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Resin Modified Glassionomer cement

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Resin Modified Glassionomer cement …

Resin Modified Glassionomer cement
Conference on 16 September 2010


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  • ข้อดี1. ลด shrinkage 2. bond ในตำแหน่ง root dentin ได้ดีกว่า adhesive 3. ปลดปล่อย FClose sandwich - F release สู่ oral environment จะลดลง แต่มีข้อดีในแง่ esthetic, wear resistance
  • There is some evidence that they maybe associated with a reduced incidence of secondary caries (Randall RC . J Dent Res 1999)
  • RMGIC have been characterized as havinga longer working time, a rapid set, improved esthetic appearance and translucency, and higher earlystrength
  • Transcript

    • 1. Glass Ionomer in Contemporary Restorative Dentistry
      By RoojRojasawasthien. DDS, MSc.
      16 August 2010
    • 2. Direct Tooth Colored Material
      Resin composite
      Compomer (Polyacid Modified Resin)
      Glass Ionomer
      Resin Modified Glass Ionomer
    • 3. Direct Tooth Colored Material
      IMCR
      Ionomer-Modified
      Composite Resins
      (fluoride in resin)
      CR
      Composite Resins
      (glass-containing
      Hydrophobic resins)
      PAMR
      Polyacid-Modified
      Resin (compomer)
      RMGI
      Resin-Modified
      Glass Ionomers
      GIC
      Glass Ionomer
      Cements
    • 4. Glass Ionomer
      Silicate cements ---> Glass ionomer(Wilson and Kent, 1972)
      Powder + Liquid
      Fluoroaluminosilicate glass + Polyalkenoic acid
      Acid – Base reaction
    • 5. Phase I (Ion-leaching phase)Polyacid extracts ions from glass powder
      Mixing - Shiny, Glossy
      Phase II (Hydrogel phase)Ion cause formation of polyacid matrix
      Setting (3-6 min) - Rigid, Opaque
      Phase III (Polysalt gel phase)Silica gel forms and attaches powder to matrix
      Maturation (24 hrs – 1 yrs)
      More tooth-like color
    • 6. Fully set Glass Ionomer
    • 7. Advantages
      Less shrinkage than polymerizing resin
      No free monomers, Non-irritating to pulp
      Coefficient of thermal expansion similar to dentin
      High compressive strength
    • 8. Advantages
      Adhere chemically to enamel and dentin (hydrophilic)
    • 9. Advantage
      Fluoride release and recharge (reservoir effect)
      Delbem et al., 2005
    • 10. Disadvantages
      Poor abrasion resistance
      Average esthetic
      Technique sensitive
      Susceptible to take up additional water
      Hygroscopic expansion
      Susceptible to dehydration
      Crazing, Cracking
    • 11. Disadvantages
      Wear rate
      Tensile strength
    • 12. Development of Glass Ionomer
      Conventional GI
      (capsule)
      Conventional GI
      (hand mix)
      Metal-reinforced GI
      High viscous glass ionomer
    • 13. Classification
      Self-cure glass ionomer
      Conventional glass ionomer
      Fuji II lining (GC Co., Japan)
      KetacFil Plus (3M ESPE, USA)
      KetacCem
    • 14. Classification
      Self-cure glass ionomer
      Metal-reinforced glass ionomer
      Miracle Mix (GC Co., Japan),Ketac silver (ESPE)
    • 15. Classification
      Self-cure glass ionomer
      High viscous glass ionomer
      Fuji IX (GC Co., Japan), Ketac Molar (3M ESPE, USA)
    • 16. Development of Glass Ionomer
    • 17. Resin-modified glass ionomer
      Hydroxyethylmethacrylate (HEMA)
      Vitrebond, first commercial in 1989
      Acid-Base reaction + Photo-chemical polymerization
      Dual-cure
      Tri-cure
      : add autocure resin
    • 18. Resin-modified glass ionomer (RMGI)
      Conventional GI
      RMGI
      Vitrebond, Vitremer
      Acid-base and light-polymerization reaction compete with and inhibit one another (Berzin. et al, 2010)
    • 19. Resin-modified glass ionomer (RMGI)
      Improve properties
      Set on demand
      Fewer desiccation and hydration problems
      Immediate finishing
      Better esthetics
      Tensile strength, fracture toughness
      Resistance to microleakage
      Bond to resin composite
    • 20. RMGI products
      Luting agent
      Fuji Plus
      FujiCem
      Rely-X luting cement
    • 21. RMGI products
      Liner / Base
      Fuji lining LC
      Vitrebond
    • 22. RMGI products
      Composite bonding agent
      Fuji Bond LC
    • 23. RMGI products
      Restorative buildup
      Fuji II LC
      VitremerKetacNano
    • 24. RMGI - Restorative
      GC Fuji II LC
      Dentin conditioner
      3M Vitremer, KetacNano
      Primer
      • 46% HEMA
      • 25. 39% Ethyl alcohol
      • 26. 15% Polyacrylic acid
      • 27. Photoinitiator
      10% Polyacrylic acid
    • 28. RMGI - Restorative
      Rinse
      Do not
      Rinse
    • 29. RMGI - Restorative
      10% Polyacrylic acid
      37% Phosphoric acid
      12,000x
      800x
      An atlas of glass ionomer cements, 2002
    • 30. RMGI - Restorative
      For Fuji II LC, 10% polyacrylic acid application is able to create micro-mechanical retention.
      (Sidhu, 1999)
      For Vitremer, due to high amounts of HEMA, hydrolitic degradation of Vitremer-dentin bonds might be expected to occur. (Fritz et al., 1996)
      In term of bond durability, sealing ability, Fuji II
      LC is better than Vitremer. (Fagundeset al., 2009)
    • 31. Clinical using of RMGI – Class V
    • 32. Clinical using of RMGI – Class V
    • 33. Clinical using of RMGI – Class V
      Compomer
      Two years later
      Vitremer
      Composite
      Onal & Pamir, 2005
    • 34. Clinical using of RMGI – Class V
      Survival rate
      3-step etch and rinse
      Glass ionomer
      2-step etch and rinse
      Puemans et al., 2005
    • 35. Clinical using of RMGI – Class V
      Failure rate
      Puemans et al., 2005
    • 36. Clinical using of RMGI – Root caries
    • 37. Clinical using of RMGI – Sandwich tech.
      The sandwich technique with resin-modified glassionomer cements or compomers can improve the marginal adaptation of Class II composite restorations with cervical margins located in dentine (Dietrich. et al, 1999)
    • 38. Clinical using of RMGI – Sandwich tech.
      Liebenberg , 2005
    • 39. Clinical using of RMGI – Sandwich tech.
      Liebenberg , 2005
    • 40. Clinical using of RMGI – Sandwich tech.
    • 41. Clinical using of RMGI
      Secondary caries
    • 42. Clinical using of RMGI
      Secondary caries
      Sidhu , 2010
      Under fluoride dentifrice, the RMGI provided additional protection against secondary caries. (Sousa et al., 2009)
    • 43. Clinical using of RMGI - Repair
      Maneenut et al., 2010
    • 44. Conclusion
    • 45. Conclusion
      Advantages
      Adhere chemically to tooth structure
      Fluoride release
      Less shrinkage
      Disadvantages
      Lower wear resistance and physical properties compare to composite
      Moisture sensitivity remain
      Unstable color
    • 46. Thank You