgam alloy
into
Type II GIC powder in a ratio of 7:1.

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

• McLean and Gasser in 1985 first developed

• Fusing the glass powder to silver particles through sintering that can
be made to react with polyacid to form the cement
• Sintering is done at high pressure more than 300MPa and at a
temperature of 8000C which is ground to fine powder particle size of 3.5
µ
• 5% titanium dioxide is added as whitening agent to improve aesthetics.

• It has excellent handling characteristics.

 IMPROVED TRADITIONAL GIC :

 - HIGHLY VISCOUS/ PACKABLE GIC

 - LOW VISCOSITY GIC
 POLYACID MODIFIED GIC /COMPOMER

 SELF HARDENING GIC

 NEW FLUORIDE RELEASING GIC:

A) FLUORIDE CHARGED GIC

B) LOW PH ‘SMART’ MATERIALS

 BIOACTIVE GLASS

 FIBRE-REINFORCED GIC

 GIOMER

 ZIRCONOMER

 HAINOMER

 AMALGOMER

 CHLORHEXIDINE IMPREGNATED GIC