Glass Ionomer Cements: Best Practices
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Questions and Answers

What is the main reason for minimal tooth substance removal when preparing for a Glass Ionomer cement restoration?

  • To avoid the need for undercuts.
  • To facilitate better adhesion to sclerotic dentin.
  • To preserve as much healthy tooth structure as possible. (correct)
  • To enhance the aesthetic appearance of the restoration.
  • Which of the following is NOT a recommended practice for isolating the operative field when using GICs?

  • Ensuring blood and saliva do not contaminate the working area.
  • Using a rubber dam for complete isolation.
  • Conducting a thorough drying of the area before application.
  • Allowing slight moisture to remain for enhanced adhesion. (correct)
  • What consideration should be taken into account when preparing dentin surfaces for GIC placement in terms of surface quality?

  • Only freshly exposed dentin from caries removal requires cleaning. (correct)
  • Opening of dentinal tubules is necessary for optimal bonding.
  • Sclerotic dentin should be treated less rigorously than carious dentin.
  • All types of dentin should undergo extensive roughening to maximize adhesion.
  • What material is recommended for lining deep cavities that involve micro-exposure of the pulp prior to GIC placement?

    <p>Calcium hydroxide lining. (C)</p> Signup and view all the answers

    What is a critical factor during the dispensing and mixing of the powder-liquid systems for GICs?

    <p>Excess powder should be removed before mixing. (D)</p> Signup and view all the answers

    Why is it suggested to avoid bevelled cavo-surface margins when using Glass Ionomer cements?

    <p>They compromise the bond strength of the restoration. (A)</p> Signup and view all the answers

    What should be avoided to maintain the integrity of the filling material during insertion, setting, and finishing?

    <p>Contamination with saliva (D)</p> Signup and view all the answers

    What is the recommended time frame for performing final finishing on GICs?

    <p>After 24 hours (B)</p> Signup and view all the answers

    Which method is NOT recommended during the finishing of glass-ionomer cements?

    <p>Using abrasive discs with water spray (A)</p> Signup and view all the answers

    Which type of varnish is considered less permeable and soluble for protecting GIC restorations?

    <p>Polyurethane varnish (A)</p> Signup and view all the answers

    What is a significant advantage of using glass-ionomer cements over composite materials?

    <p>Better fluoride protection (C)</p> Signup and view all the answers

    What is a key issue observed in many early studies of GICs regarding restoration techniques?

    <p>Inconsistent powder-to-liquid ratios were used (A)</p> Signup and view all the answers

    Which of the following is an effective sealing agent for GICs but may create a small ledge at the gingival margin?

    <p>Light-activated enamel bonding resins (B)</p> Signup and view all the answers

    What is critical to avoid during trimming of excess GIC material?

    <p>Trimming towards the tooth (D)</p> Signup and view all the answers

    What is a common issue when finishing GICs too early, specifically at the 8-minute mark?

    <p>Surface finish is notably poor (B)</p> Signup and view all the answers

    In what scenarios are GICs primarily used?

    <p>As luting agents for metal restorations (B)</p> Signup and view all the answers

    Which property of Resin-Modified Glass-Ionomer Cement is significantly greater than that of standard Glass-Ionomer Cement?

    <p>Compressive strength (B)</p> Signup and view all the answers

    What is a primary disadvantage of incorporating HEMA in Resin-Modified Glass-Ionomer Cement?

    <p>Cytotoxic effects on pulp tissues (D)</p> Signup and view all the answers

    How does the setting mechanism of Resin-Modified Glass-Ionomer Cement primarily differ from standard Glass-Ionomer Cement?

    <p>It involves light activation for rapid setting. (B)</p> Signup and view all the answers

    What advantage does Resin-Modified Glass-Ionomer Cement have in its application compared to traditional Glass-Ionomer Cement?

    <p>Stronger bond without surface etching (D)</p> Signup and view all the answers

    Which component is crucial for the composition of Resin-Modified Glass-Ionomer Cement?

    <p>Hydrophilic monomers (C)</p> Signup and view all the answers

    What is the approximate diametral tensile strength of Resin-Modified Glass-Ionomer Cement?

    <p>37 MPa (C)</p> Signup and view all the answers

    In what way does a redox reaction curing process benefit Resin-Modified Glass-Ionomer Cement?

    <p>Allows for rapid setting without light exposure. (A)</p> Signup and view all the answers

    Which factor primarily influences the unique handling properties of Resin-Modified Glass-Ionomer Cement?

    <p>Amount and type of resin incorporated (A)</p> Signup and view all the answers

    What is the setting time of Resin-Modified Glass-Ionomer Cement?

    <p>20 seconds (D)</p> Signup and view all the answers

    What manages to improve the resistance to acid attack in Resin-Modified Glass-Ionomer Cements?

    <p>Incorporation of resin chemistry (D)</p> Signup and view all the answers

    What is the primary advantage of new RMGICs compared to traditional GICs?

    <p>Superior mechanical properties (A)</p> Signup and view all the answers

    Which company launched the product Ketac Nano?

    <p>3M/ESPE (A)</p> Signup and view all the answers

    What is currently a key limitation of nano-ionomer cements in dental applications?

    <p>Limited commercial availability (C)</p> Signup and view all the answers

    In which specific dental applications are resin composites preferred over RMGICs?

    <p>High-stress-bearing situations (A)</p> Signup and view all the answers

    What is a suggested future potential benefit of using nanotechnology in GICs?

    <p>Improved wear resistance (B)</p> Signup and view all the answers

    What was a significant advancement introduced alongside GICs in restorative dentistry?

    <p>Condensable GICs (A)</p> Signup and view all the answers

    What represents a significant improvement of modern GICs over the original ASPA cements?

    <p>Improved mechanical properties (D)</p> Signup and view all the answers

    Which of the following is NOT a common property associated with the latest RMGICs?

    <p>Limited adhesive capabilities (A)</p> Signup and view all the answers

    Which statement best contrasts RMGICs with resin composites in high-stress dental situations?

    <p>Resin composites have superior performance in high-stress areas compared to RMGICs. (B)</p> Signup and view all the answers

    What is the primary composition of silver cermets used in dental materials?

    <p>Glass and silver (C)</p> Signup and view all the answers

    What are the significant disadvantages of resin-modified glass-ionomer cements (GICs)?

    <p>Short working time and low toughness (A)</p> Signup and view all the answers

    Which of the following components contributes to the whitening effect in silver cermets?

    <p>Titanium dioxide (Ti₂O) (C)</p> Signup and view all the answers

    Which factor limits the use of silver cermets in larger multiple surface restorations?

    <p>Potential wear problems (C)</p> Signup and view all the answers

    What is a characteristic of the manufactured liquid component in silver cermets?

    <p>Aqueous solution of a copolymer of acrylic and/or maleic acid and tartaric acid (D)</p> Signup and view all the answers

    What is the primary reason for the short working time associated with resin-modified GICs?

    <p>Rapid polymerization during setting (A)</p> Signup and view all the answers

    What is the typical particle size of silver in silver cermets?

    <p>3-4 µm (B)</p> Signup and view all the answers

    What type of restoration has performance expectations not met in silver cermets?

    <p>Occlusal restorations in deciduous teeth (A)</p> Signup and view all the answers

    Which term is often used improperly to refer to resin-modified glass-ionomer cements?

    <p>Hybrid GICs (C)</p> Signup and view all the answers

    What commercial product is associated with the manufacturer Dentsply?

    <p>CHEMFLEX (C)</p> Signup and view all the answers

    Flashcards

    Silver Cermet

    Dental material composed of glass and silver particles bonded together by sintering, used for small restorations.

    Sintering

    The process of heating a material to a high temperature and then cooling it to create a strong bond between particles.

    Radiopaque

    High level of opacity to X-rays, making it visible in radiographs.

    Wear Resistance

    The ability of a material to resist wearing away.

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    Fluoride Release

    A material that releases fluoride ions to protect teeth from decay.

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    Resin-Modified GIC

    A type of dental cement that combines the properties of a glass-ionomer cement with the advantages of resins.

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    Working Time

    The time a dental material has to be mixed before setting begins.

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    Setting Time

    The amount of time it takes for a dental material to solidify and harden.

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    Toughness

    The ability of a material to withstand scratches and other forms of damage.

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    Acid Resistance

    The ability of a material to resist the corrosive effects of acids.

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    GICs: Evolution and Improvements

    Glass ionomer cements (GICs) have significantly improved since their inception, with new variations like condensable GICs and resin-modified GICs (RMGICs) enhancing their clinical applications.

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    What are RMGICs?

    Resin-modified glass ionomer cements (RMGICs) are enhanced GICs that offer advantages like improved handling and reduced setting time.

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    RMGICs vs. Resin Composites: Where do they differ?

    RMGICs currently don't quite match the performance of resin composites in high-stress areas, such as biting surfaces or front teeth.

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    What are Nano-ionomer Cements?

    Nano-ionomer cements are a relatively new development, incorporating nanoscale fillers (tiny particles) into RMGICs. This aims to improve properties like wear resistance and fluoride release.

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    Nanotechnology and GICs: What's the Verdict?

    While nanotechnology holds promise for GICs, research on its effectiveness is still ongoing. More clinical studies are needed to confirm its long-term benefits.

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    Key Take Away about Nano-ionomer Cements

    The incorporation of nanoscale fillers in RMGICs, leading to the creation of nano-ionomer cements, is a promising area of development in dental materials.

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    GICs: A Continuously Evolving Material

    The introduction of condensable GICs and RMGICs is a testament to the continuous evolution of GICs and their growing potential in dentistry.

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    Future of GICs in Dentistry

    The potential for further improvements in GICs suggests their continued importance in restorative dentistry.

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    Ongoing Research on Nano-ionomer Cements

    Clinical trials and research are underway to further evaluate the potential of nanotechnology in improving the properties of GICs.

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    Finishing and Polishing

    The process of shaping and smoothing a dental restoration to achieve a desired contour and surface finish.

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    Varnish

    A protective layer applied to a GIC restoration to prevent contamination and dehydration during setting.

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    Class I Restoration

    A type of restoration that involves filling a cavity in the biting surface of a tooth.

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    Class III Restoration

    A type of restoration that involves filling a cavity on the in-between surfaces of teeth.

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    Class V Restoration

    A type of restoration that involves filling a cavity on the smooth surface of a tooth.

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    Adhesive Quality

    The process of bonding a material to the tooth structure, creating a strong and durable attachment.

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    Fluoride Protection

    The ability of a material to release fluoride ions, which help strengthen tooth enamel and prevent decay.

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    Isolation with GICs

    GICs are hydrophilic, meaning they require a dry field to set properly. Contamination with saliva or blood weakens the bond and affects aesthetics.

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    GIC Cavity Prep: Butting Technique

    GICs rely on adhesion for strength, so beveling and undercuts are generally avoided. Instead, a butt joint is preferred.

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    GIC Preparation: Polyacrylic Acid

    Polyacrylic acid is used to clean and condition the dentinal surface before GIC application to improve bond strength. However, its effect on the dentin tubules is still debated.

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    GIC Preparation: Smear Layer Removal

    Smear layers (debris on the dentin surface) must be removed using polyacrylic acid without further opening the dentinal tubules. This helps preserve the pulp and prevents sensitivity.

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    Pulpal Protection with GICs

    GICs are more sensitive to bacterial contamination, requiring thorough cleansing of the cavity. The use of a calcium hydroxide lining is recommended for deep cavities to protect the pulp.

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    GICs: Antimicrobial Properties

    GICs have a strong antimicrobial effect, minimizing harmful bacteria compared to other cements like zinc-phosphate or zinc-polycarboxylate.

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    What is a Resin-Modified Glass Ionomer Cement (RMGIC)?

    A glass ionomer cement (GIC) with added resin, resulting in faster setting and improved bonding to dentin and enamel.

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    What are the components of an RMGIC?

    RMGICs typically contain a combination of hydrophilic monomers like HEMA (hydroxyethyl methacrylate), polyacrylic acid, or a copolymer with methacryloxy groups. This allows them to be water-soluble.

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    How does an RMGIC set?

    The setting reaction in RMGIC is a combination of acid-base reaction, similar to GICs, and light-activated polymerization of the resin components.

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    What is the role of light in RMGIC setting?

    Light activation triggers a rapid setting reaction in RMGICs by polymerizing the HEMA within the material.

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    What is the difference in working time between RMGIC and GIC?

    RMGICs offer a longer working time compared to GICs due to the slower acid-base reaction involved. They also exhibit a faster setting reaction when exposed to light.

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    How does RMGIC compare to GIC in terms of strength?

    Resin-modified GICs exhibit improved strength compared to traditional GICs. This is attributed to the added resin component that enhances tensile strength.

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    What are the applications of RMGIC in dentistry?

    RMGICs are commonly used as direct restorative materials, bases, or liners for composites, amalgams, and ceramic restorations.

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    How well do RMGICs bond to teeth?

    RMGICs provide a strong bond to both dentin and enamel, which is considered comparable to or even better than traditional GICs. This is due to the enhanced tensile strength provided by the resin component.

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    Are RMGICs superior to GICs?

    RMGICs are considered an alternative to traditional GICs for restorations and as bases/liners. They offer improved properties and a wider range of applications, however long-term studies are still ongoing to compare their effectiveness.

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    What are some potential drawbacks of RMGICs?

    HEMA, a common component in RMGICs, has a potential for cytotoxicity. Proper polymerization procedures are crucial to minimize this risk and ensure the material is safe for use.

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    Study Notes

    Summary

    • Glass-ionomer cements (GICs) have significantly improved restorative dentistry.
    • New formulations (resin-modified GICs, or RMGIcs) offer superior properties compared to original GICs.
    • RMGIcs offer improved properties, especially in high-stress restorations and posterior teeth.
    • Clinical significance suggests that more improvements can be expected.

    Further Reading

    • Billingstion, et al (1990) - Studied variations in powder-liquid ratio of a glass-ionomer restorative material.
    • Dent Mater 17(5) (2001) - Examined bond strength of glass-ionomer
    • Kilpatrick, et al (1995) - Investigated the use of reinforced glass-ionomer for clinical trials.
    • Nicholson, et al (2003) - Studied the interaction of glass-ionomer with water.
    • Peumans,et al (2005) - Performed a systematic review of contemporary adhesives.
    • Chen, et al (2003) - Investigated interaction of biological hydroryapatite proteins with glass-ionomer cement.
    • Espel, et al (1999) - Studied clinical behaviour of glass-ionomer restorations.
    • Inoue, et al (2001) - Examined the effect of conditioners on micro-tensile wear resistance.
    • Smal, et al (2004) - Examined longevity of a resin-modified glass
    • Wilson and Kent (1972) - Discovered a new translucent cement.
    • Dent Mater. 21(8) (2004) - Review of current clinical trials.

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    Description

    This quiz tests your knowledge on the best practices for using Glass Ionomer Cements (GIC) in dental restorations. It covers essential topics like tooth preparation, isolation techniques, and finishing methods. Enhance your understanding of the critical factors that impact GIC usage.

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