Podcast
Questions and Answers
What is a significant advantage of using the open sandwich technique in deep Class II preparations?
What is a significant advantage of using the open sandwich technique in deep Class II preparations?
- Enhanced aesthetics compared to traditional methods
- Lower cost of composite materials
- Simplified bonding process with no acid etching required
- Greater resistance to microleakage and caries at dentin margins (correct)
Which of the following statements about the use of GIC is accurate?
Which of the following statements about the use of GIC is accurate?
- GIC is less biocompatible than composite resins
- GIC can cause significant postoperative sensitivity
- GIC requires extensive acid etching to bond effectively
- GIC releases fluoride, offering additional protective benefits (correct)
What is a disadvantage of the open sandwich technique?
What is a disadvantage of the open sandwich technique?
- Reduces bulk and minimizes polymerization shrinkage
- High technique sensitivity and time consumption (correct)
- Eliminates the need for dentin bonding agents
- Requires fewer composite resin increments during application
During the clinical steps, what is the purpose of conditioning the prepared tooth with polyacrylic acid?
During the clinical steps, what is the purpose of conditioning the prepared tooth with polyacrylic acid?
What is necessary if the GIC restoration has matured over time?
What is necessary if the GIC restoration has matured over time?
What was the primary motivation behind the invention of Glass Ionomer Cements (GIC)?
What was the primary motivation behind the invention of Glass Ionomer Cements (GIC)?
Which additive in the GIC liquid serves to improve handling characteristics and extend working time?
Which additive in the GIC liquid serves to improve handling characteristics and extend working time?
What is one major advantage of resin-modified glass ionomer cements (RMGIC)?
What is one major advantage of resin-modified glass ionomer cements (RMGIC)?
During which phase of the setting reaction does the polyacid attack the glass particles?
During which phase of the setting reaction does the polyacid attack the glass particles?
What components primarily make up RMGIC?
What components primarily make up RMGIC?
What role does water play during the setting of Glass Ionomer Cements?
What role does water play during the setting of Glass Ionomer Cements?
Which of the following options is a function of calcium ions during the setting of GIC?
Which of the following options is a function of calcium ions during the setting of GIC?
What is the main purpose of using polyacrylic acid in the preparation of RMGIC?
What is the main purpose of using polyacrylic acid in the preparation of RMGIC?
What is one disadvantage of resin-modified glass ionomer cements?
What is one disadvantage of resin-modified glass ionomer cements?
Which property of GIC is enhanced by additives like lanthanum, strontium, and barium?
Which property of GIC is enhanced by additives like lanthanum, strontium, and barium?
What are the clinical steps to improve the adhesion of glass ionomer cements?
What are the clinical steps to improve the adhesion of glass ionomer cements?
What is a key advantage of using highly viscous glass ionomers for dental restorations?
What is a key advantage of using highly viscous glass ionomers for dental restorations?
What notice should clinicians make about freshly mixed cements exposed to air?
What notice should clinicians make about freshly mixed cements exposed to air?
How long should finishing and polishing of GIC typically be delayed after placement?
How long should finishing and polishing of GIC typically be delayed after placement?
What is the final phase in the setting reaction of Glass Ionomer Cements?
What is the final phase in the setting reaction of Glass Ionomer Cements?
Which factor limits the aesthetic appeal of glass ionomer cements compared to composites?
Which factor limits the aesthetic appeal of glass ionomer cements compared to composites?
What is the nature of the setting reaction for RMGIC?
What is the nature of the setting reaction for RMGIC?
What is a potential limitation when using glass ionomer cements during their setting phase?
What is a potential limitation when using glass ionomer cements during their setting phase?
What innovation was introduced by GC Corporation in 2014 regarding glass-hybrid technology?
What innovation was introduced by GC Corporation in 2014 regarding glass-hybrid technology?
Which form of RMGIC is NOT commonly used?
Which form of RMGIC is NOT commonly used?
How can the strength of GICs be enhanced?
How can the strength of GICs be enhanced?
What is a characteristic of the EQUIA Forte® HT Fil launched in 2019?
What is a characteristic of the EQUIA Forte® HT Fil launched in 2019?
What mechanism primarily facilitates the adhesion of glass-ionomer cements to the tooth surface?
What mechanism primarily facilitates the adhesion of glass-ionomer cements to the tooth surface?
What is a common method for enhancing the flexural strength of reinforced glass ionomer cements?
What is a common method for enhancing the flexural strength of reinforced glass ionomer cements?
Which glass ionomer cement combines amalgam alloy powders with GIC to enhance its properties?
Which glass ionomer cement combines amalgam alloy powders with GIC to enhance its properties?
Which type of glass-ionomer cement is specifically categorized as a restorative material for aesthetic purposes?
Which type of glass-ionomer cement is specifically categorized as a restorative material for aesthetic purposes?
What concentration of aqueous fluoride is effective enough to inhibit fluoride-resistant Streptococcus mutans bacteria?
What concentration of aqueous fluoride is effective enough to inhibit fluoride-resistant Streptococcus mutans bacteria?
What is a key advantage of glass-ionomer cements compared to other types of dental cements?
What is a key advantage of glass-ionomer cements compared to other types of dental cements?
Which classification of glass-ionomer cements is designed for use as a liner or base?
Which classification of glass-ionomer cements is designed for use as a liner or base?
Which of the following is an indication for using glass-ionomer cements?
Which of the following is an indication for using glass-ionomer cements?
What is the primary chemical interaction involved in the adhesion of glass-ionomer cements to the enamel and dentin?
What is the primary chemical interaction involved in the adhesion of glass-ionomer cements to the enamel and dentin?
What potential benefit does fluoride release from glass-ionomer cements provide?
What potential benefit does fluoride release from glass-ionomer cements provide?
What is the primary reason for protecting newly placed GIC restorations immediately after matrix removal?
What is the primary reason for protecting newly placed GIC restorations immediately after matrix removal?
Which of the following teeth is a tunnel preparation recommended for?
Which of the following teeth is a tunnel preparation recommended for?
What is the correct angle for penetrating the occlusal surface using a round bur in a tunnel preparation?
What is the correct angle for penetrating the occlusal surface using a round bur in a tunnel preparation?
Which equipment is NOT specifically mentioned as a method to protect GIC restorations?
Which equipment is NOT specifically mentioned as a method to protect GIC restorations?
What does the Atraumatic Restorative Treatment (ART) primarily involve?
What does the Atraumatic Restorative Treatment (ART) primarily involve?
In the sandwich technique, which material is used to replace dentin?
In the sandwich technique, which material is used to replace dentin?
During the tunnel preparation, what should be done after removing caries and before applying the matrix band?
During the tunnel preparation, what should be done after removing caries and before applying the matrix band?
What is the primary advantage of using the sandwich technique in restorations?
What is the primary advantage of using the sandwich technique in restorations?
Flashcards
Anticariogenic GICs
Anticariogenic GICs
Glass ionomer cements that release fluoride to prevent tooth decay.
GIC Technique Sensitivity
GIC Technique Sensitivity
Glass ionomer cements are less dependent on the skill of the dental professional to place correctly.
Highly Viscous GICs
Highly Viscous GICs
High viscosity glass ionomers are fast-setting, low-moisture cements, good for atraumatic treatments.
Glass Hybrids
Glass Hybrids
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Reinforced GICs
Reinforced GICs
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Disperse-phase Strengthening
Disperse-phase Strengthening
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Fiber-reinforced GICs
Fiber-reinforced GICs
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Metal-reinforced GICs
Metal-reinforced GICs
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Glass-ionomer cement (GIC) adhesion
Glass-ionomer cement (GIC) adhesion
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GIC fluoride release
GIC fluoride release
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GIC types (application)
GIC types (application)
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GIC types (clinical use)
GIC types (clinical use)
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GIC indications
GIC indications
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GIC advantages
GIC advantages
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GIC strength
GIC strength
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Proper wetting of tooth-surface
Proper wetting of tooth-surface
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Glass Ionomer Cement (GIC)
Glass Ionomer Cement (GIC)
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GIC Powder Composition
GIC Powder Composition
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GIC Liquid Composition
GIC Liquid Composition
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Setting Reaction Ion Leaching
Setting Reaction Ion Leaching
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Setting Reaction Hydrogel Phase
Setting Reaction Hydrogel Phase
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Setting Reaction Polysalt Gel Phase
Setting Reaction Polysalt Gel Phase
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GIC Setting and Water
GIC Setting and Water
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GIC Handling and Air Exposure
GIC Handling and Air Exposure
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GIC advantages
GIC advantages
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GIC disadvantages
GIC disadvantages
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GIC application steps
GIC application steps
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GIC adhesion
GIC adhesion
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GIC technique sensitivity
GIC technique sensitivity
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Tunnel Preparation
Tunnel Preparation
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Atraumatic Restorative Treatment (ART)
Atraumatic Restorative Treatment (ART)
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Sandwich Technique
Sandwich Technique
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Surface Protection (GIC)
Surface Protection (GIC)
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Tunnel Preparation Indications
Tunnel Preparation Indications
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Clinical Steps (Tunnel Prep)
Clinical Steps (Tunnel Prep)
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Protecting GIC Restoration
Protecting GIC Restoration
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GIC
GIC
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Resin-Modified GICs (RMGICs)
Resin-Modified GICs (RMGICs)
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Setting Reaction (GICs)
Setting Reaction (GICs)
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GIC Surface Conditioning
GIC Surface Conditioning
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GIC Placement
GIC Placement
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Finishing and Polishing Delay (GICs)
Finishing and Polishing Delay (GICs)
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Cermet Cements
Cermet Cements
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Working Time (RMGICs)
Working Time (RMGICs)
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Adhesion Mechanisms (RMGICs)
Adhesion Mechanisms (RMGICs)
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Study Notes
Glass Ionomer Restorations
- Glass ionomer cements (GIC) were introduced in 1972, marketed in Europe in 1975, and in the US in 1977.
- GICs are a hybrid of silicate cements and zinc polycarboxylate cements.
- GICs use organic chelating acids instead of phosphoric acid in dental silicate cements.
- GIC powder is primarily an acid-soluble calcium fluoroaluminosilicate glass, similar to silicate glass but with a higher alumina-silicate ratio to enhance its reactivity.
- GIC liquid is an aqueous solution of polymers and copolymers of acrylic acid, and includes itaconic and tricarboxylic acids to decrease viscosity and promote glass-liquid reactivity.
- Tartaric acid also increases handling time though accelerates setting time.
- Raw material percentages in GIC powder: silica (41.9%), alumina (28.6%), aluminum fluoride (1.6%), calcium fluoride (15.7%), sodium fluoride (9.3%), and aluminum phosphate (3.8%).
- Liquid composition: polyacrylic acid (40-55%), maleic acid (6-15%), tartaric acid (30%), and water.
- Setting reaction is an acid-base interaction between the acidic polyelectrolyte and aluminosilicate glass, occurring in three phases.
Ion Leaching Phase
- This phase begins when the powder and liquid are mixed, releasing ions, like Ca2+ and Al3+, from the glass particles.
Hydrogel Phase
- Calcium ions released rapidly react with the polyacrylic acid, forming calcium bridges and a calcium polycarboxylate gel.
- Water acts as the initial reaction medium and hydrates the crosslinked agents to form a stable gel structure, creating moisture resistance.
Polysalt Phase
- Hydrogen ions continue to attack the glass, releasing Al ions as AlF ions, forming a water-insoluble Ca-Al-carboxylate gel.
- This Ca-Al-carboxylate gel strengthens the cement.
Clinical Tips
- Freshly mixed GIC should be protected from air exposure to prevent desiccation and cracking.
- Water contamination during this stage can lead to matrix dissolution and release of ions.
Adhesion
- Proper wetting of the tooth surface facilitates GIC adhesion due to the hydrophilic nature of both the cement and the tooth surface.
- Hydrogen bonds form between the free carboxyl groups of the cement and bound water on the tooth surface.
- A chemical bond forms between carboxylate groups and calcium ions, further enhancing adhesion.
Fluoride Release
- Fluoride released from GIC penetrates deeply into demineralized dentin at concentrations of about 5000 ppm.
- Concentrations as low as 600 ppm inhibit fluoride-resistant Streptococcus mutans bacteria.
Classification of GICs
- GICs are categorized based on use/application and clinical use. Specific Type I-VI classifications categorized by luting cements, restorative cements, liners, bases, fissures, sealants, orthodontic, and core build-up applications,
- Various classes exist: Type I-Luting, Type II-Restorative, Type III-Liner-base, Type I-luting, Type II-restorative, Type III-liners/bases, Type IV-fissure sealants, Type V-orthodontic, Type VI-core build up
Indications of GICs
- Restoration of permanent teeth (Class V, Class III, Class I-tooth preparations, abrasions, erosions, root caries)
- Restoration of deciduous teeth (Class I, Class VI-tooth prep, rampant caries, nursing bottle caries)
- Luting/cementing (metal/nonmetal restorations, inlays, onlays, crowns, pins, posts orthodontic bonding, brackets)
- Preventive restorations (tunnel prep, pit and fissure sealants)
- Protective liner under composite/amalgam
- Bonding agent
- Dentin substitute
- Core build-up
Advantages of GIC
- Inherent adhesion to tooth enamel and dentin through ion exchange.
- Biocompatibility due to large-sized polyacrylic acid molecules.
- Minimal shrinkage and good marginal seal.
- Anticariogenic properties due to fluoride release, easily replenished through fluoride applications.
- Requires minimal tooth preparation, use on children.
- Less technique-sensitive than composite resins.
Disadvantages of GIC
- Lower compressive strength than amalgam/resin composites.
- Reduced wear resistance.
- Susceptible to water during setting, impacting physical properties and aesthetics.
- Opaque, reducing aesthetic appeal compared to composites.
- Requires moisture control during manipulation and application.
- Technique sensitivity and time-consuming method
High Viscosity Conventional GICs
- Benefit in atraumatic restorative treatment, using high-viscosity GICs as an alternative to amalgam.
- Allows for using higher powder-liquid ratios in the cement.
Glass Hybrids
- Introduced in 2014 as EQUIA Forte, the first glass-hybrid technology for stress-bearing Class II restorations.
- Introduced in 2019 as EQUIA Forte HT, enhanced translucency and suitable for stress-bearing and non-stress-bearing Class I, II, and V restorations.
- Reinforced with ultrafine glass particles and optimized polyacrylic acid, resulting in excellent mechanical properties.
Reinforced GICS
- Enhancing GIC strength via modifying the chemical composition of the original glass powder.
Disperse-phase Glasses
- Strengthening is improved by incorporating corundum and tielite crystallites.
Fiber-reinforced Glasses
- Strength is enhanced through the addition of alumina, glass, silica, and carbon fibers.
Metal-reinforced GICs
- Notable examples include "Miracle Mix," combining amalgam alloy powders with GIC to improve flexural strength.
Cermet Cements
- Sintering metal and glass powders creates strong bonds, thus improving resistance to abrasion and flexural strength.
Resin-Modified GICs (RMGICs)
- Introduced in 1988 to address limitations of conventional GICs, improved by including resin.
- Resin bonding to tooth structure occurs via micromechanical and chemical mechanisms, forming ionic bonds with enamel and dentin.
- RMGIC typically comprises approximately 80% GIC components.
RMGIC Advantages
- Extended working time, controlled setting.
- Good adaptation, chemical adhesion to enamel and dentin
- Fluoride release, improved aesthetics, superior strength characteristics.
RMGIC Disadvantages
- Shrinkage during setting, limited depth of cure.
Forms of RMGIC
- Powder and liquid form.
- Capsules with premeasured powder and liquid components.
- Paste dispensing systems.
GIC Setting Reaction
- Combined slow acid-base reaction and resin polymerization.
- Dual mechanism is chemically induced and completed by light.
Clinical Steps: GIC Application
- Conditioning of the preparation surface using a polyacrylic acid to increase adhesion.
- Restorative procedures, using a carrier to optimally place and minimize voids in the prep.
- Remove excess, shape/contouring is completed.
- Photoactivation using light curing is used if needed for light-cured GICs.
- Finishing and polishing are delayed for at least 24-hours to allow for ionic equilibrium with the surrounding environment, protecting from moisture contamination/desiccation.
Surface Protection (GICs)
- GICs are sensitive to moisture contamination and surface desiccation.
- Resin bonding agents, cocoa butter, petroleum jelly, and varnishes protect the restoration after matrix removal.
Tunnel GIC Restoration
- Tunnel preparation removed proximal caries, preserving the marginal ridge.
- Deciduous teeth and mobile/geriatric teeth, suitable for incipient proximal lesions in posterior teeth in patients with low caries.
- Clinical steps are: assess caries, bitewing x-ray, isolate/dry tooth, place a wedge in the preparation.
Atraumatic Restorative Treatment (ART)
- Removing carious lesions with hand instruments (spoon excavators) and restoring with high-viscosity GICs.
Sandwich Technique
- A laminated restoration utilizing glass ionomer (to replace dentin) and composite resin (enamel for cervical margins).
- Advantages: Strength, aesthetics, finish of composite resins, fluoride release from GIC, reduced composite bulk, reduces polymerization shrinkage, eliminates need for acid etching of dentin. Avoiding postoperative sensitivity.
Sandwich Technique Disadvantages
- Technique sensitive, time-consuming
Clinical Steps Overview: Sandwich Technique
- Isolate, tooth preparation with cavity prep involving dentin butt junction.
- Condition the dentin prep using polyacrylic acid
- Fill the cavity with fast-setting GIC.
- Acid etching is only required for immature or longer-time-in-place GICs as a washout of matrix around filler particles creating a rough surface.
- Apply dentin bonding agent, cure for 20 seconds
- Place composite and cure according to manufacturer's guidelines.
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Description
Explore the fundamentals of Glass Ionomer Cements (GIC), their introduction, composition, and unique properties. This quiz will test your understanding of the material's history and chemical composition, as well as its applications in dentistry. Ideal for dental students and professionals looking to reinforce their knowledge of GICs.