Recentl advance

2. RECENT ADVANCES
IN GIC
DR . SHRAVYA S GIRJI

3. CONTENTS
 INTRODUCTION
 DEFINITION
 CLASSIFICATION
 COMPOSITION
 APPLICATION & AVAILABILITY
 SETTING REACTION
 PHYSICAL PROPERTIES
 MANUPULATION
 WATER SETTABLE CEMENTS
 PACKABLE GIC
 MODIFIED GIC
 CONDENSABLE OR SELF HARDNING GIC
 BIOACTIVE GLASS
 FIBER REINFORCED GIC
 GIOMER

4.  GIOMER
 AMALGOMERS
 HAINOMERS
 CHLORHEXIDINE IMPREGNATED GIC
 PROLINE CONTAINING GLASS IONOMER CEMENT
 CPP-ACP CONTAINING GIC
 ZIRCONIA CONTAINING GIC
 NANO -APATITE MODIFIED GIC
 NANO RMGIC
 CERAMIR

5. CEMENT
A Cement is a substance that hardens to act as ,
filling material or adhesive to bind devices or
prosthesis to the tooth structure or to each other.
- philips science of dental
materials(11th ed)

6. - philips science of dental materials(11th ed)
Glass ionomer is the generic name of a
group of material that use silicate glass
powder and aqueous solution of poly
acrylic acid.
- Kenneth J Anusavice

7.  Glass ionomer term was coined by wilson and kent
 Glass ionomer cement is water based cement
 ADA specification number is : 96
SYNONYMS
Poly alkenoate cement
ASPA-Alumno silicate polyacrylate

8. CLASSIFICATION OF GIC
By Wilson & Mclean (1988)
Type I - Luting
Powder/liquid ratio - 1.5: 1
Particle size - 15 microns
Type II- Restorative
1. restorative esthetic
2. restorative reinforced
Powder/liquid ratio- 3:1
Particle size – 50 microns
Type III - Liners and Base
Powder/liquid ratio – 1.5:1 (liner)
3: 1 (Base)

9. BASED ON APPLICATION
Type I - Luting cement
Type II - Restorative cement
Type III - Liners and base
Type IV - Fissure sealents
Type V - orthodontic cement
Type VI - For core build up
Type VII - Fluoride releasing cements
Type VIII and IX- For ART (Atraumatic Restorative
Technique)

10. OF CONVENTIONAL GIC

12. APPLICATION
 Anterior esthetic restorative
material for class III cavities.
 Restorative material for eroded areas
and class V restorations.
 As a luting agent for restorations
and orthodontic brackets.
 As liners and base
 For core build up
 Intermediate restorative material.

13. AVAILABLE AS:
 Powder /liquid in bottles
 Pre- Proportioned powder/liquid in capsules
 Light cure system
 Powder /distilled water( water settable type)

14. ADVANTAGES
 Adhesion to enamel and dentin.
 Anticariogenic effect.
 Less technique sensitive compared to
composites.
 Biocompatibility - pulpal response is
favorable.

15. DISADVANTAGES
 Low fracture resistance .
 Low wear resistance.
 Sensitivity to moisture soon after setting
 Esthetics inferior to silicates and composites
 Lacks translucency, rough surface texture, stains
over time.

16. SETTING
 TYPE I – 7 minutes
 TYPE II – 4 to 5 minutes

17. PACKABLE GLASS IONOMER FOR
POSTERIOR RESTORATIONS
A packable GIC (Fuji ix) with dough like consistency is
available .
 It is cheaper alternative to compomers and composite
posterior restorations.

18. INDICATIONS
 In Atraumatic restorative technique
 Pediatric and gediatric restoration
 Intermediate restorative material
 Permanent restorative material in non stess zones
 As a core material
ADVANTAGES
 High wear resistance then conventional GIC
 Packable , pressable or condensable
 Fluroide release, simple one step

19. MODIFIED GIC
 METAL MODIFIED GIC
 RESIN MODIFIED GIC

20.  Metal modified GIC was introduced to
improve strength ,fracture toughness and
resistence to wear and yet maintain potential
for adhesion and anticariogenic property
TYPES
1. SILVER ALLOY ADMIXED –
Silver amalgam powder is mixed with type
II GIC powder(miracle mix).
2. CERMET – this is done by sintering a
mixture of two powders at a high
temperature

21. PROPERTIES
 Metallic fillers have little or no influence on mechanical
properties of restorative gic.
 In vitro wear tests has shown that when used on the
occlusal surface of primary molars they perform well
initially but do not perform any better then conventional
GIC in long term
 In vitro acidic condition both conventional and metal
reinforced GI exhibit similar degree of wear at contact
free areas at pH of solution between 6-7 and greater
wear at pH 5.
 Both silver alloy admix and cermet release appreciable
amount of fluoride initially but magnitude decreases
substantially.

22. USES
 Restorations of small class I cavities as an alternative to
amalgam or composite resins. They are particularly
useful in young patients who are prone to caries.
 For core build up when the cement will constitute less
than 40% of build up.

23. ADVANTAGES
 Harden rapidly so can be finished immediately
 Adheres to the tooth structure
 Show resistance to caries .
DISADVANTAGES
• Not esthetic because its grayish in colour
• Low fracture toughness

24. RMGIC

25. RESIN MODIFIED GIC
OTHER NAMES
 Resin ionomer
 RMGI
 Light cured GIC
 Dual cure GIC
 Tricure GIC
 Reinforced GIC
 Hybrid ionomer
They were developed to over come drawbacks of conventional
GIC like
 Moisture sensitivity
 Low intial strength
 Fixed working times

26. CLASSIFICATION
DEPENDING ON PREDOMINANT COMPONENT
1. RESIN MODIFIED GLASS IONOMER CEMENT
2. COMPOMERS OR POLYACID MODIFIED COMPOSITES

27. USES
 Restoration of class I , III, IV cavities.
 Base and liners
 As adhesives for orthodontic brackets
 Cementation of crowns and FPDs.
 Retrograde root canal filling materials.
 Fissure sealant

28. SUPPLIED AS
 Chemical cure ( acid –base setting reactions of glass
ionomer portion).
 Dual cure ( combines acid base reaction of the GIC
portion and light curing of resin portion
 Tricure (combines acid base setting reaction ,chemical
and light cure polymerization of resin portion).
All of them are supplied in powder & liquid .
The light cured type is supplied in dark bottles for light
protection.

29. COMPOSITION
POWDER
Ion leachable fluroaluminosilicate glass particles
Photoinitiators or chemical initiators or both polymerizable
resin
LIQUID
Polyacrylic acid ,Water or
Polyacrylic acid modified with Methacrylate monomer &
Hydroxyethyl methacrylate monomers

30. SETTING REACTION
 The initial setting reaction of the material occurs by the
polymerization of methacrylate groups
 The slow acid base reaction is ultimately responsible for
unique maturing process and final strength.

31. PROPERTIES
COMPARING TO CONVENTIONAL GIC
 Good translucency because monomer brings
refractive index of liquid close to the particle.
 Fluroide release equivalent.
 Higher diametral strength .
 Similar bonding to tooth structure
 Bond strength to tooth structure & resin based
composite is higher.
 Comparable biocompatiblity
DRAWBACKS
 Greater polymerization shrinkage upon setting.
 Microleakage more then conventional GIC

32. MANIPULATION
 Conditioning the tooth with polyacrylic acid (10 to 25%)
 Powder & liquid mixed according to manufactures
instructions.
 Then inserted into cavity and light cured

33. COMPOMERS

34.  This material has structure and physical properties similar to
composites as well as release fluoride and it undergoes acid
base reaction in the presence of saliva.
 AVAILABLE AS
Light cured single paste in moisture proof packets.
 Consists of silicate glass particles ,sodium fluoride, and
polyacid modified monomer without any water

35. SETTING REACTION
 The initial set is by free radical polymerization reaction
activated by light.
 Subsequently water is absorbed from saliva by the
cement that contributes to acid base reaction between
acidic functional groups within the matrix and silicate
glass particles which is further responsible for fluoride
release.
 Because of absence of water in the formulation they are
not self adhesive like conventional GIC and requires
separate bonding agent.

36. PROPERTIES
 They have fluoride release less compared to
conventional GICs.
 Bond strength of compomer to tooth structure is same as
conventional GIC because of dentin bonding agent.
INDICATIONS
 Restorations in low stress areas.
 Base
 Luting
 Class V lesions

37. ADVANCES
 In recent years compomers are also marketed in
powder & liquid form as well as two paste system
 POWDER
Strontium aluminium fluro silicate
Metallic oxides
Chemically or light activated initiators
 LIQUID
Polymerizable methacrylate / carboxylic acid
monomers
Multifunctional acrylate monomers
Water
Because of presence of water they are self adhesive
and an acid base reaction starts at the time of mixing.

38. INDICATIONS
They are indicated mainly for cementing prosthesis
fabricated with metallic substrate .

39. MANIPULATION
 SINGLE COMPONENT SYSTEM
Tooth is etched and bonding agent applied
followed by injecting the material into cavity and
light cured.
 TWO COMPONENT SYSTEM
Powder and liquid system is dispensed and mixed
according to manufacturers instructions for 30 sec
The cement mixture is placed only on the prosthesis
and the prosthesis is seated with finger pressure.
 After 90 sec the excess cement has to be removed
 The margins should be light cured immediately to
stabilize the prosthesis.

40. CONDENSABLE / SELF
HARDNING GIC
 These are purely chemically activated RMGIC with no
light activation required
 Developed mainly for luting purpose
 They contain monomers and chemical initiators such as
benzoyl peroxide and t – amines to allow for self
polymerization.
 Mainly used in pediatric dentistry for
Cementation of stainless steel crown , space
maintainer, bands and brackets
Ravi dhoot et al.Advances in glass ionomer (GIC):
review.Iosr-jdms.2016;15:124-126.

41. ADVANTAGES
 Packable + condensable
 Easy placement
 Non sticky
 Rapid finishing can be carried out
 Improved wear resistance
 Low solubility in oral fluids

42. THE BIOACTIVE GLASS
 Developed by Hench and co in 1973.
 They are called bioactive because they induce biological
response and result in formation of bond b/w material and
tissue.
 They are silicate based containing calcium and phosphate
 Most commonly used bioactive glass is Bioglass TM
(45S5) .
Ravi dhoot et al.Advances in glass ionomer (GIC):
review.Iosr-jdms.2016;15:124-126

43. Mechanism of action
Bioactive glass in aqueous solution reacts with it
resulting in change in its structure and chemical
composition which causes its dissoution and
formation of hydroxycarbonated apatite

44. USES
 Retrograde filling material
 For perforation repair
 Augmentation of alveolar ridges in edentulous ridges.
 Infra bony pocket correction.
 In reducing dentinal hypersensitivity as it causes
occlusion of dentinal tubules.
 Antibacterial effects as its raises p H of the aqueous
solution.

45. FIBER REINFORCED GIC
This technology is called polymeric rigid inorganic
matrix material.
 It involves incoperation of a continous network /
scaffold of alumina and Sio2 ceramic fibers
ADVANTAGES
 Increased depth of cure
 Reduced polymerisation shrinkage
 Improved wear resistance
 Increase in flexural strength
Ravi dhoot et al.Advances in glass ionomer
(GIC): review.Iosr-jdms.2016;15:124-126

46. GIOMER
 It is the hybridization of GIC and composite using a
unique technology called prereacted glass ionomer
technology.
 PRG fillers are fabricated by the acid-base reaction
between fluoroalumino –silicate glass (FASG) and
polyalkenoic acid (PAA) in the presence of water to
form a wet siliceous hydrogel. After freeze-drying they
are further milled and silanized to form PRG fillers
 This pre reacted glass is then mixed with the resin

47.  Depending on the amount of glass reacted ,the PRG
technology can be of 2 types
F-PRG – Reaction of full / entire glass
S-PRG – Surface of glass.
Eg. Beautifil , reactmer
Modified S-PRG:
This trilaminar structure forms a
type of stable glass ionomer which
allows :
• Ion release and recharge to take
place
• Protecting the glass core from the
damaging effects of moisture
• Greatly improving long-term
durability
• Releases the F-ion as well as
other ions such as Al, B, Na, Si, and
Sr .

48. ADVANTAGES
 Fluoride release and fluoride recharge
 Formation of acid resistant layer
 Reinforcement of tooth structure
 Antiplaque effect
 Remineralization of dentin
 Acid buffering capacity and reduce acid production by
acidogenic bacteria .
 Excellent aesthetics.
 Compressive strength greater then compomers and
composites

49. APPLICATIONS
 Restorations of Class III, IV and V cavities
 Restorations of Class I cavities
 Restorations in deciduous teeth
 Base / liner under restorations
 Fissure sealant
 Undercut blockout
 Restorations of fractured porcelain and composites
 Restoration of cervical erosion and root caries
 Repair of fractured incisal edges
 Veneers
 Direct cosmetic repairs
 Pulp capping agent

50. AIM : to evaluate the long-term performance
of Giomer restorative system (Beautifil, Shofu,
Kyoto, Japan) containing surface prereacted
glass ionomer filler ; a 13-year recall
examination
CONCLUSION:
The study results showed that most of the
restorations observed at the 13-year recall
examination maintained acceptable clinical
qualities in terms of color match, marginal
adaptation, anatomy, surface roughness,
marginal staining, interfacial staining, &
secondary caries.
Valeria V. Gordan et al, A clinical evaluation of a giomer restorative
system containing surface prereacted glass ionomer filler: results of
13 year recall examination, Journel of american dental association
,145,1036-1043,2014

51. AMALGOMERS
 These restoratives are glass ionomer based but with
the strength of amalgam.

52. PROPERTIES
 Sustained high level of fluoride release.
 Natural adhesion to tooth structure
 Good biocompatibility
 Prevent shrinkage, creep, corrosion or thermal
conductivity problems associated with other filling
materials.
 Good wear resistance.
 Minimal cavity preparation needed
 Mercury and metal free.

53.  Compressive strength greater (323Mpa) then
amalgam and GIC
 Flexural strength, tensile strength and fracture
toughness are also reportedly much higher than
conventional GICs thus preventing fracture
 Young s modulous is higher and close to dentin
meaning that under stress the material deforms
similarly to the dentine so that the adhesive bond is
less likely to fail.
 Excellent esthetics

54. TYPES
 AMALGOMERS ANTERIOR
 AMALGOMERS CR (POSTERIOR)

55. AMALGOMER ANTERIOR
INDICATIONS
 Class V cavities
 Class III cavities
 pits and fissures

56. AMALGOMERS CR
 Class I and II cavities
 Repair of amalgam restored teeth when either
tooth or restoration has fractured
 As a Base under amalgam and posterior composite
restorations
 As a core build up under crowns
 On the root surfaces for locating overdentures
 Long term temporary replacement for cusp(s)

57. HAINOMERS
 These are newer bioactive materials developed by
incorporating hydroxyapetite within glass ionomer
powder.
 They mainly being used as bone cements in oral and
maxillofacial surgery.
 They have a role in bonding directly to bone and its
growth and development.

58. CHLORHEXIDINE IMPREGNATED
GIC
 Developed to increase the anticariogenic action of GIC.
 Still under experimental stage.

59. Luana Mafra Marti et al.Addition of chlorhexidine gluconate to a
glass ionomer cement: A study on mechanical ,physical and
antibacterial propeties.Brazilian Dental Journal ,25,33-37, 2014
CONCLUSION :
•The addition of 0.5% chlorhexidine to GIC
increased its antibacterial activity without changing
its physical and mechanical properties.
• Higher the concentration of chlorhexidine greater
is the decrease in the physical –mechanical
properties .
AIM : To determine the effect of different
concentration s of chorhexidine on setting time
,surface hardness , maximum tensil bond strength
and antibacterial activity of gic.

60. PROLINE CONTAINING GLASS
IONOMER CEMENT
 It is amino acid containing GIC
 It has better surface hardness properties then commercial
FUJI IXGIC
 It is a fast set glass ionomer showing increased water
sorption without adversly affecting the amount of
fluoride release.
 It is biocompatible
 It can also be used as bone cement with low
cytotoxicity.
Ansari S,et al.Properties of proline containing glass ionomer dental
cement. J Prosthet Dent ,110,408-13,2013

61. CPP-ACP CONTAINING GIC
 Casein phosphopeptide –amorphous calcium phosphate (
1.56% w/w) is incorporated into glass ionomer cement.
 This improved microtensile bond strength (33%) &
compressive strength (23%).
 Also there is significant increase of calcium, phosphate,
and fluoride ions in neutral and acidic pH .
Mazzaoui SA ,et al. Incorporation of casein phosphopeptide
amorphous calcium phosphateinto GIC , journel of dental
research 82(11),914-18,2003

62. ZIRCONIA CONTAINING GIC
 ZIRCONOMER defines a new class of restorative glass
ionomer that promises strength and durability of amalgam
with protective benefits of GI with completely eliminating
hazard of mercury.
 It is a potential sustitute for Miracle mix.
 Its diametral tensile strength is greater then then miracle mix
due to better interfacial bonding between the particles and
matrix.

63. PROPERTIES
 Reinforced with special zirconia fillers to match the
strength and durability of amalgam
 Sustained high fluoride release for anti-cariogenic
benefits especially in cases with high caries risk
 Packable and condensable like amalgam without the
hazard of mercury, the risk of corrosion, expansion and
thermal conductivity

64.  High flexural modulus and compressive strength ensures
longevity in stress bearing areas
 Chemically bonds to enamel/dentin and has tooth-like
co-efficient of thermal expansion resulting in low
interfacial stresses and long-lasting restorations
 Ceramic fillers impart remarkable radiopacity for
accurate follow up and diagnosis
 Adequate working time
 Excellent resistance to abrasion and erosion

65. INDICATIONS
 Class I & II cavities
 Structural base in sandwich restorations
 Core build-up under indirect restorations
 Root surfaces where overdentures rest
 Pediatric and Geriatric restorations
 Long-term temporary replacement for fractured cusps
 Fractured amalgam restoration
 Suitable for ART techniques

66. AIM : To assess the clinical performance of zirconia
infused GIC compared to conventional GIC
CONCLUSION
 Zirconia infused GIC showed better colour stability
.
 But conventional GIC is better then zirconia
containing gic in terms of colour match , surface
texture, and marginal adapation .
Ar prabhakar et al,assessment of the clinical performance
of zirconia infused glass ionomer cement: an in vivo study,
International journal of oral health sciences,5,74-79,2015

67. DISADVANTAGES
 Poor working consistency
 Longer setting time then conventional GIC
 Rough surface texture
 Nonblending with the tooth structure.
 High microleakage compared to composite and amalgam

68. NANO -APATITE MODIFIED GIC
 Here Nano hydroxyapatite /fluroapatite particles added to
FUJI II GC.
 This has improved the mechanical properties due to ionic
interaction b/w polyacrylic acid and apatite crystals.
 Also improved bond strength to dentin
1. Because of formation of strong ionic linkage b/w apatite
crystals and Ca ions in the tooth structure
2. also decrease in the size of apatite particles increases the
surface area and infilteration of crystals into demineralized
dentin and enamel pores .

69. PROPERTIES CONVENTIONAL GIC NANO –APATITE
MODIFIED GIC
COMPRESSIVE
STRENGTH
160 177 - 179 MPa
DIAMETRAL
STRENGTH
11.8 19- 20 Mpa
FLEXURAL
STRENGTH
14. 8 26 – 28 MPa

70. NANO FILLED- RMGIC
 Nano-sized fillers and bioceramics particles are
added to RMGICs
 But this combination has shown no added
advantages over conventional RMGIC .
 Only advantage is good finishing and polishing
characteristics because of smaller filler particles
and presence of bioceramics.

71. CERAMIR
 It is a permanent ,radiopaque , luting cement
combining calcium aluminate and GIC
INDICATIONS
 conventional cementation of metal-, lithium
disilicate-, alumina- and zirconia-based
restorations.

72. AVAILABLE AS
 Capsules containing glass ionomer and
bioceramic (calcium aluminate) powder plus
water.
 Capsules activated using ceramir activator for 5
sec and then titurated for 8 sec followed by
dispensing using ceramir applicator

73. ADVANTAGES
 Reduction in micro leakage
 Excellent biocompatibility
 Long term stability and strength.
 Good marginal integrity
Steven R. Jefferies, Cornelis H. Pameijer, David C. Appleby,
Daniel Boston & Jesper Lööf. A bioactive dental luting cement -
Its retentive properties and 3-year clinical findings. Compend
Contin Educ Dent. 2013;34 Spec No 1:2-9.

75.  Philips science of dental materials(11th ed).
 Ravi dhoot et al.Advances in glass ionomer (GIC): review.Iosr-
jdms.2016;15:124-126
 Valeria V. Gordan et al, A clinical evaluation of a giomer restorative
system containing surface prereacted glass ionomer filler: results of 13
year recall examination, Journel of american dental association ,145,1036-
1043,2014
 Luana Mafra Marti et al.Addition of chlorhexidine gluconate to a glass
ionomer cement: A study on mechanical ,physical and antibacterial
propeties.Brazilian Dental Journal ,25,33-37, 2014
 Ansari S,et al.Properties of proline containing glass ionomer dental
cement. J Prosthet Dent ,110,408-13,2013
 Mazzaoui SA ,et al. Incorporation of casein phosphopeptide amorphous
calcium phosphateinto GIC , journel of dental research 82(11),914-
18,2003
REFERENCES

76.  Ar prabhakar et al, assessment of the clinical performance of
zirconia infused glass ionomer cement: an in vivo study,
International journal of oral health sciences,5,74-79,2015
 Steven R. Jefferies, Cornelis H. Pameijer, David C. Appleby, Daniel
Boston & Jesper Lööf. A bioactive dental luting cement - Its
retentive properties and 3-year clinical findings. Compend Contin
Educ Dent. 2013;34 Spec No 1:2-9.