Resin-modified Glass Ionomer Restorations Research Articles

Clinical performance of resin-modified glass ionomer cement restorations in primary teeth: A retrospective evaluation

The authors retrospectively evaluated the clinical performance of one resin-modified glass ionomer cement as a restorative material in Class I, Class II, Class III and Class V restorations in primary teeth. A total of 306 patients who had received a total of 864 resin-modified glass ionomer restorations, which had been in their mouths for a minimum of three years, were included in this evaluation. The authors assessed the clinical observations recorded in patients' records and used bitewing radiographs to assess Class II restorations. The authors found an overall restoration success rate of 93.0 percent, with Class I restorations having a 92.6 percent success rate, Class II restorations having a 93.3 percent success rate, Class III restorations having a 100 percent success rate, and Class V restorations having a 98.0 percent success rate. The resin-modified glass ionomer cement functioned well as a Class I, Class II, Class III and Class V restorative material in primary teeth. Resin-modified glass ionomer restorative cement is a durable and reliable material to use for Class I, Class II, Class III and Class V restorations in primary teeth. Therefore, dentists have a proven alternative to silver amalgam and resin-based composite for primary tooth restoration.

Clinical behaviour of glass ionomer restorations in primary teeth

Objective: To compare a silver-reinforced glass ionomer material (cermet) with a resin-modified glass ionomer in minimal Class II preparations in primary teeth. Methods: Matched pairs of primary molars with approximal caries that required operative treatment were used. Each cavity was filled with either Vitremer or Ketac-Silver. The restorations were followed for at least 36 months and examined annually using bitewing radiographs and clinical inspections. Impressions were taken at each recall and models were examined microscopically. Results: After 36 months, one of the resin-modified glass ionomer (RMGI) restorations and 13 (26.5%) of the silver cermet restorations had failed. The RMGI failed because of secondary caries, while most of the failures of the silver cermet fillings were marginal defects alone or in combination with secondary caries. The median survival time (MST) for the silver cermet restorations was 37 months. The RMGI restorations had a MST exceeding 42 months, but MST could not be calculated exactly because of the low failure rate during the study period. Conclusions: The resin-modified glass ionomer had the overall best performance of the two materials under comparison. The silver cermet material cannot be recommended for Class II restorations in primary teeth.

The effect of a resin-modified glass ionomer restorative material on artificially demineralised dentine caries in vitro

Objectives: Recurrent caries is one of the most common reasons for the replacement of restorations. One method of reducing the frequency of this problem may be by using fluoride-releasing restorative materials. The aim of this in vitro study was to evaluate the progression of artificial lesions around resin-modified glass ionomer (Vitremer) restorations placed in root surfaces. Class V cavities were prepared on the mesial and distal surfaces of 28 human premolar teeth. Artificial carious wall lesions were created in all cavities. The root of each tooth was then hemisected through the middle of the two cavities, before being restored with either the glass ionomer or amalgam, while the opposing cavities on the same root portion were varnished as negative controls. Forty-eight specimens were pH-cycled in remineralising and demineralising solutions for 20 h and 4 h, respectively, each day for 4 weeks, whilst in a smaller control group of eight specimens, the demineralising solution was replaced with deionised water. Mineral changes in the carious lesions were evaluated using contact microradiography. Results: Results showed that varying degrees of subsurface demineralisation and remineralisation were evident, with a laminated appearance in lesions adjacent to the glass ionomer. There was higher remineralisation in the glass ionomer-filled cavities compared with the amalgam-filled cavities. In the water-cycled group, glass ionomer showed an increase in mineral content ( p < 0.05), while no changes were observed in the amalgam-filled cavities. Conclusions: This model has shown that glass ionomer has a greater potential than amalgam for remineralisation of artificially created wall lesions within an acidic environment.

An FTIR study on the setting mechanism of resin-modified glass ionomer restoratives

Objectives. An experimental method was used to assess the glass ionomer and resinous character in three “dual-cure” (Fuji II LC, Photac-Fil, Variglass) and a “triple-cure” (Vitremer) resin-modified glass ionomer restoratives to evaluate their acid-base and free-radical setting mechanisms.Methods. Four groups (A-D) of three specimens (5 × 4 × 1 mm) were prepared from each material and subjected to the following treatments: A: mixing; B,C: mixing, 60 s irradiation, 20 min dark/dry storage; and D: mixing, 20 min dark/dry storage and then 60 s irradiation. Micro-multiple internal reflectance FTIR spectroscopy was used to determine: 1) the curing efficiency of the products immediately after irradiation; 2) the effect of irradiation 20 min after dark/dry storage on the curing efficiency; and 3) the extent of the acid-base reaction on irradiated and non-irradiated specimens after 20 min dark/dry storage.Results. The curing efficiency immediately after irradiation was determined from the percentage of residual double bonds which ranged from 33–50% for these materials. Irradiation after 20 min dark/dry storage significantly reduced curing efficiency in all the products, except Variglass. The latter showed no acid-base reaction under the conditions of this study. Non-irradiated specimens after the dark storage period demonstrated higher car☐ylate yields compared to their irradiated analogues. Non-irradiated specimens from Vitremer had the highest car☐ylate yield and a curing efficiency of ∼50% residual double bonds.Significance. Photopolymerization seemed to greatly reduce the acid-base reaction during the early setting stages of resin-modified glass ionomer restoratives. The free-radical formation rates are slower than those achieved by chemically initiated polymerization, but they produce adequate conversion and high car☐ylate salt yields. This study demonstrated an experimental model for identification and characterization of the acid-base reaction in water-containing resin-modified glass ionomer restoratives.