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Resin Modified Glassionomer cement
 

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

Resin Modified Glassionomer cement Resin Modified Glassionomer cement Presentation Transcript

  • Glass Ionomer in Contemporary Restorative Dentistry
    By RoojRojasawasthien. DDS, MSc.
    16 August 2010
  • Direct Tooth Colored Material
    Resin composite
    Compomer (Polyacid Modified Resin)
    Glass Ionomer
    Resin Modified Glass Ionomer
  • 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
  • Glass Ionomer
    Silicate cements ---> Glass ionomer(Wilson and Kent, 1972)
    Powder + Liquid
    Fluoroaluminosilicate glass + Polyalkenoic acid
    Acid – Base reaction
  • 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
  • Fully set Glass Ionomer
  • Advantages
    Less shrinkage than polymerizing resin
    No free monomers, Non-irritating to pulp
    Coefficient of thermal expansion similar to dentin
    High compressive strength
  • Advantages
    Adhere chemically to enamel and dentin (hydrophilic)
  • Advantage
    Fluoride release and recharge (reservoir effect)
    Delbem et al., 2005
  • Disadvantages
    Poor abrasion resistance
    Average esthetic
    Technique sensitive
    Susceptible to take up additional water
    Hygroscopic expansion
    Susceptible to dehydration
    Crazing, Cracking
  • Disadvantages
    Wear rate
    Tensile strength
  • Development of Glass Ionomer
    Conventional GI
    (capsule)
    Conventional GI
    (hand mix)
    Metal-reinforced GI
    High viscous glass ionomer
  • Classification
    Self-cure glass ionomer
    Conventional glass ionomer
    Fuji II lining (GC Co., Japan)
    KetacFil Plus (3M ESPE, USA)
    KetacCem
  • Classification
    Self-cure glass ionomer
    Metal-reinforced glass ionomer
    Miracle Mix (GC Co., Japan),Ketac silver (ESPE)
  • Classification
    Self-cure glass ionomer
    High viscous glass ionomer
    Fuji IX (GC Co., Japan), Ketac Molar (3M ESPE, USA)
  • Development of Glass Ionomer
  • Resin-modified glass ionomer
    Hydroxyethylmethacrylate (HEMA)
    Vitrebond, first commercial in 1989
    Acid-Base reaction + Photo-chemical polymerization
    Dual-cure
    Tri-cure
    : add autocure resin
  • 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)
  • 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
  • RMGI products
    Luting agent
    Fuji Plus
    FujiCem
    Rely-X luting cement
  • RMGI products
    Liner / Base
    Fuji lining LC
    Vitrebond
  • RMGI products
    Composite bonding agent
    Fuji Bond LC
  • RMGI products
    Restorative buildup
    Fuji II LC
    VitremerKetacNano
  • RMGI - Restorative
    GC Fuji II LC
    Dentin conditioner
    3M Vitremer, KetacNano
    Primer
    • 46% HEMA
    • 39% Ethyl alcohol
    • 15% Polyacrylic acid
    • Photoinitiator
    10% Polyacrylic acid
  • RMGI - Restorative
    Rinse
    Do not
    Rinse
  • RMGI - Restorative
    10% Polyacrylic acid
    37% Phosphoric acid
    12,000x
    800x
    An atlas of glass ionomer cements, 2002
  • 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)
  • Clinical using of RMGI – Class V
  • Clinical using of RMGI – Class V
  • Clinical using of RMGI – Class V
    Compomer
    Two years later
    Vitremer
    Composite
    Onal & Pamir, 2005
  • Clinical using of RMGI – Class V
    Survival rate
    3-step etch and rinse
    Glass ionomer
    2-step etch and rinse
    Puemans et al., 2005
  • Clinical using of RMGI – Class V
    Failure rate
    Puemans et al., 2005
  • Clinical using of RMGI – Root caries
  • 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)
  • Clinical using of RMGI – Sandwich tech.
    Liebenberg , 2005
  • Clinical using of RMGI – Sandwich tech.
    Liebenberg , 2005
  • Clinical using of RMGI – Sandwich tech.
  • Clinical using of RMGI
    Secondary caries
  • Clinical using of RMGI
    Secondary caries
    Sidhu , 2010
    Under fluoride dentifrice, the RMGI provided additional protection against secondary caries. (Sousa et al., 2009)
  • Clinical using of RMGI - Repair
    Maneenut et al., 2010
  • Conclusion
  • 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
  • Thank You