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Glass Ionomer in Contemporary Restorative Dentistry<br />By   RoojRojasawasthien. DDS, MSc.<br />16  August 2010<br />
Direct Tooth Colored Material<br />Resin composite<br />Compomer (Polyacid Modified Resin)<br />Glass Ionomer<br />Resin M...
Direct Tooth Colored Material<br />IMCR<br />Ionomer-Modified<br />Composite Resins<br />(fluoride in resin)<br />CR<br />...
Glass Ionomer<br />Silicate cements ---> Glass ionomer(Wilson and Kent, 1972)<br />Powder + Liquid<br />Fluoroaluminosilic...
Phase I (Ion-leaching phase)Polyacid extracts ions from glass powder<br />Mixing - Shiny, Glossy<br />Phase II (Hydrogel p...
Fully set Glass Ionomer<br />
Advantages<br />Less shrinkage than polymerizing resin<br />No free monomers, Non-irritating to pulp<br />Coefficient of t...
Advantages<br />Adhere chemically to enamel and dentin (hydrophilic)<br />
Advantage<br />Fluoride release and recharge (reservoir effect)<br />Delbem et al., 2005<br />
Disadvantages<br />Poor abrasion resistance<br />Average esthetic<br />Technique sensitive<br />Susceptible to take up add...
Disadvantages<br />Wear rate<br />Tensile strength<br />
Development of Glass Ionomer<br />Conventional GI<br />(capsule) <br />Conventional GI<br />(hand mix) <br />Metal-reinfor...
Classification<br />Self-cure glass ionomer<br />Conventional glass ionomer<br />Fuji II lining (GC Co., Japan)<br />Ketac...
Classification<br />Self-cure glass ionomer<br />Metal-reinforced glass ionomer<br />Miracle Mix (GC Co., Japan),Ketac sil...
Classification<br />Self-cure glass ionomer<br />High viscous glass ionomer<br />Fuji IX (GC Co., Japan), Ketac Molar (3M ...
Development of Glass Ionomer<br />
Resin-modified glass ionomer<br />Hydroxyethylmethacrylate (HEMA)<br />Vitrebond, first commercial in 1989<br />Acid-Base ...
Resin-modified glass ionomer (RMGI)<br />Conventional GI<br />RMGI<br />Vitrebond, Vitremer<br />Acid-base and light-polym...
Resin-modified glass ionomer (RMGI)<br />Improve properties<br />Set on demand<br />Fewer desiccation and hydration proble...
RMGI products<br />Luting agent<br />Fuji Plus<br />FujiCem<br />    Rely-X luting cement<br />
RMGI products<br />Liner / Base<br />                Fuji lining LC<br />Vitrebond<br />
RMGI products<br />Composite bonding agent<br />Fuji Bond LC<br />
RMGI products<br />Restorative buildup<br />Fuji II LC<br />VitremerKetacNano<br />
RMGI - Restorative<br /> GC Fuji II LC<br />Dentin conditioner<br />  3M Vitremer, KetacNano<br />Primer<br /><ul><li> 46%...
 39% Ethyl alcohol
 15% Polyacrylic acid
Photoinitiator</li></ul>10% Polyacrylic acid<br />
RMGI - Restorative<br />Rinse<br />Do not<br />Rinse<br />
RMGI - Restorative<br />10% Polyacrylic acid<br />37% Phosphoric acid<br />12,000x<br />800x<br />An atlas of glass ionome...
RMGI - Restorative<br />For Fuji II LC, 10% polyacrylic acid application is able to create micro-mechanical retention.<br ...
Clinical using of RMGI – Class V<br />
Clinical using of RMGI – Class V<br />
Clinical using of RMGI – Class V<br />Compomer<br />Two years later<br />Vitremer<br />Composite<br />Onal & Pamir, 2005<b...
Clinical using of RMGI – Class V<br />Survival rate<br />3-step etch and rinse<br />Glass ionomer<br />2-step etch and rin...
Clinical using of RMGI – Class V<br />Failure rate<br />Puemans et al., 2005<br />
Clinical using of RMGI – Root caries<br />
Clinical using of RMGI – Sandwich tech.<br />The sandwich technique with resin-modified glassionomer cements or compomers ...
Clinical using of RMGI – Sandwich tech.<br />Liebenberg , 2005<br />
Clinical using of RMGI – Sandwich tech.<br />Liebenberg , 2005<br />
Clinical using of RMGI – Sandwich tech.<br />
Clinical using of RMGI<br />Secondary caries<br />
Clinical using of RMGI<br />Secondary caries<br />Sidhu , 2010<br />Under fluoride dentifrice, the RMGI provided additiona...
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Resin Modified Glassionomer cement

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Resin Modified Glassionomer cement
Conference on 16 September 2010

Resin Modified Glassionomer cement

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

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