Glass Ionomer ( Part 2 ) What's Glass ionomer & its Classification ? ( conventional & RMGIC ).

What's a Glass ionomer?

it's a restoration which consists of ( Glass powder + Liquid ).

Glass Powder, the powder is composed of mainly ( Fluoro-Alumino-silicate glass particles ).

Calcium Fluoride + Sodium Fluoride + Radiopaqu e materials.

N.B) as you notice, Glass ionomer powder has a high percentage of Fluoride which makes it ( Anti Cariogenic ).

Liquid ( Polyacrylic acid + water )

 

A mix of ( Powder & Liquid ) is an Acid-base reaction.

mixing leads to metal precipitation & Aqueous solution ( Which is called Gelation Phase )

in Gelation Phase, restoration becomes:

easy to wash off

High solubility

No reach for full strength

and prevent that with Varnish application for 24h.

After 24h, the Gelation phase is completed to give Unreacted unsoluble GI restoration.

VARNISH is used with all glass ionomer Restoration where protection from moisture is required. This product self-cures quickly to put a smooth, sealing finish on glass ionomer restorations.

(GC Fuji VARNISH )

Classification of Glass ionomer?

according to ( Uses ):-

Type 1 Luting Cement ( for cementation of crown & bridges ).

Type 2 Restoration Cement ( restoration ).

Type 2 ( I ) Restorative Esthetic 

 Ionolux, VocoGmbH™ 

Type 2 ( II ) Restorative Reinforced

Riva GI,© Universal Dental ( Pvt ). 

Type 3 Liner / Base ( Base under restoration like Amalgam & Composite ).

Ionoseal, Voco GmbH ™ 

Type 4 Pits & Fissure sealant.

Composeal, ProMedica DM GmbH ™ 

Type 5 Orthodontic Cement.

RelyX™,3M™

GC Fuji ORTHO™ BAND,© GC America Inc.

Type 6 Core Build-up Material.

Vitremer Core Build-Up,3M™

Type 7 High Fluoride releasing command set 

Type 8 Atraumatic restoration treatment 

Type 9 Pediatric GIC.

according to ( Mixture):-

Powder & liquid

Water settable

Capsule " most useable type in the market "

 Main Type of Glass Ionomer in Market

1) Conventional GIC: is a glass ionomer cement developed as a transitional restorative material for clinical situations where a high rate of Caries and strong clour contrast are preferred.

For example

🌟) PREVEST MICRON SUPERIOR II 

Glass ionomer restorative self-cure in hand mix version for restoration of primary teeth

 Benefits:

High fluoride release.

2) Metal Conventional GIC: is a silver alloy - glass ionomer cement developed as a core build-up and transitional restorative material for clinical situations where high radiopacity and strong colour contrast are preferred.

For example

 a) Miracle Mix,© GC America Inc.

Spherical Silver amalgam alloy + Type II GIC Powder (7:1).

Indications: 

Core build-up Material & Class I ( Pedo ).

Disadvantage :

Poor Esthetic 

Poor Abrasion resistance

Weak matrix interface

Rough surface with a finishing & polishing

b) Ketac™,3M™.  ( Silver-reinforced glass ionomer restorative )

 

Indications:

Core build-up Material

Class I ( Pedo )

Base under amalgams

Contra-Indications:

Anterior Restoration 

high occlusion loading

Disadvantage :

Poor Esthetic

Tooth discolouration

Poor Abrasion resistance

Difficult mixing

 (N.B) These Products Are not available for Purchase by General Public.

1) Resin Modified GIC ( RMGic): hybrid material of traditional glass ionomer cement with a small addition of light-curing resin, and hence exhibit properties intermediate to the two, with some characteristics superior to conventional glass ionomer materials.

Advantage :

increase esthetic & physical properties

increase Fluoride release 

increases abrasion resistance

Fluoride Recharge

Dual or Light curing, which gains control of working time

Disadvantage :

Poor Margin Elevation

increase Shrinkage during the setting or curing phase

Maximum Layer = 2mm ( require using Incremental Tech.)⭐⭐

For example

1) Restoration 

2) Cement 

3) Liner/base 

4) Core build-up

1) Restoration 

a) Riva GI,© Universal Dental ( Pvt ). ( Resin Reinforced Glass Ionomer Restorative Material )

Can be:-

Light Cure Capsules

Light Cure Capsules HV ( high viscosity )

Self Cure Capsules

Light Cure P/L 

Self Cure P/L 

Silver Capsules

Silver P/L.

N.b ( Mostly Light Cure Capsules & Light Cure Capsules HV only present in markets )

Advantages:

Easy Activation ( 70% easier to activate.

This saves you time and effort when preparing a restoration.)

A unique blend of different sizes of ultrafine highly reactive glass particles

Bioactive proprietary hybrid glass  enables long term restoration

Highly Strength and esthetics

Bonds chemically to tooth, no etching or adhesive is required.

Less of sensitivity

High Flexural strength 

High fluoride release 

Exceptional handling 

Optimal translucency 

Indications:

small Class I

Class III

Class V

Cervical erosion

Abfraction lesions

Root surface restorations

Core build-up

Deciduous teeth restorations

Geriatric restorations

Temporary fillings

ART technique restorations

Dentine replacement

Sandwich technique restorations

Molar Incisal hypomineralisation (MIH) (intermediate approach)

Liner except (Light Cure Capsules HV ).

Pit and fissure sealant except (Light Cure Capsules HV ).

The main difference between Rive Light Cure Capsules & Rive Light Cure Capsules HV are:-

Rive Light Cure Capsules 

Class III

Class V

A lot of shades ( 12 Shades )

Pit and fissure sealant

Liner

Rive Light Cure Capsules HV 

Small Class I

Able to condensation 

Not sticky 

Sandwich technique restorations

Deciduous teeth restorations

b) Photac™ Fil Quick Aplicap™,3M™.  ( Duel Cure reinforced glass ionomer restorative )

 

Advantages :

Dual cure provides light-cure control and the assurance of a complete cure

High fluoride release

Excellent mechanical properties

 radiopaque

biocompatible

Convenience, simplicity and accuracy of the Aplicap delivery system

self-adhesive property eliminates the need for bonding and cavity conditioning

Don't need Dentin Conditioner or Glazing, which Less time Consuming

Indications:

Class III and Class IV restorations.

Small Class I restorations.

Primary tooth restorations.

Temporary restorations.

Contra-Indications:

Don't use it as a base under Composite,

Because it has Less amount of Resin makes make it has Bonding Strength with Resin Composite compared with other RMGI

c) Ionolux, VocoGmbH™ ( light-cured resin-modified glass ionomer restorative material )

 

Advantages :

Composite-like esthetics

Light-curing for a fast finish

Immediately packable after application

Does not stick to the instrument, easy to shape

Excellent translucency for better esthetic results

High fluoride release minimizes

 secondary caries

Highly radiopaque

No dentin conditioner or adhesive is needed 💗

Indications:

Class III and Class V restorations.

Root caries 

Small Class I restorations.

Primary tooth restorations.

Temporary restorations.

d) GC Fuji AutoMix LC,© GC America Inc.  ( resin-reinforced glass ionomer available in AutoMix System) 

Advantages :

excellent bond strength because it forms a chemical bond to the tooth, even in presence of saliva.

Less Pulp Sensitivity

Automix ( Control Working & Setting time ).

Indications:

Core build-up Material

Base or liner under composite restorations.

Restoration of primary teeth (Pedo)

Permanent class III and V restorations

e) GC Fuji II LC,© GC America Inc.  ( resin-reinforced glass ionomer available in Powder & Liquid or Capsules)

Advantages :

excellent bond strength because it forms a chemical bond to the tooth, even in presence of saliva.

Less Pulp Sensitivity

Indications:

Base or liner under composite restorations.

cervical erosions/abfraction lesions and as a liner/base

Permanent class III and V restorations

  

Before we can compare different brands, we have to know some definitions like  :

1)Dentin Conditioner: 

this is a mild polyacrylic acid solution designed to remove the dentinal smear layer and to condition dentine and enamel before the application of your glass ionomer restorative.

It will increase the bond between your glass ionomer cement and tooth structure for added longevity.

N.B ( Not all types of Glass ionomer Restorations required Dentin Conditioner )

1)Glazing: is a Nano-filled light-curing coating for surface sealing, which uses

•  to Protect Glass inonmer restoration from Wearing 
•  Gives it Highly Glossy and aesthetic surfaces 
•  protection against discolouration of Glass ionomer or Composite Restoration.

Difference between RMGI ( Riva L.c.  Vs  Ionolux Vs Photac 3M Vs Fuji GC II )

1) Riva L.c.

need Dentin conditioner 

don't need varnish 

don't require Glazing

can use as Liner/Base except HV type.

Can't be used in Huge Bulk, as normal RMGI ( Maximum 2mm Layer)

2) Ionolux

don't need Dentin conditioner 

don't need varnish 

don't require Glazing

can use as Liner/Base 

 Can't be used in Huge Bulk, as normal RMGI ( Maximum 2mm Layer)

3) Photac 3M 

don't need Dentin conditioner 

don't need varnish 

don't require Glazing

cannot use as Liner/Base 

 Can't be used in Huge Bulk, as normal RMGI ( Maximum 2mm Layer)

4) Fuji GC II 

don't need Dentin conditioner 

need varnish 

don't require Glazing

cannot use as Liner/Base 

Can be used in Huge Bulk, not as normal RMGI ( More than 2mm)

2) Cement 

a) GC FujiCEM® Evolve, © GC America Inc. ( radiopaque resin-reinforced glass ionomer cement in a syringe delivery with a tack-cure feature and high radiopacity. It can be used for the cementation of a variety of substrates and different types of indirect restorations. )

Advantages:

Superior bond strength to Zirconia than a leading competitor

the new tack-cure feature reduces cleanup time to seconds

High radiopacity for easy visualization

Ideal for cementation of Zirconia, PFM and Lithium disilicate restorations

Rechargeable fluoride release & moisture tolerance

Indications:

               cementation of Zirconia, PFM and Lithium disilicate restorations

                                              Higher Strenght restoration

                                            need high marginal adaptation 

b)GC FujiCEM® 2,© GC America Inc.  (is a second-generation, resin-modified glass ionomer luting cement) "GC FujiCEM® Evolve"

 

Advantages:

High-elastic crosslink monomers with modified filler-surface treatment, which increases strength properties

Higher fluoride release 

Low film thickness 

Excellent marginal integrity 

Automix paste system ensures to obtain consistent mix every time

Indications:

               cementation of Metal, Resin, alumina and Zirconia-based inlays,onlay, crowns and bridges 

c) RelyX™,3M™  (RMGI cement with a tack light cure option that shortens cleanup to seconds.)

Advantages :

A long history of Bond Strength

Sustained Fluoride release

No post-operative sensitivity

Moisture tolerant

Indications:

PFM Crown & Bridges Cementation

Metal Crowns, Onlays, inlays

All-alumina or all-zirconia Core ceramic restoration (such as Lava™ Zirconia or Procera® AllCeram).

Orthodontic bands

Final Cementation of the crown - implant abutments

3) Liner/base 

a) Vitrebond™,3M™  (light cure glass ionomer liner/base).

Advantages :

Excellent adhesion to 3M dental adhesive system, whether using composite or amalgam.

Sustained Fluoride release to help protect the tooth long after the restoration is complete.

Produces zone of inhibition against bacteria 

Forms a strong bond to dentin, sealing the tooth to reduce the incidence of microleakage which helps reduce post-operative sensitivity.

Fast technique and excellent handling characteristics allow for quickness & easies.

Indications:

Under Composite, amalgam, metal and ceramic restorations

b)NOVASEAL, President Dental™ (light cure glass ionomer, radiopaque cavity base material is highly pressure resistant .).

Advantages : 

One component is ready to use a syringe so it will save time, setting in seconds

Excellent adhesion to the adhesive system, whether using composite or amalgam.

Sustained Fluoride release to preventive secondary caries.

Bio-compatibility 

Radiopaque

High-pressure resistant ( 200 Mpa )

Indications:

Under Composite, amalgam, metal and ceramic restorations

c)Composeal, ProMedica DM GmbH ™ (light cure glass ionomer composite  Liner).

Advantages : 

One component is ready to use a syringe so it will save time, setting in seconds

Excellent adhesion to composite.

Sustained Fluoride release to preventive secondary caries.

Universal dentine shade 

High flexural and compressive strength

Acid-resistant

Indications:

Cavity linings

Extended fissure sealing 

fillings of small lesions

d)Ionoseal, Voco GmbH ™ (light cure glass ionomer composite Flowable  Liner).

Advantages : 

One component is ready to use a syringe so it will save time & Money, setting in seconds

High compressive strength ( 226 Mpa )

Excellent adhesion to composite.

Sustained Fluoride release to preventive secondary caries.

Bio-compatibility 

200% Radiopaque

Universal dentine shade 

High flexural strength

Acid-resistant

Indications:

Lining under all types of filling material especially Composite

Extended fissure sealing 

fillings of small lesions

4) Core build-up

a)Vitremer Core Build-Up,3M™  (Core build-up / Restoration RMGI ).

Advantages :

Excellent adhesion to 3M dental adhesive system, whether using composite or amalgam.

Sustained Fluoride release to help protect the tooth long after the restoration is complete.

 light-cured or self-cured to meet your application needs

Unique dark-cure chemistry allows for bulk placement which eliminates the need for layering and saves time

true glass ionomer cure for long-term fluoride release and adhesion to tooth structure which provides better patient protection and increased doctor confidence

it provides good handling properties and extended working time in the mouth for easier use

variety of shades to better match existing tooth structure for esthetic restorations.

Pedo shade is available for pedodontic applications 

 Blue shade for core buildup applications.

Indications:

As a core buildup where at least half the coronal tooth structure is remaining to provide structural support for the crown.

Class III and Class V restorations.

Restoration of cervical erosion/abrasion lesions.

Restoration of root caries lesions.

Class I and Class II restorations in primary teeth.

Temporary repair of fractured teeth.

Filling defects and undercut areas in crown preparations.

sandwich restorations.

Contra-Indications:

Class I & II or Posterior Restorations

b)GC Fuji II LC® CORE Material,© GC America Inc.   (is a triple-cured, resin-reinforced glass ionomer crown and core build-up material ).

Advantages :

Excellent adhesion to the dental adhesive system, whether using composite or amalgam.

Sustained Fluoride release to help protect the tooth long after the restoration is complete.

Triple-Cured to meet your application needs

it provides good handling properties and extended working time in the mouth for easier use

well suited for use as a base under composite resin and amalgam, or as a temporary restorative.

Indications:

As a core buildup where at least half the coronal tooth structure is remaining to provide structural support for the crown.

Class I and Class II restorations in primary teeth.

Temporary repair of fractured teeth.

sandwich restorations.

Contra-Indications:

Class I & II or Posterior Restorations

Class III and Class V restorations.

Restoration of root caries lesions.