GLASS IONOMER CEMENT

Dr Mohd Haidil Akmal Mahdan

D.D.S (USM), PhD (Cariology & Operative Dent (Tokyo)
DENTAL MATERIAL
BLOCK 2
• A cement is a substance that hardens to act as
a base , liner , filling material or adhesive to
bind devices or prosthesis to the tooth
structure or to each other. - philips’ science of
dental materials (12th ed)
 Content
• Definition
• Background
• Composition
• Classification
• Setting reaction
• Properties
• Usage
• References
 DEFINITION
• The word “ionomer” was coined by Dupont
company
• Describe its range of polymers containing a small
proportion of ionized or ionizable groups generally
of the order of 5% to 10%.

• Glass-ionomer is the generic name of a group of

materials that use silicate glass powder and
aqueous solution of polyacrylic acid” -Kenneth J
Anusavice.

• “Glass - ionomer cement” is a generic one for all

glass polyacid cements.
• Glass : Acid-decomposable glass
• Acidic polymer :Typically poly(acrylic acid) ;
Successful acids are – water soluble &
polyelectrolytes.
Acid-base
: reaction
• The cement forming reaction is defined as the
conversion of initially viscous paste to a hard
solid, & in a true glass-ionomer cement this
reaction takes place within a clinically
acceptable time i.e, a few minutes.)
• Definition of glass ionomer cement: A cement
that consists of a basic glass & an acidic
polymer which sets by an acid-base reaction
between these components. (Mclean &
Wilson 1994)
• Elements of a true glass ionomer :
1. Acid-base setting reaction
2.Ion-exchange adhesion with underlying
tooth structure
3.Continuing ion activity, with mobility of
fluoride, calcium and phosphate ions
• (Akinmade & nicholson, 1993) water based
cement where-in following mixing, the glass
powder & polyalkenoic acid undergo an
acid/base setting reaction. The acid attacks
the surface of powder particles, releasing
calcium & aluminium ions, thus developing a
diffusion-based adhesion between powder &
liquid
 BACKGROUND
 1965 : A.D Wilson mixed dental silicate glass
powder & aqueous solutions of various organic
acids including poly acrylic acid Set cement is
sluggish.
 1971: The invention of glass ionomer cement
was done in 1969.first reported by Wilson and
Kent in ( ASPA I)
 First practical material: ASPA II in 1972 by Crisp
and Wilson,added tartaric acid.
 ASPA III- Methyl alcohol was added.
 First marketable material, ASPA IV in 1973
 Luting agent ASPA IVa in 1975 by Crisp and Abel
con”t…

Metal reinforced cements in 1977 by Sced and

Wilson
 Cermet ionomer cements in 1978 by Mc Lean and
Glasser
 Improved traslucency, ASPA X by Crisp,
Abel.Wilson in 1979
 Water activated cements, ASPA V in 1982 by
Prosser et al
Clinical Development:

First clinical trials in 1970 by Mc Lean

 Class I restorations, fissure sealing and
preventive dentistry in 1974 by Mc Lean and
Wilson
 Erosion lesions, deciduous teeth, lining,
composite ionomer laminates in 1977 by J. W.
Mclean & A. D. Wilson.
 Improved clinical techniques between 1976-
77 by G.J.Mount & Makinson,1978
 Approximal lesions and minimal cavity
preparation in 1980 by Mc Lean

Water activated luting cements in 1984 by Mc

Lean et al

Tunnel class I and II preparations by Hunt and

Knight in 1984

Double etch ionomer /composite resin

laminates,1985, Mc Lean
 Other names…
Glass ionomer-term coined by wilson & kent glass-
alumino silicate glass particles ionomer-poly
carboxylic acid.
 ISO terminology- poly alkenoate cement.
 Since its extensive usage to replace the dentin ,has
given different names
Dentin substitute
Man made dentin
Artificial dentin
Introduced into USA as ASPA- Alumno silicate
polyacrylate
 COMPOSITION

• Acid-base reaction cement (Wilson

1978,Wygant 1958)
Acid Component
polyelectrolyte which is a
Base Component homopolymer or
copolymer of unsaturated
Calcium aluminasilicate carboxylic acids known
glass containing fuoride scientifically as alkenoic
acid
The glass ionomer powder is an acid soluble
calcium fluoroalumino silicate glass-
ion leachable glass.
Components A B

Si02 41.9% 31.2%

Al203 28.6% 20.1%

AlF3 1.6% 2.4%

CaF2 15.6% 20.1%

NaF2 9.3% 3.6%

AlPO4 3.8% 12.8%

Types of calcium aluminasilicate glass
SiO2 - Al2O3 - CaF2 (Simple 3-component system)
SiO2 - Al2O3 - CaF2 - AlPO4
SiO2 - Al2O3 - CaF2 - AlPO4 – Na3AlF6

The raw materials are fused to a uniform glass by

heating them to a temp.of 1100 °C- 1500°C
 Lanthanum,strontium,barium or zinc oxide
additions provide radio opacity.
 The glass is ground into a powder having
particles in the range of 15-50 µm (50µm for
restoration and 20µm for luting).
 Function of Components in powder
• The role of Al2O3 & SiO2 of the glass is crucial and is
required to be of 1:2 or more by mass for cement
formation.
• CaF2-Supplemented by the addition of cryolite
(Na3AIF6).
• This flux -reduces the temperature at which the glass
will fuse -increases the translucency of the set cement.
• Fluoride is an essential constituent which –
 Lowers fusion temp., acts as flux
 improves working characteristics & strength
 improves translucency
 improves therapeutic value of the cement by
releasing fluoride over a prolonged period
• Al3PO4 - Improves translucency. Apparently adds body
to the cement paste
• Visual appearance of glass – clear / opal / opaque
• Glasses high in SiO2 (>40%) - transparent
• Glasses high in Al2O3 - opaque
• Al2O3 / SiO2 ratio : Crucial , required to be 1:2
• Increase in ratio
• Decreases setting time
• Clear to opaque
• Compressive strength increases
• Determines the rate at which breakdown of
glass matrix occurs
 Liquid
The liquid is an aqueous solution of polymers and
copolymers of acrylic acid.
 In most of the current cements, the acid in the form of a
coploymer with itaconic ,maleic ,or tricarboxylic acids.
 polyacrylic acid-is the most important acid contributing to
formation of the cement matrix.
Water-
o It is reaction medium.

o It serves to hydrate the siliceous hydrogel and the

metal salts formed.
o It is essential part of the cement structure. If water is
lost from the cement by desiccation while it is setting,
the cement-forming reactions will stop.
• Forms of water
i) Loosely bound – readily removed by
dessication
ii) Tightly bound --cannot be removed and is
associated with the hydration shellof the cation-
polyacryate bond, particularly that of aluminium
and some silica gelwater

• With aging, tightly bound water increases,

increasing the strength, modulus ofelasticity and
decreasing the plasticity
• Cement is stable in an atmosphere of 80% humidity.
• Polyacrylic Acid……45%
• Water…………50%
• Modifiers…….0.5%
o Itaconic acid viscosity
o Maleic acid inhibit gelation
o Tricarballylic acid shelf life
• Tartaric acid………… Working time & setting
time
• Itaconic acid
o promotes reactivity between the glass and the
liquid.
o It also prevents gelation of the liquid which can
result from hydrogen bonding between two
polyacrylic acid chains
• Maleic acid
o A stronger acid than polyacrylic acid
o Causes the cement to harden and lose its
moisture sensitivity faster.
o More carboxyl (COOH) groups which lead to
more rapid polycarboxylate crosslinking
Tartaric acid
o The 5% optically active dextro-isomer of
tartaric acid is incorporated.
o It is also hardener that controls the pH of the
set cement during setting process, which in
turn controls the rate of dissolution of the
glass.
o It facilitates extraction of ions from the glass.
o It typically increases the working time and
also aids in manipulation
 CLASSIFICATION
1. A.D wilson & JW McLean 1988
o type I : Luting cement
o type II : restorative aesthetic
: restorative reinforced
2. Skinners
o Type I- Luting cement
o Type II-restorative
o Type III – liners and bases
3. According to characteristics specified by
manufacturers
o Type I : luting cement (Fuji I,KETAC)
o Type II : filling material (Fuji II,IX,KetacFil)
o Type III : fast setting lining ,base cement
o Type IV : fissure sealing cement
o Type V : orthodontic cement
o Type VI : core build up
4. Recent classification
i) Traditional glass ionomer .
a.Type I --- Luting cement
b. Type II --- Restorative cements
c. Type III --- Liners & Bases
ii) Metal modified Glass Ionomer
a) Miracle mix
b)Cermet cement
iii) Light cure Glass Ionomer --HEMA added to liquid
iv) Hybrid Glass Ionomer/resin modified Glass Ionomer
a) Composite resin in which fillers substituted with glass
ionomer particles
b)Precured glasses blended into composites
SETTING REACTION
STAGES OF SETTING REACTION
1. Decomposition and migration of glass
• The glass particles are attacked at the surface by
poly acid which leads to withdrawal of the cations
thus the glass network breaks down to silicic acid.
• Principally Al3+, Ca2+, F-, are released and migrate
into aqueous phase of cement and form complexes
Decomposition of glass & migration of ions
• Initially calcium complexes predominate but later
Aluminium complexes are more.
• pH and viscosity increases
 2. Gelation and Vulnerability of water
• At critical pH and ionic conc. Precipitation of
insoluble poly acrylates takes place.
• Initial set occurs due to calcium polyacrylate but
hardening of cement is due to slow formation of
aluminium polyacrylate
• When cement is not fully hardened Al, Ca, F and
polyacrylate ions may leach out leading to
irretrievable loss of cement matrix •
• Calcium acrylate is more vulnerable to water. So the
freshly set cements are to be protected.
 3. Hardening and slow maturation

• This process continues for about 24 hrs

• Undergoes slight expansion and increase in
translucency
• Cement becomes resistant to dessication and
strength also increases for at least a year
• Increase in strength and rigidity are associated
with slow increase in cross linking.
 Factors affecting setting
• Glass composition : increase in Al/Si ratio –
faster set
• Particle size : finer – faster set
• Tartaric acid – sharpens set without
shortening working time
• Relative proportion of constituents – Powder :
Liquid
• Temperature of mixing – increase – faster set
 Mechanism of Adhesion
• Polyalkenoic acid attacks dentine and enamel:
displaces PO4,Ca ions
• Migrate into cement and develop an ion
enriched layer firmly attached to tooth
structure.
• The bond strength to enamel is always higher
than that to dentin because of the greater
inorganic content & greater homogenity.
• Barriers to adhesion
i. smear layer not removed
ii. contamination (blood, saliva, too much water)
iii. setting reaction too far advanced before
application (cement must have a glossy
surface when applying to tooth.)
a) Luting cements
b) Restorative cements
Biocompatibility
• Resistance to plaque because presence of F-
• Pulp response to GIC is favorable
• Freshly mixed --- acidic pH 0.9 – 1.6 -- mild
inflammation resolve 10 -20 days * used to
protect mech / traumatic exposure of healthy
pulp
• Glass ionomer cement showed greater
inflammatory response than ZOE but less than
Zn phosphate cement, other cements but it
resolved in 30 days (Garcia et al, 1981)
Fluoride release
• The influence of fluoride action is seen of at least
3 mm around the glass ionomer restoration
• Released for a sustained period of 18 months
(Wilson et al 1985)
• Thickly mixed cements release more flouride
than thinly mixed ones.
• Fluoride release is restricted by sodium and to
some extent by calcium content and not the total
fluoride content of the glass.
 Does the Fluoride able to recharge back?
• Glass ionomers may have synergistic effects when
used with extrinsic fluorides
• In the presence of an inverse fluoride
concentration gradient, glass ionomers may
absorb fluoride from the environment and
release it again under specific conditions
• topical APF (acidulated phosphate fluoride), with
fluoride rinses and fluoridated dentifrices
recharging takes place
Thermal Properties:
• The thermal diffusivity value of GIC is close to
that for dentin. •
• The material has an adequate thermal
insulating effect on the pulp and helps to
protect it from thermal trauma
 Solubility & disintegration
• lower than ----Zn phosphate Zn
polycarboxylate
• In water --- less than Silicate cement
• Resin-modified GIC is less resistant to
solubility
ESTHETICS
• Glass ionomer cement has got a degree of
translucency because of its glass filler
• Unlike composite resins, glass ionomer cement
will not be affected by oral fluids
Durability
• Affected by the factors
I. Inadequate preparation of the cement
II. Inadequate protection of restoration
III. Variable conditions of mouth
• Failure rate is more a measure of clinician’s skill
than inherent quality of the material.
• One of the longest observation periods for the
conventional glass ionomers in non-carious
cervical lesions showed retention in the order of
90% after 10 yrs for KetacFil
• Some other properties :
i. Low exothermic reaction
ii. Adheres chemically to the tooth structure •
Less shrinkage than polymerizing resins
iii. Dimensional stability at high humidity
iv. F release discourages microbial infiltration
v. Early moisture sensitive --- requires protection
vi. Poor abrasion resistance
vii. Average esthetic
 ADV vs Dis ADV
ADVANTAGES DISADVANTAGES
Inherent adhesion to the tooth Brittle
High retention rate Soluble
Low shrinkage Abrasive
Fluoride release Water sensitive
Biocompatible Aesthetic lesser
Minimal cavity preparation Low fracture resistance
1. Restorative pupose
• Restoring of erosion/ abrasion lesions
without cavity preparation.
• Restoration of deciduous teeth.
• Restoration of class III lesions, preferably
using a lingual approach with labial plate
intact.
• Repair of defective margins in restorations
• Minimal cavity preparations – Approximal
lesions, Buccal and Occlusal approach (tunnel
preparation)
2. Fast setting lining cement and bases:
• Lining of all types of cavities where a biological
seal and cariostatic action are required
• replacement of carious dentin the attachment of
composite resins using the acid etch technique
• Sealing and filling of occlusal fissures showing
early signs of caries
3. Luting cement:
• Fine grain versions of the glass ionomer Cements
are used.
• Useful in patients with high caries index
• Crown cementation
4. Pit & Fissure sealant
• A cariostatic action is essential for caries
preventive material GIC is recommended as a
P and F sealant where the orifices of the
fissure are patent .
• The size of the fissure should allow sharp
explorer tip to enter the crevice which should
be > 100 µ wide. Otherwise, GIC can get lost
through erosion due to its low wear resistance
and solubility
5. GIC IN ENDODONTICS
• Sealing root canals orthogradely , retrogradely
• Restoring pulp chamber
• Perforation repair
• Sometimes for repairing vertical fracture GIC was
used because of :
i. Its capacity to bond which enhances seal &
reinforce the tooth
ii. Its good bio compatibility, which would
minimize irritation to peri radicular tissues
iii. Its F release, which imports an anti microbial
effect to combat root canal infection
• Class IV carious lesions or fractured incisors.
• Lesions involving large areas of labial enamel
where esthetics is of major importance
• class II carious lesions where conventional
cavities are prepared.
• replacement of existing amalgam restorations.
• Lost cusp areas.
 Recent modifications in GIC

1. WHY??
• Increase mechanical properties
• Decrease moisture sensitivity

2. Modification in either powder or liquid.

A. Metal – reinforced Cement
• Miracle Mix
• GI powder + amalgam alloy powder

B. CERMET
• Bonding of silver particles to glass ionomer
particles by fusion through high temperature
sintering.
• Used as core buildup, decidous posterior
rest.
C. Resin-modified GIC.
• Glass ionomer cement in which the acid-base
setting reaction has been supplemented by a
polymerization reaction of added resin
components.
• the following criteria must be fulfilled:
i. the acid base reaction must be critical to the
setting reaction.
ii. must contain fluoroaluminosilicate glass,
polymeric carboxylic acid and water.
4. Compomer ( POLYACID MODIFIED
COMPOSITE RESINS )
• Compomer is a composite resin that uses an
ionomer glass which is the major component
of glass ionomer as the filler.
• Small quantity of dehydrated polyalkenoic
acid incorporated with filler particles,
• Setting reaction is
light activated.
 REFERENCES
• Proposed nomenclature for glass-ionomer dental cements
& related materials. JohnW. Mclean et al.QI vol. 25, no. 9,
1994 ; 587-589.
• GIC – Past, present & future. Graham J. Mount.
Buonocore memorial lecture (Michael B.) Operative
dentistry 1994, 19, 82-90.
• Glass ionomer cements in restorative dentistry. JohnW.
Nicholson et al. QI vol. 28, no.11, 1997, 705-714.
• The need for caries preventive restorative
materials.Gordon J. Christensen. JADA, vol. 131, sept.
2000, 1347-1349.
• Composite resin & GIC : current status for use in
cervical restorations – WilliamW. Brackett et al. QI
1990; 21: 445-447.
• Longevity in glass-ionomer restorations: review of
successful technique. Graham J. Mount. QI 1997 ;
28: 643-650.
• Viscous GIC : a new alternative to amalgam in
primary dentition. Roland frankenberger et al. QI
1997 ; 28:667-676.
• Adhesion of GIC in clinical environment.G.J.Mount.
operative dentistry 1991;16:141-148. 9. Glass
ionomer : a review of their current status.
G.J.Mount.Operative dentistry 1999 ; 24 : 115-124.