Alistair Mayoh discusses using glass ionomer cement to achieve long-lasting and aesthetic restorations.
When choosing materials for use in posterior restorations it is important to consider their quality in terms of resilience.
Due to enhanced dental care, patients are able to keep their natural teeth for longer, making restorative procedures more common than they once were. The material you choose for these restorations will determine the long-term survival of the treatment. Even though aesthetics is of less concern in the posterior region than the anterior, good aesthetic results are still likely to be important for some patients, so should be taken into consideration. Glass ionomer cement (GIC) is a fantastic solution for both of these challenges, providing patients with a durable restoration and great aesthetic results.
Risk factors for posterior restorations
There are a number of risk factors which may impact the long-term survival of posterior restorations. These include occlusal stress and caries. When assessing whether your patient is at risk for occlusal stress, examine their bite for areas of increased pressure, and consider whether your patient is prone to bruxism. If they are unsure whether they are experiencing bruxism, ask whether they feel pain in their teeth, gums, or jaw on awakening, or temporal headaches. If they do likely suffer from bruxism, this may put the survival of their restoration at risk for fracture and chipping, so it is important to treat this first. If you believe your patient may be at risk for caries, recommend proper brushing and interdental cleaning techniques to improve oral hygiene, and discuss the benefits of a low intake of sugary foods.
Glass ionomer cement functionality
GIC is a great alternative to amalgam and composite for posterior restorations. It is durable, tough, and resistant to edge chipping – along with being affordable and easy to use. It adheres to both enamel and dentine, with no need for acid etching, and saving both time and expense. This makes the entire application process easy, predictable, and fast.
GIC itself is extremely versatile. Because of its adhesive, tooth-coloured, and fluoride-releasing properties, it can be used in a variety of clinical situations as a restorative, lining, luting and sealing material, making it the restorative material with the widest range of applications.
When GIC is placed with a technique which removes caries using hand instruments, good retention rates can be achieved. Conditioning of the dentine is also not necessary for GIC restorations, as it bonds directly to the tooth without impacting retention rates. Additionally, GIC and composite resin performed similarly in a systematic reviewi in terms of marginal adaptation, marginal discolouration, and anatomical form, though GIC presented superior performance when it came to secondary carious lesions. These factors make GIC the material of choice in key clinical scenarios.
Maintaining optimal results
GIC offers patients superior aesthetic results as the material is a good colour match for natural dentition, especially when compared to materials such as amalgam – making it well suited for patients with high aesthetic demands. Because the material adheres directly to the tooth, you will be able to create fantastic results very quickly. Not only this, but simple finishing and polishing of the glass ionomer restoration will produce a highly aesthetic finish.
Glass ionomer cement is a great option for long-term restorations in stress bearing posterior teeth. Recent research notes the durability of GIC and its bond strength to the tooth, making the need for further restoration less likely/less regular. This means less expense and time for the patient. There is also no polymerisation shrinkage and consequential cracking. That being said, to properly maintain posterior restorations, good oral hygiene should always be a priority so as to reduce the risk of developing secondary caries. It is just as important to ensure patients return for regular check-ups so as to monitor for micro cracks, as these are the main cause of secondary caries.
The Diamond Rapid Set Capsules from Kemdent are a fantastic choice for glass ionomer cement. A real alternative to posterior composites and amalgam, they are tough, durable, and resistant to edge chipping. The Diamond Rapid Set Capsules are pre-dosed for predictable results every time, and the chemical snap set makes the material moisture resistant almost instantly.
When your patients are in need of strong, predictable, and resilient posterior restorations, consider using glass ionomer cement as a great solution. Its resilience, low risk for cracking, and good aesthetic finish makes it an appealing choice. For those on the lookout for a material which is at low risk for the development of secondary caries, which is user friendly and inexpensive, GIC is the obvious choice.
For more visit www.kemdent.co.uk