gic and cavities for tooth coloured restorative materialsstudedit.pdf

7/27/2019 GIC AND CAVITIES FOR TOOTH COLOURED RESTORATIVE MATERIALSstudedit.pdf

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GIC AND CAVITIES FOR TOOTHIC AND CAVITIES FOR TOOTH

COLOURED RESTORATIVEOLOURED RESTORATIVE

MATERIALSATERIALS

DRDR WAN ZARIPAH WAN BAKARWAN ZARIPAH WAN BAKAR

PPPPSG, USMCKSG, USMCK



GLASS IONOMER CEMENTS (GIC)GLASS IONOMER CEMENTS (GIC)

GlassGlass ionomer ionomer materialsmaterials

GIC is a water GIC is a water --based material.based material.

Developed in Britain, and firstly described by Wilson and Kent iDeveloped in Britain, and firstly described by Wilson and Kent in 1972n 1972

Early versions for Class V abrasion lesionEarly versions for Class V abrasion lesion – – lack of aesthetic and translucency.lack of aesthetic and translucency.

Conserve tooth structure, assist inConserve tooth structure, assist in remineralisationremineralisation while maintaining aestheticwhile maintaining aestheticappeal.appeal.

Formed from the reaction of an ionFormed from the reaction of an ion--leachableleachable calciumcalcium aluminosilicatealuminosilicate glass powder glass powder and aand a polyalkenoicpolyalkenoic acid.acid.

““GlassGlass polyalkenoatepolyalkenoate cementscements””..



GLASSGLASS--IONOMER CEMENTIONOMER CEMENT

Types :Types :

I) Conventional GICI) Conventional GIC

2) RMGIC2) RMGIC

Conventional GICConventional GIC – – subgroups are glasssubgroups are glass polyalkenoatespolyalkenoates andand

glassglass polyphosphonatespolyphosphonates..

RMGICRMGIC – – consist of the components of a glassconsist of the components of a glass--ionomer, modifiedionomer, modified

by the inclusion of a small quantity of addby the inclusion of a small quantity of additional resinitional resin--

mostly HEMA.mostly HEMA.

-- set partly by an acidset partly by an acid--base reaction and partly by abase reaction and partly by a

photochemical polymerization.photochemical polymerization.

Conventional GICConventional GIC – – chemically cured; acidchemically cured; acid--base reaction.base reaction.

RMGICRMGIC – – consist of the components of a glassconsist of the components of a glass--ionomerionomer, modified, modified

by the inclusion of a small quantity of addby the inclusion of a small quantity of additional resinitional resin--

mostly HEMA.mostly HEMA.

-- set partly by an acidset partly by an acid--base reaction and partly by abase reaction and partly by aphotochemical polymerization.photochemical polymerization.



COMPOSITIONCOMPOSITION

Powder: Calcium fluoroaluminosilicate glass which containPowder: Calcium fluoroaluminosilicate glass which contain

quartz, alumina, fluorite, cryolite,quartz, alumina, fluorite, cryolite, aluminiumaluminium fluoride,fluoride,

aluminiumaluminium phosphate.phosphate.

-- Fused, quenched, ground and sieved to obtain particles in sizeFused, quenched, ground and sieved to obtain particles in size 44 --

5050µµm.m.RadiopacityRadiopacity – – lanthanum, strontium, barium, amalgam alloy,lanthanum, strontium, barium, amalgam alloy, ZnOZnO..

Abrasion resistance Abrasion resistance – – sintering metals such as silver or gold to glasssintering metals such as silver or gold to glass

particles.particles.

FluorideFluoride

Color Color – – titanium oxide up to 5%titanium oxide up to 5%

Liquid : 2:1 acrylicLiquid : 2:1 acrylic-- acidacid--itaconicitaconic--acid copolymer in water or a copolymer of acid copolymer in water or a copolymer of

maleicmaleic acid and acrylic acidacid and acrylic acid – – 4040--55%55%

Tartaric acidTartaric acid – – assist the extraction of ions from the glass powder, retain wassist the extraction of ions from the glass powder, retain wtime, sharpen setting time.time, sharpen setting time.

RMGICRMGIC – – addition of resin mostlyaddition of resin mostly hydroxyethylhydroxyethyl methacrylatemethacrylate HEMA)HEMA) – – 1515--25%.25%.

Encapsulated GIC need to be mixed by crushing and agitatinEncapsulated GIC need to be mixed by crushing and agitating the capsule for ag the capsule for a

prescribed time.prescribed time.



PROPERTIESPROPERTIES

Ability to bond chemically to mineralized tooth structures throuAbility to bond chemically to mineralized tooth structures through an iongh an ion--exchangeexchange

mechanismmechanism – – mountain formation.mountain formation.

Release of fluoride.Release of fluoride.Ability to reabsorb fluoride ions and therefore react as a fluorAbility to reabsorb fluoride ions and therefore react as a fluorideide

reservoir.reservoir.

LimitationsLimitations – – susceptibility to brittle fracturesusceptibility to brittle fracture

-- unable to withstand undueunable to withstand undue occlusalocclusal--incisalincisal loading.loading.



SETTING REACTIONETTING REACTION

GIC: Ca polyacrylate chains form first followed by Al PA chainsRMGIC : HEMA (resin) included-additional chain superimposed over the

acid-base reaction.

Fluoride release



CLASSIFICATIONLASSIFICATION

Type IType I – – lutingluting

Type IIType II – – restorationrestoration

Type II.1Type II.1 – – restorative aestheticrestorative aesthetic

Type II.2Type II.2 – – restorative reinforced.restorative reinforced.

Type IIIType III – – lining or baselining or base

INDICATIONS FOR GICINDICATIONS FOR GICTemporary restorationsTemporary restorations

Base and linersBase and liners

Permanent restorationsPermanent restorations – – not load bearing areas.not load bearing areas.

Core buildCore build--up for crowns.up for crowns.

Cervical cariesCervical caries – – ““ Sandwich techniqueSandwich technique””Erosion lesionsErosion lesions

Root cariesRoot caries

Hypersensitive cavityHypersensitive cavity

Rampant cariesRampant caries

High caries riskHigh caries risk



STEPSSTEPS

Removal of caries and prepare the cavity surface as smooth as poRemoval of caries and prepare the cavity surface as smooth as possible.ssible.

Clean tooth surface using a slurry of plain pumice and water Clean tooth surface using a slurry of plain pumice and water

Condition cavity with cavity conditioner Condition cavity with cavity conditioner – – 20%20% polyacrylicpolyacrylic acid for 10 seconds.acid for 10 seconds.

Wash vigorously with water spray for 30 seconds.Wash vigorously with water spray for 30 seconds.

Dry for 5 seconds lightly but not dehydrate the surface.Dry for 5 seconds lightly but not dehydrate the surface.

Application of the GIC materials with the help of celluloid stri Application of the GIC materials with the help of celluloid strip or matrix.p or matrix.

Light cure for RMGIC.Light cure for RMGIC.



COMPOSITE RESINCOMPOSITE RESIN

Materials created when inorganic fillers are added to syntheticMaterials created when inorganic fillers are added to synthetic resins.resins.

Introduced commercially in midIntroduced commercially in mid--1960s.1960s.

The use of intense visible light for polymerization developed inThe use of intense visible light for polymerization developed in

the latethe late

1970s.1970s.

Herculite - Kerr Filtek supreme



TYPESTYPES

Type 1 : Macrofilled composite resinType 1 : Macrofilled composite resin

-- glass, quartz, ceramicglass, quartz, ceramic

-- crushed, grinded, sieved to achieve splinter crushed, grinded, sieved to achieve splinter --shapedshaped

particles.particles.

-- particle size 5particle size 5--3030µµmm

Type 2 : Microfilled CRType 2 : Microfilled CR

-- amorphous silica diameter average 0.04amorphous silica diameter average 0.04µµm.m.

Type 3 : Hybrid CRType 3 : Hybrid CR

-- particle size 0.5particle size 0.5--88µµmm

-- Lutz and Philips (1983)Lutz and Philips (1983)

Nanocomposite.Nanocomposite.

-- particle size : nanometer particle size : nanometer

-- nanoparticles and nanoclustersnanoparticles and nanoclusters

a –macrofill; b-microfill, splintered prepolymerised particles;

a-microfill, homogenous; d-microfill, spherical prepolymerised particles;

e-microfil, agglomerated complexes; f- hybrid composite



COMPOSITIONCOMPOSITION

MatrixMatrix – – organic resin: diacrylates, bisorganic resin: diacrylates, bis--GMA, TEGDMA, EGDMAGMA, TEGDMA, EGDMA

HEMA.HEMA.

Inorganic filler: glass, quartz, ceramic, silica powder.Inorganic filler: glass, quartz, ceramic, silica powder.

-- 52%52% -- 88%.(wt.)88%.(wt.)

Coupling agentCoupling agent – – silanesilane-- to unite the resin with the filler to unite the resin with the filler

Initiator systemInitiator system – – didi--ketone and tertiary amineketone and tertiary amine

-- photosensitivephotosensitive – – camphorquinonecamphorquinone

-- to activate the setting mechanismto activate the setting mechanism Stabiliser (inhibitor)Stabiliser (inhibitor)

Pigments.Pigments.

INDICATIONS FOR RESIN RESTORATIONSINDICATIONS FOR RESIN RESTORATIONS

InterproximalInterproximal ((ClCl. III) lesions of anterior teeth.. III) lesions of anterior teeth.

Facial (Facial (ClCl. V) lesions of anterior teeth.. V) lesions of anterior teeth.

Facial (Facial (ClCl. V) lesions of premolars.. V) lesions of premolars.

Loss of Loss of incisalincisal angles (angles (ClCl. IV).. IV).

Fracture of anterior teeth.Fracture of anterior teeth.Rebuilding of teeth to support castings.Rebuilding of teeth to support castings.

Alternative to amalgam restorations.Alternative to amalgam restorations.-- ClCl. I,. I, ClCl. II,. II, ClCl. VI.. VI.



Direction of ShrinkageDirection of Shrinkage

Light activation occurs towards light

- 60% occurs within 60 seconds

- balance within 2 days

Chemical activation directed towards centre of restoration.- occurs slowly and evenly throughout restoration.

Incremental buildIncremental build--upup

Lamination technique – 2mm thickness.

Types of failure at the margin of a composite resin



POLYACIDPOLYACID--MODIFIED COMPOSITE RESINSMODIFIED COMPOSITE RESINS – –

‘‘COMPOMERSCOMPOMERS’’

Contain resins and fillersContain resins and fillers

ResinResin – – contains functional groups of polycarboxylic acid andcontains functional groups of polycarboxylic acid andmethacrylates combined in one molecule.methacrylates combined in one molecule.

-- carboxyl gps. for acidcarboxyl gps. for acid--base reaction (as in GIC)base reaction (as in GIC)

-- methacrylic gps. for crossmethacrylic gps. for cross--linking (as in CR)linking (as in CR)

Filler Filler – – fluoride containing glass.fluoride containing glass.

EgEg. :. : DyractDyract,, CompoglassCompoglass



CLASS III CAVITYCLASS III CAVITY

Interproximal cavity.Interproximal cavity.

When feasible, the preparation should be designed from the linguWhen feasible, the preparation should be designed from the lingual withal withthe incisal part of the contact point is not removedthe incisal part of the contact point is not removed..



Moisture control and isolationMoisture control and isolation – – rubber dam, cottonrubber dam, cotton--role, saliva ejector.role, saliva ejector.

Local anesthetic if needed.Local anesthetic if needed.

Access Access – – palatal approach for esthetics.palatal approach for esthetics.

-- round bur size 1, jet 330.round bur size 1, jet 330.

Caries removalCaries removal – – large SS bur # 2, 3large SS bur # 2, 3 -- spoon excavator spoon excavator

Outline formOutline form

Resistance and retention formResistance and retention form – – round bur #round bur # ¼¼ @@ ½½

BevelsBevels – – margin trimmer, bur.margin trimmer, bur.

Shade selectionShade selection

Etch, prime and bond (adhesive)Etch, prime and bond (adhesive)

Celluloid strip insertionCelluloid strip insertion Composite resin placementComposite resin placement – – ‘‘press and pullpress and pull’’ technique.technique.

Light cure.Light cure.

PolishingPolishing – – white stone bur, soflex disc, rubber cup and diamond paste.white stone bur, soflex disc, rubber cup and diamond paste.



Burs: Jet 330, F20, L10, TC 169L.



CLASS IV CAVITYCLASS IV CAVITY

Cavity involving edge of incisal tip or fractured teeth.Cavity involving edge of incisal tip or fractured teeth.



CLASS V CAVITYCLASS V CAVITY

Cavities atCavities at buccalbuccal or cervical surface of the tooth.or cervical surface of the tooth.

Erosion cavityErosion cavity – – superficial loss of dental hard tissue due to asuperficial loss of dental hard tissue due to a

chemical process not involving bacterchemical process not involving bacteria.ia.

AbfractionAbfraction – – erosive lesion due to excessiveerosive lesion due to excessive buccalbuccal or lingualor lingualocclusalocclusal load through either compression or tension inload through either compression or tension in

the cervical region of the tooth.the cervical region of the tooth.



CLASS II CAVITYCLASS II CAVITY



Other Tooth Coloured Restorations Suitable Cases



TUNNEL CAVITYTUNNEL CAVITY



SLOT CAVITYSLOT CAVITY

POLISHING BURSPOLISHING BURS



REFERENCESREFERENCES

Graham JM, Hume WR. Preservation and restoration of toothGraham JM, Hume WR. Preservation and restoration of tooth

structure. Mosby 1998.structure. Mosby 1998. Baum, Philips, lund. Textbook of operative dentistry. Second ed.Baum, Philips, lund. Textbook of operative dentistry. Second ed.;;

W.B. Saunders Company 1985.W.B. Saunders Company 1985.

gic and cavities for tooth coloured restorative materialsstudedit.pdf

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