Operative Dentistry - Best Practices
(last modified August 5, 2014)
“Glass Ionomers” = glass ionomer cement (GIC) and resin-modified glass ionomers (RMGI)
Although they have excellent adhesion and fluoride release/recharging ability they are limited in usage by their relatively poor bulk mechanical properties, esthetics and durability. Although not all studies and systematic reviews have shown a caries inhibitive/remineralization effect from the placement of glass ionomers we think that when high risk caries sites/populations are considered the evidence is supportive of the caries-inhibiting effect, eg. orthodontic brackets, ART restorations, direct fillings in high risk for caries patients.
- high caries risk sites and patients
- GIC mainly limited to provisional restorations
- GIC or RMGI as sealants for erupting teeth
- RMGI used as final restorations (primarily limited to crown margin repair and root caries)
- RMGIs material of first choice for root caries
- RMGI used when performing open sandwich
- Acid exposure: acidic diets, GERD, bulimia
- Heavy occlusal forces
- Department currently limits our selection of “fluoride-releasing materials” to those with water in their composition (as opposed to those that rely upon absorbed water subsequent to placment)
- Glass ionomers are more durable with butt joint margins and when placed with sufficient bulk/thickness; however, due consideration must be given to conservation of tooth structure and a minimally invasive surgical approach.