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Advanced Restorative > Glass Ionomers > Flashcards

Glass Ionomers Flashcards

1
Q

what are the challenges of glass ionomers

A
  • esthetics
  • proximity to pulp
  • bonding to dentin
  • isolation
  • control of sulcular fluids effecting bond/seal
  • micro leakage at margin
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2
Q

what is the chemical composition of glass ionomer

A
  • polycarboxylic acid
  • FAS glass
  • water
  • tartaric acid
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3
Q

what is the mechanism of glass ionomer adhesion

A
  • chelation of carboxyl groups of the polyacrylic acids with the calcium in the apatite of the enamel and dentin
  • polyacrylic acid (weak acid) primer may be provided by manufacturer
  • smear layer is removed. however weak acid leaves dentinal tubules plugged. do not use phosphoric acid to etch!
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4
Q

what is the bond strength of glass ionomer

A

3Mpa higher with new materials

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5
Q

what are the 2 types of glass ionomers

A
  • reinforced glass ionomers
  • resin modified glass ionomers
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6
Q

what are the the reinforced glass ionomers

A
  • expand use of materials beyond cementing/luting
  • miracle mix and ketac silver (amalgam particles)
  • ketac molar and fuji IX
  • equia forte
  • chem-fil rock
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7
Q

what are the resin modified glass ionomers and what do they do

A
  • improved esthetics and handling characteristics
  • complex setting reactions- class GI acid based reaction as well as light activation resin polymerizaion. some have an additional chemical cure reaction and can set in the absence of light
  • fuji II LC, vitremer restorative material, ketac nano, geristore
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8
Q

what is compomer

A
  • polyacid modified composite resin (Dyract)
  • light polymerized composite resin restoratives, modified to contain ion- leachable glass particles and anhydrous polyalkenoic acid
  • have decreased in use due to development of type II GI/RMGI that have more favorable characteristic
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9
Q

what is Giomer

A
  • relatively new resin with pre-reacted glass ionomer particles
  • the particles are made of fluorosilicate glass that has been reacted with polyacrylic acid prior to being incorporated into the resin
  • shofu beautifil
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10
Q

what is cavity liner

A

used at a thickness of no more than 0.5mm under either an amalgam or composite restorative material
- seals deep dentin exposed during caries removal
- vitrebond plus
- fuji liner

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11
Q

what are type 1 glass ionomer cements used for

A

luting crowns, FPP, orthodontic brackets

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12
Q

what are type 2 glass ionomer cements used for

A

esthetic restorative cements GI and RMGI

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13
Q

what are type IIb glass ionomer cements used for

A

reinforced restorative cements

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14
Q

what are type III lining cements used for

A

lining cements

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15
Q

what are the advantages and disadvatntages of type II reinforced restorative cements

A
  • advantages: radiopaque, adhesion, fluoride release, quick set for finishing
  • disadvantages: weaker than resin, no significant improvement in characteristics or longevity over other RMGIC
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16
Q

what are the advantages and disadvantages of esthetic restorative cements

A
  • advantages: useful in high caries risk patients due to fluoride release, adequate esthetics, low polymerization shrinkage, excellent retention
  • disadvantages: shade matching not equal to composite resin, low compressive strength
17
Q

what are the indications for type II esthetic restorative cements

A
  • non carious cervical lesions and root caries
  • base to replace dentin
  • block out undercut or void- not recommended for core build up
  • primary dentition small class I or class II
  • permanent dentition- open sandwhich or closed sandwhich
  • interim therapeutic restoration or sedative filling
18
Q

what are the contraindications for type II esthetic restorative cements

A

load bearing areas- class IV, II, large class I
- areas where esthetics is extremely important

19
Q

what are the advantages of newer formulas

A
  • improved handling
  • decreased viscosity
  • lengthens shelf life before gelation
  • increased working time
  • shortened setting time
  • R and D expensive to replace amaglam
20
Q

how is caries control performed with glass ionomer

A
  • SDF for cavitated lesions or partial caries removal and interim restoration of all cavitated caries leisons in 1-2 apointments and restoring with glass ionomer
  • this is sufficient to removal the bacterial load and prevent further progression on the lesion
  • then perform definitive restorative care once caries control phase is complete
21
Q

describe GI materials and fluoride release

A

GI materials must be recharged with fluoride which can then be re-released in order to provide protection

22
Q

describe GC equia forte

A
  • bulk fill
  • non sticky, packable
  • optimal marginal seal for resistance to micro leakage/discoloration
  • high fluoride release
  • high resistance to wear/erosion
  • 8 shades- I recoemmend choosing one shade darker if using on the gingival third.
  • if tooth is A2 choose A3-5
23
Q

what is the sandwhich technique

A

the placing of glass ionomer cement as an intermediate layer between the tooth structure and a resin based composite restorative material; this restoration design combines the adhesion and fluoride releasing nature of a glass ionomer cement with the esthetic quality and durability of a resin based composite

24
Q

what are the indications for open sandwhich technique

A

when any part of the gingival margin of the class II or class V prep has been extended past the CEJ and no longer has a cavo surface of enamel

25
Q

what are the steps in the open sandwich technique for the class II restoration

A
  • prepare class II prep
  • place appropriate matrix
  • scrub dentin at gingival floor with manufacture provided primer
  • place GI at the dentin/cementum margin to fill until the height of the material is approximately at the level of the CEJ, light cure if using RMGI
  • etch remaining dentin/enamel keepin etchant clear of GI/RMGI
  • place bonding resin and composite, light cure
  • finish and polish
26
Q

what are the advantages to the sandwich technique

A
  • minimize gap formation at margin due to shrinkage of the composite resin
  • less technqiue sensitive than composite resin systems
  • fluoride release provides anti cariogenic environment
  • usefull for class II and class V restorations
  • use in moderate and high risk for caries
27
Q

what is the treatment of choice in the high caries risk patient

A

open sandwich technique with RMGIC with resin

28
Q

what are the steps in root caries preparation

A
  • tooth prep with infected caries and dentin removed
    -retention grooves placed
29
Q

what are the advantages of GI

A
  • minimal cavity prep required
  • adhesion to enamel and dentin
  • fluoride release, recahrging, possible caries inhibition
  • minimal shrinkage
  • excellent marginal seal
  • low solubility
  • good esthetics
  • excellent tissue compatibility
30
Q

what are the disadvantages to GI

A
  • lower resistance to wear compared to amalgam/resin
  • lower bond strengths compared to resin
  • shades sometimes not ideal for highly esthetic areas
31
Q
A

Advanced Restorative (9 decks)

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