38624704 Glass Ionomers PPT

8/8/2019 38624704 Glass Ionomers PPT

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GLASS IONOMERSGLASS IONOMERSin Restorative Dentistryin Restorative Dentistry

The many faces of glass ionomers

GI -- what are they ?

GI categories ? GI setting reactions ? GI release of F and recharging ? GI applications ?


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19701970 19801980 2000200019901990

Dental AmalgamDental Amalgam

Dental CompositeDental Composite

Glass IonomerGlass Ionomer

First GIC in 1972First GIC in 1972Dentsply A.S.P.A.Dentsply A.S.P.A.

A.S. =A.S. = AAluminoluminossilicate glassilicate glassP.A. =P.A. = PPolyacrylicolyacrylic aacid in watercid in water

DEVELOPMENTDEVELOPMENTTimeline for direct restorative materials usageTimeline for direct restorative materials usage


3/17

Glass IonomerGlass Ionomer:: glass refers to the glassy ceramic particles and theglass refers to the glassy ceramic particles and theglassy matrix (non-crystalline) of the set material, while ionomerglassy matrix (non-crystalline) of the set material, while ionomerrefers to ion-crosslinked polymer.refers to ion-crosslinked polymer.

Polyalkenoic or PolyalkenoatePolya

lkenoic or Polyalkenoate:: refers to polymer chain whichrefers to polymer chain which

incorporates alkenoic monomers such as acrylic acid, tartaric acid,incorporates alkenoic monomers such as acrylic acid, tartaric acid,maleic acid, etc.maleic acid, etc.

F-ReleaseF-Release:: refers to release of fluoride ions but there is no implicationrefers to release of fluoride ions but there is no implicationas to the source of the ions -- and there are many possibilities. Theas to the source of the ions -- and there are many possibilities. Theconfusion for current systems is, if F does not come from theconfusion for current systems is, if F does not come from thetraditional GI matrix, then some people say that the system is not atraditional GI matrix, then some people say that the system is not a

true GI (but the point is irrelevant).true GI (but the point is irrelevant).Multiple-CureMultip

le-Cure:: refers to multiple curing mechanisms possible withrefers to multiple curing mechanisms possible withresin-modified systems -- the terminology was first introduced in 1992resin-modified systems -- the terminology was first introduced in 1992by 3M for their Vitremer product because it underwent the (1)by 3M for their Vitremer product because it underwent the (1)traditional GI chemical setting reactions, (2) a self-curedtraditional GI chemical setting reactions, (2) a self-curedpolymerization reaction, and a (3) light-cured polymerization reaction.polymerization reaction, and a (3) light-cured polymerization reaction.

TERMINOLOGYTERMINOLOGYDont be confused by some of the strange language.Dont be confused by some of the strange language.


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Si, Na,

F, Ca,

Al

H2O,

H3PO4,

Al, Zn

+

Ca+2

Al+3

F-

Si+4

H+

Glass particle

Etched periphery

Ca, Al, Na, Zn

Phosphates and

Fluorides

Silicate CementSilicate Cement

ZnOH2O

PAA

ZnO + COOH

HOOC

COOHHOOC

-OOC

COO-

-OOC

COO-Zn++

Zn++

COO-

-OOC

COO--OOC

Residual

ZnO

Zinc polyacrylate gel

Polycarboxylate CementPolycarboxylate Cement

GLASS IONOMERSGLASS IONOMERSHYBRID =HYBRID = SC [Powder]SC [Powder] andand PCC [Liquid]PCC [Liquid] = A.S.P.A.= A.S.P.A.


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SiO2,Al2O3,Na, Ca,

F

PAAin

H2O

SiO2,Al2O3,Na, Ca,F

Residual Glass Particle

POLYACRYLATE HYDROGEL(initially Ca polyacrylate geland later Al polyacrylate gel)

Si+4 , Al+3 , Ca+2 , Na+, F- Ions

SiO2,Al2O3,Na, Ca,F

Si+4

Al+3

Na+

Ca+2

F-

PAA

H2O

GLASS IONOMERSGLASS IONOMERSHYBRID =HYBRID = SC [Powder]SC [Powder] andand PCC [Liquid]PCC [Liquid] = A.S.P.A.= A.S.P.A.


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COOCOO

COOCOO

OOCOOC

COOCOO

COOCOO

COOCOO

COOCOO

OOCOOC

OOCOOC

OOCOOC

OOCOOC

Al+3Al+3

--O-Si+4(OH)--O-Si+4(OH)22

Ca++Ca++

Ca+Ca+

Ca+Ca+

OOCOOC

OOCOOC

COOCOOOOCOOC

COOCOO

F-Al-SiOF-Al-SiO22CaFCaF22

H-O-HH-O-H

H-O-HH-O-H

H-O-HH-O-H

H-O-HH-O-H

H-O-HH-O-H

CaCa+2+2 AlAl+3+3

SiSi+4+4FF--

GI SETTING REACTIONSGI SETTING REACTIONS


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UniversalUniversalCEMENTSCEMENTS

GIGI

COMPOSITECOMPOSITE

HYDROGELHYDROGEL

Hydrophobic POLYMERHydrophobic POLYMER

RM-GIRM-GI

GI andVLC Hydrophilic

monomer and polymer

CEMENTSCEMENTS

MM-GIMM-GIGI andMetallic fillersCermet fillers

CORESCORES

COMPOMERCOMPOMER

VLCComposite and F source

FILLING MATERIALSFILLING MATERIALS

RR-GIRR-GIGI andResin-Fillers

A.R.T. andA.R.T. andTEMPORARIESTEMPORARIES

GIOMERGIOMER

VLCComposite and Pre-reacted GIC powder


CEMENTSCEMENTS



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FLUORO-ALUMINO-SILICATEFLUORO-ALUMINO-SILICATE

PARTICLEPARTICLE

CEMENTCEMENT

MATRIXMATRIX

F-1,Ca+2 , Al+3 , Si+4

Initialdissolution

forstartingreaction

rapid earlyF release

from matrixSlow long term

F releaseby diffusionfrom particle

FLUORIDE RELEASEFLUORIDE RELEASEFluoride comes from matrix and particles at different rates.Fluoride comes from matrix and particles at different rates.


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EFFECTIVE LEVELSEFFECTIVE LEVELS

2020

1010

1515

55

1414 2121 28287700

TIME (Days)TIME (Days)

FL

UO

RIDE

RE

LEASE

(pp

m)

FL

UO

RIDE

RE

LEASE

(pp

m)

Fluoride Toothpaste,Fluoride Toothpaste,Topical Fluoride,Topical Fluoride,Fluoride MouthrinseFluoride Mouthrinse

PARTICLESPARTICLES

MATRIX

MATRIX


10/17

Mjor IA.Mjor IA.Glass ionomer cement restorations and secondary caries: aGlass ionomer cement restorations and secondary caries: apreliminary report.preliminary report. Quintessence IntQuintessence Int1996;1996;27(3):171-174.

Glass IonomerGlass Ionomer

CompositeComposite

AmalgamAmalgam

Replacement rate (%) for secondary cariesReplacement rate (%) for secondary caries

0 20 40 60 80 100

CARIOSTATIC EFFECTSCARIOSTATIC EFFECTSGI is not more effective than composite or amalgam.GI is not more effective than composite or amalgam.


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1.1. CementCement2.2. Liner / BaseLiner / Base3.3. RestorationRestoration4.4. Core / FoundationCore / Foundation5.5. (Tunnel Restoration)(Tunnel Restoration)6.6. (Sandwich Restoration)(Sandwich Restoration)7.7. Retrograde Filling MaterialRetrograde Filling Material8.8. P/F SealantP/F Sealant9.9. Root Caries Cervical RestorationRoot Caries Cervical Restoration10.10. Temporary, or ART RestorationTemporary, or ART Restoration

Technical modifications:> P/LPrecapsulated> Addition of etching and then BA> Addition of different reinforcing fillers> Finer and finer particle sizes

General Properties:> Strength> Adhesion> Biocompatibility> Fluoride release

APPLICATIONSAPPLICATIONSGI have been tried for about every conceivable application.GI have been tried for about every conceivable application.


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COMMERCIAL PRODUCTSCOMMERCIAL PRODUCTS


13/17

Hytac

Vitremer

Ketac-Cem Dyract Flow

Fuji Miracle Mix

SOME PRODUCTSSOME PRODUCTS


14/17

Fuji IX

Now being used as permanent restoration in pedodontics.

Developed as temporary restorations for 3rd world countries.First tested in African countries.Now used widely in Asian countries.

Current technique = P/L or precapsulated mixture.Original technique = scoop, finger mix, finger insertion.

A.R.T. RESTORATIONSA.R.T. RESTORATIONSART = Atraumatic Restorative TechniqueART = Atraumatic Restorative Technique


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WHO Global A.R.T. ProjectWHO Global A.R.T. ProjectAtraumatic Restorative Treatment (ART) = prevention and treatment ofdental cariesbased on excavating and removing caries using handinstruments only and restoring glass ionomer.

Fuji IX GPFuji IX GP

Minimal equipment and instrumentation


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TEMPORARY RESTORATIONSTEMPORARY RESTORATIONSFuji IX Dominates the LandscapeFuji IX Dominates the Landscape


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38624704 Glass Ionomers PPT