Glass-Ionomers in Dentistry (eBook)

S.K. Sidhu, BDS, MSc, PhD, is Clinical Senior Lecturer/Honorary Consultant in Restorative Dentistry at Barts & The London School of Medicine and Dentistry, Queen Mary University of London. She is a Specialist in Prosthodontics and Restorative Dentistry. Her academic career has involved teaching both undergraduates and postgraduates, as well as clinical service. Her research interests include interfaces, adhesive materials and glass-ionomers. Her PhD thesis was titled “Resin-modified glass-ionomer restorative materials: an evaluation involving microscopy” and she has both supervised and examined several PhD theses since then. Dr. Sidhu has presented nationally and internationally, has published widely (well over 70 papers in peer-reviewed journals), and is a member of the editorial boards of several international dental journals. She is recognized as one of the leading authorities on glass-ionomer cements and has been invited as a speaker on this subject, including at the Glass-ionomer Symposium at the International Dental Association for Dental Research (IADR) Annual Meeting in Toronto, Canada in 2008

Foreword 6
Preface 8
Contents 10
Contributors 12
1: The History and Background to Glass-Ionomer Dental Cements 13
1.1 Introduction 14
1.2 Dental Silicate Cement 15
1.2.1 Composition of Dental Silicates 16
1.2.2 The Setting Reaction of Dental Silicate Cements 16
1.2.3 Physical Properties of Dental Silicate Cements 18
1.2.4 Solubility and Ion Release 18
1.3 Zinc Polycarboxylate Cements 19
1.4 Invention of the Glass-­Ionomer Cement 21
1.5 Pioneering Studies of Glass-­Ionomer Cements 22
1.6 Early Research on Glass-Ionomers 23
1.6.1 The Composition and Structure of the Glasses 23
1.6.2 The Acidic Polymer Component 25
1.6.3 Tartaric Acid and Its Role 26
1.6.4 Maturation and the Role of Water 28
1.6.5 Fluoride Release 29
1.6.6 Physical Properties 29
1.6.7 Adhesion 30
1.6.8 Early Studies on Clinical Applications 32
Conclusion 33
References 33
2: Physicochemical Nature of Glass-Ionomer-Based Materials and Their Clinical Performance 37
2.1 Introduction 38
2.2 Composition and Classification 38
2.2.1 Type 1: Luting and Bonding (RM-GIC Adhesive) Materials 38
2.2.2 Type 2: Restorative Materials 39
2.2.3 Type 3: Lining or Base Cements 39
2.3 Method of Delivery 40
2.3.1 Setting Reaction 41
2.3.1.1 Glass 43
2.3.1.2 Liquid 45
2.3.2 Strength 45
2.3.3 Fracture Toughness 47
2.3.4 Shear Punch Strength 47
2.3.5 Erosion 48
2.3.6 Abrasion 49
2.3.7 Adhesion 50
2.3.7.1 Adhesion to Composite and Repair 52
2.3.8 Ion Release 52
2.3.8.1 Ion Release and Biofilm Formation 56
2.4 Clinical Performance 57
2.4.1 Clinical Evaluation of GICs Placed in Non-carious Cervical Lesions 57
2.4.2 Other Clinical Studies 59
2.4.3 ART Restorations and Their Performance 60
2.4.4 Sealants 62
Conclusions 63
References 64
3: The Benefits and Limitations of Glass-Ionomer Cements and Their Use in Contemporary Dentistry 69
3.1 Clinical Benefits 70
3.1.1 Adhesion 70
3.1.2 Ion Exchange Layer and Fluorapatite Formation 70
3.1.3 Fluoride Release 70
3.1.4 Remineralization 70
3.1.5 Marginal Caries Protection 72
3.1.6 Gingival Biocompatibility 72
3.1.7 Contouring 72
3.1.8 Aesthetics 72
3.2 Limitations of Glass-Ionomer Cements 73
3.2.1 Wear Resistance 73
3.2.2 Buffering Oral Acids 73
3.2.3 Residual HEMA (2-Hydroxyethylmethacrylate) 73
3.3 Clinical Applications 74
3.3.1 Surface Preparation 74
3.3.2 Condition or Etch? 74
3.4 Auto-Cure or Resin-Modified Glass-Ionomer Cements? 74
3.5 Auto-Cure Glass-Ionomer Cements 74
3.5.1 Fissure Protection 74
3.5.1.1 Technique 75
3.5.2 Management of Cervical Hypersensitivity 75
3.5.2.1 Technique 76
3.5.3 Luting Cements 76
3.6 Auto-Cure Glass-Ionomer Cement as a Restorative Material 76
3.6.1 Occlusal Restorations with Supported Cusps: OI-Type Cavity 76
3.6.1.1 Technique 77
3.6.2 Occlusal Restorations with Unsupported Cusps: OII-Type Cavity 77
3.6.2.1 Technique 78
3.6.3 Proximal Restorations with Supported Cusps: PI-Type Cavity 79
3.6.3.1 Technique 79
Slot Restorations 79
Tunnel Restorations 80
3.6.4 Proximal Restorations with Unsupported Cusps (Fig. 3.22) 81
3.6.4.1 Technique 83
3.6.5 Silver-Sintered Auto-Cure Glass-Ionomer Cements 83
3.6.6 Managing Endodontically Treated Teeth in a Collapsing Dentition 84
3.6.6.1 Technique 84
3.6.7 Resin-Modified Glass-Ionomer Cements 84
3.6.7.1 Resin-Modified Glass-Ionomer Cement as a Restorative Material 84
3.6.7.2 Cavity Liners 85
3.6.8 Dental Adhesives 85
3.6.8.1 Bonding Composite Resin to Tooth Structure 85
3.6.9 Co-curing: Bonding Auto-Cure Glass-Ionomer Cements to Composite Resin 85
3.6.10 Bonding Auto-Cure Glass-­Ionomers to Tooth Structure 87
3.6.11 Resin-Modified Glass-Ionomer Bonding Agents Used as a Carrier for  Medicaments Under Restorations 87
3.6.12 Bonding Amalgam to Enamel and Dentine 89
Conclusion 90
References 90
4: The Role of Glass-Ionomer Cements in Minimum Intervention (MI) Caries Management 92
4.1 Introduction: What is Minimum Intervention Dentistry? 92
4.1.1 Minimum Intervention Care (Fig. 4.1) 93
4.1.2 Minimally Invasive (MI) Dentistry 93
4.2 GIC Adhesion to Tooth Structure 94
4.2.1 Enamel 94
4.2.2 Fluoride and Mineralized Tissues 94
4.2.3 Sound Dentine 94
4.2.4 Caries-Affected Dentine 96
4.3 GIC and Remineralization 97
4.4 Clinical Studies of GIC Use in the MI Management of Deep Caries 98
4.5 GIC and Atraumatic Restorative Treatment (ART) 100
4.6 The Longevity of GIC Restorations 101
4.7 GIC and the Pulp Response 103
4.8 Adhesion Between GIC and Resin Composite 103
Conclusions 104
References 104
5: Glass-Ionomers in Contemporary Endodontics 108
5.1 Introduction 108
5.2 Properties Relevant to Endodontics 108
5.2.1 Adhesive Properties 108
5.2.2 Fluoride Release 110
5.2.3 Biocompatibility 111
5.2.4 Antibacterial Properties 114
5.3 Uses of Glass-Ionomer Cements in Endodontics 115
5.3.1 Root Canal Sealers 115
5.3.2 Intra-orifice Barrier and Restorative Material 116
5.3.3 Root-End Filling Material 117
5.3.4 Perforation Repair 117
Conclusions 120
References 120
6: The Role of Glass-ionomers in Paediatric Dentistry 124
6.1 Introduction 124
6.2 Prevention of Caries 125
6.3 Effects on Approximal Surfaces 127
6.4 Restorative Care 127
6.5 ‘Contemporary’ Carious Tissue Removal 127
6.6 Endodontic Care 131
6.7 Orthodontic Care 131
6.8 Parental Concerns 132
Conclusions 132
Bibliography 132
7: The Future of Glass-ionomers 135
7.1 Introduction 136
7.2 GIC as an Alternative to Amalgam 136
7.3 Improvements in Glass Filler Systems 137
7.4 Nanoparticle Technology 137
7.5 Spherical Particles 138
7.6 Glass Fibre Reinforcement 138
7.7 Incorporation of Polymeric Filler Carriers 139
7.8 Controlled-Release Vehicle Additions to GIC 139
7.9 Self-Healing Technology 140
7.10 Other Novel Polymer Networks for Improvements in Strength and Other Properties 141
7.11 Porosity Reduction 142
7.12 Improvements in Fracture Toughness 142
7.13 Improvements in Adhesion to Dentine and Enamel 143
7.14 Future Delivery Systems 146
7.15 Wear Improvements 146
7.16 Aesthetic Improvements 149
7.17 Fluoride Release 150
7.18 Bioremineralisation/Biopromoting Improvements 151
7.19 Biofilm Alteration 151
7.20 Self-Cleaning Glass Technology 152
7.21 Antimicrobial Properties/Bio-protection of GICs 152
7.22 Antibiotic Additions 153
7.23 Future Pit and Fissure Sealing 154
7.24 Participation in Future Pharmacological Approaches to Caries Reduction 154
Conclusions 154
References 154
Index 159