Introduction

 Glass ionomer cements were developed by Wilson and Kent in the

Laboratory of the Government Chemist, London in 1972.
 Developed as a replacement for silicate cements by combining
aluminosilicate glass powder with polyacrylic acid and were hence
called ASPA – Alumino Silicate Poly Acrylate Cements.
Classification Of Glass Ionomer Cements :-
Type I : Luting
Type II : Restorative
Type III : Liner/Bases
Type IV : Pit & Fissure
Type V : Orthodontics
Type VI : Core Build Up
Type VII : Fluoride Charged Glass Ionomer Cement
Type VIII : Condensable & Packable
Type IX : Geriatric & Pediatric
Composition Of Glass Ionomer Cements:-
The cement is supplied usually as a powder and a liquid.

A.Conventional glass ionomer cements:-

Powder :-

Silica (SiO 2) - 29.0%

Alumina (Al 2 O3) - 16.6%
Calcium Fluoride (CaF 2) - 34.3%
Aluminium Fluoride (AlF 3) - 5.3%
Sodium Aluminium Fluoride (Na 3AlF6) - 5%
Aluminium Phosphate (AlPO 4 ) - 9.9%
Lanthanum, Barium, Strontium - Traces

 The GIC powder is an acid-soluble calcium fluoroaluminosilicate

glass.
 Lanthanum, Strontium, barium or zinc oxide are added to provide
radiopacity.
 The raw materials are fused to a uniform glass by heating them to a
temp. of 1100 oC to 1500 oC.
 The glass is then ground into a powder with particle sizes in the
range of 15-50μm.
 Finer particles are used for luting and lining cements & Coarser are
used for restorative cements as they provide better translucency.

Liquid :-

Polyacrylic Acid
Itaconic Acid - 40-55%
Maleic Acid
Tartaric Acid - 5-15%
Water - 30%

 The liquids for GIC were aqueous solutions of polyacrylic acid in a

concentration of 40-50% but it was viscous and tended to gel over time.
 Now, it is a 40-55% solution of acrylic acid-itaconic acid copolymer
in water or a copolymer of acrylic acid and maleic acid. This
- Increases the reactivity of the liquid,
- Decrease its viscosity & Tendency for gelation.
Tartric acid is added
- To improve the handling characteristics
- Icreases the working time while it shortens the setting time to
produce a snap set.
B.Metal-reinforced GIC :-

1.Silver alloy admix GIC :-

Powder :- Physical blend of silver alloy and glass powder in a 1:7 ratio.
Liquid :- GIC liquid.
- This increases the strength and abrasion resistance of the cement
to some extent.
Eg., Miracle Mix
2.Cermet Cement :-
Powder :- Sintered glass-pure silver powder.
- Manufactured by intimately mixing equal volume of fine pure silver
powder and glass ionomer powder and compressing them in a
pelletizer at pressure above 350MPa.
- The palletizing chamber is then evacuated at 100MPa pressure
following which the compressed pellets are fused at 800 oC.
- This produces a sintered glass-silver composite – a “Cermet”
(Ceramic-Metal), which is then ground to a fine powder.
- 5% (by weight) of titanium oxide powder is added to this powder to
make it more elastic.
Liquid :- GIC liquid.
Eg ., Ketac silver, Chelon silver.
C.Resin-modified GIC :-

 Powder :- Ion-leachable fluoroaluminosilicate glass particles.

 Initiator for light-curing and/or chemical curing.
 Liquid :- Polyacrylic acid and water modified with pendant
methacrylate groups & HEMA monomers.
 Resin component is between 15 to 25%.
D.Condensable / High viscosity GIC :-

 They exhibits high strength, improved physical properties and early

resistance to water uptake..
 Eg., Ketac Molar, Fuji IX and Fuji IX GP.

Indication :-
Restoration of deciduous teeth.
Long-term temporary restorations.
Liner/base application.
ART technique.
 RESIN MODIFIED COMPOMER
GLASS IONOMER
Application CEMENT,RESTORATIV RESTORATIVE
E
Acid-base setting reaction YES NO
Polymerization setting YES YES
reaction
VLC depth of cure (mm) 2.7 4.7
Radiopacity (mm of Al) 1.8 3
Water 174 26
absorption(ụg/mm3)
Fluoride release(ụg/cm2) 21.2 7.8

Flexural modulus (GPa) 9.6 7.6

{DRY}
 DUAL CURE
• Resin luting cement
• Dual curing resin have combined light curing component & chemical curing
component
• On exposure to light of proper wave length, the light curing component
polymerizes. At the deeper area where light does not penetrate, slow chemical
polymerization occurs
• Dual curing is more complete in polymerizing than light cure
Eg. Panavia, Relyx ARC
INDICATION-
Area where limited access to light
1. Crown foundation
2. Bonded post and ceramics
3. Composite inlay, onlay and crown
 TRI CURE
• Resin modified glass ionomer cement
• Acid- base reaction between glass powder and
polyacrylic acid
• Light cure of the resin component
• Chemical cure of residual resin component occur
Setting Reaction Of Conventional Glass Ionomer Cement :-

 It is an acid-base reaction between the polyalkenoic acid liquid and

the glass powder particles.
 Three stages occur during setting of glass ionomer cements.

Stage 1 Dissolution :-
 The surface of glass particles is attacked by the polyacid results
in dissolution of the surface of the glass particles releasing calcium
and aluminium ions to the formation of a cement sol.
Stage 2 Precipitation of salts; gelation and hardening :-
 Calcium and aluminium ions bind to the polycarboxylate groups.
 Initial set : Due to cross-binding of the more readily available
calcium ions, complete within 4-5min after mixing.
 Final set : Occurs over next 24hrs when the aluminium ions get
bound within the cement matrix to form a more rigid cross-linking
between the polyacid chains.
 Sodium and fluoride ions do not take part in the cross-linking of
cement.
 Unreacted portions of the glass particles are sheathed by a silica
gel which develops during removal of cations from the surface of the
particles.
Stage 3 Hydration of salts :-
 Progressive hydration of matrix salts which leads to a sharp
improvement in the physical properties of the cement.
Structure of the set Conventional Glass Ionomer Cement :-

 Contains unreacted glass, supported & surrounded by a siliceous

hydrogel, embedded in the polysalt matrix.
 The fluoride ions released from the glass lie free within the matrix
and can move freely in and out of the set cement.
 Water plays an important role in the setting of glass ionomer
cements.
 Initially it serves as the reaction medium.
 Later slowly hydrates the cross-linked matrix making the set cement
stable, stronger and less sensitive to moisture.
 In the early stages of the setting reaction the cement is affected by
both dessication and moisture contamination.
 Dessication of the cement dehydrates it by removing the unbound
water causing loss of strength and physical integrity.
 Moisture contamination causes dissolution of the calcium
polyacrylate chains leading to their loss.
 So, cement must be protected against water loss or water gain during
placement and for a few days after setting.
Setting reaction of the resin-modified glass ionomer cements:-

Two chemical reactions begin.

i. Acid-base reaction between the glass and the polyacrylic acid.
ii. The cross-linking of the methacrylate groups due to chemical
initiator in the powder.
 On exposure to the curing light, there will be rapid cross linking of
the HEMA and the methacrylate groups of the powder.

Structure of the set resin-modified glass ionomer :-

 The set material has either a multiple cross-linked matrix or a matrix

containing two separate phases (polysalt matrix and poly HEMA
matrix).
Dispensing and Manipulation :-

Glass ionomer cements are available commercially in two forms:

1) Powder and liquid for hand mixing.
2) Pre-proportioned capsules for mechanical mixing.

1) Hand Mixing :-
 Great care is required to ensure proper powder-liquid ratio.
 Mixing may be done in a cool, dry glass slab or a paper pad using a thin-bladed plastic spatula.
 Main objective of mixing is to wet the Surface of each glass particle with the liquid.
 The powder is divided into two halves.
 The first half is rapidly incorporated into the liquid within 10 seconds by gently but rapidly rolling the
powder into the liquid.
  The second half is then incorporated and mixed within 15
seconds.
 Mixing should be completed within 25-30 seconds.
 The finished mix should be ‘glossy wet’ on the surface.
 The working time for the mixed cement is 1-2 minutes.

2) Mechanical Mixing :-
 Pre-proportioned capsules provide consistent powder-liquid
ratio, mechanical mixing in an amalgamator ensures standardized
mixing and setting times.
 The material can also be syringed into the cavity and
exhibits optimum physical properties.
 The loss of gloss/slump test helps in checking the efficiency
of the mechanical mixer.
Properties of Glass Ionomer Cements :-

1.Adhesion to enamel and dentin :-

- Adhere chemically to enamel and dentin.
- Diffusion based adhesion: Calcium phosphate-polyacrylate
crystalline structure at the interface between the tooth and set
cement.
- Bond to collagen of dentin by hydrogen bonding or metallic ion
bridging.
- Failure of the bond is usually due to cohesive failure in the
cement.
- Resin-modified glass ionomers exhibits similar or superior
bond to tooth structure.
- Resin-modified glass ionomers bond better to composite resins
due to presence of polymerizable groups within them.
 2.Biocompatibility :-
- Pulpal response to glass ionomer cement is favourable.
- The freshly mixed cement has a pH of 1 to 2 but this rises
rapidly within the first hour after setting.
- Cause mild inflammation which resolves soon.
- Factors responsible to this :
High buffering capacity of the hydroxyapatite.
ii. Large molecular weight of the polyacrylic acid.
3.Fluoride release :-
- Glass ionomer cement release fluoride into the mouth for the
prolonged periods of time.
- Released by the initial attack of the acid on the surface of the
glass particles.
- Initial release is high but declines rapidly after the first 3
months.
- Absorb fluoride from the mouth when topical fluorides are
applied.
- Thus serves as a fluoride reservoir.
4.Colour and translucency :-
- Both conventional and resin-modified glass ionomer cements
are available in various shades and provide acceptable colour
matching and translucency.

5.Radiopacity :-
- Conventional glass ionomer cements are radiolucent.
- Resin-modified and luting glass ionomer cements are
radiopaque due to the presence of lanthanum, barium or strontium in
the powder.
- Metal modified glass ionomer are more radiopaque due to
presence of silver particles.
6.Strength and Fracture resistance :-
- The compressive strength is similar to that of zinc phosphate
cement.
Type I 70-150MPa
Type II 140-220MPa
- The tensile strength is slightly higher than that of zinc
phosphate cement.
- The modulus of elasticity ranges from 7GPa to 13GPa.
- Weak and lack fracture resistance when compared to composite
resins and amalgams.
7.Abrasion resistance :-
- Less resistance to abrasion than composite resins but improves
as the cement matures.
- Cermet ionomers have improved abrasion resistance due to the
presence of silver particles.
8.Solubility and disintegration :-
- Exhibits low solubility in the oral environment.
- Resin modified glass ionomer cements are more resistance to
solubility and disintegration than conventional glass ionomer
cements because of initial setting by polymerization.

9.Thermal expansion and diffusivity :-

- Have a linear coefficient of thermal expansion & thermal
diffusivity is similar to that of tooth structure.
Advantages Of Glass Ionomer Cements :-

1.Adhesion to enamel and dentin :-

Chemically adhered to enamel and dentin through ion exchange.

2.Anticariogenic effect :-
- Released fluoride which prevents development of recurrent caries
and also plaque accumulation on the surface of glass ionomer
restoration.

3.Acceptable esthetics :-
- Available in various shades which exhibit good colour matching &
translucency.
4.Low solubility :-
Less soluble than other restoration.

5.Biocompatibility :-
Pulpal response to glass ionomer cement is favourable.
Freshly mixed cement is acidic in nature.

6.Less technique sensitivity :-

Less technique than composite resin & simple & easy to handle.
Disadvantages of Glass Ionomer Cements :-

1.Low fracture resistance :-

Weak and lack rigidity when compared with composite resin and amalgam.
Have low modulus of elasticity.

2.Low wear resistance :-

Low resistance to wear than composite resins.

3.Colour :-
Autocured glass ionomer cements are not as esthetic as composite resins.

4.Sensitivity to moisture soon after setting :-

- Sensitive to water uptake and loss soon after placement, which
affect physical properties and esthetics of the cement.
Indications of Glass Ionome r Cements :-

1.As a pit and fissure sealant :-

- An effective sealant for open fissures especially in children who are at
high risk for dental caries.

2.Class I restorations :-
- Indicated for restoration of buccal and lingual pits in molars and
lingual pits in anterior teeth.

3.Tunnel restorations :-
For restoring initial proximal caries in posterior teeth as tunnel
restoration.

4.Class III restorations :-

- For Class III cavities which can be approached from the lingual
aspects.

5.Class V restorations :-
- Preferred materials for carious and non-carious Class V cavities.

6.Root caries :-
- Due to adhesive potential and fluoride releasing capacity, used for
caries involving root surfaces.
7.As a liner/base :-
- Preferred as a liner/base beneath composite resins, amalgam and cast restorations
because of its adhesive nature and biocompatibility known as “Sandwich Technique”.

8.Restoration of deciduous teeth :-

- For restoration of Class I, II, III and V cavities in deciduous teeth due to ease of
handling.

9.As a core buildup material :-

- In anterior and posterior teeth, glass ionomer cements are employed as a core
buildup material prior to a full coverage restoration.

10.Luting cement :-
- Employed for luting inlays, onlays, crowns, orthodontic bands, pots and fixed
partial dentures.

11.As an interim restoration :-

- As a long-term temporary restoration in teeth with deep caries and questionable
pulpal status.

12.As a repair material :-

- For defective restoration margins such as marginal gaps in inlays, crowns.

13.In endodontics :-
- As an endodontic access filling material, root canal sealer, repair material for
root perforations and as a retrograde filling material.
Contraindications of Glass Ionomer Cements :-

1) In stress bearing areas :-

- Contraindicated in stress bearing areas like Class I, Class II and Class
IV cavities as they lack fracture toughness.

2) Labial buildup :-
- When large areas of labial enamel in anterior teeth has to be
replaced as in case of discolouration, abrasion or fractures because of
its esthetic is not as composite.

3) Cuspal coverage :-
- Not suited for cuspal replacement due to their lack of strength,
rigidity and fracture toughness.

4) In mouth-breathers :-
The restoration becomes opaque, brittle and disintegrate over a short
period of time.
General Clinical Steps For Glass Ionomer Restorations :-

Isolation :-
Highly sensitive to moisture contamination during placement so care
should be taken to isolate the tooth surface properly using rubber dam,
cotton rolls, retraction cords and saliva ejectors.

Tooth preparation :-
a) Cavity preparation :-
Required while restoring Class III or Class V carious lesions.
Cavity preparation should be dictated only by the extent of caries.
No mechanical retentive features are necessary.
For abrasion and erosion defects there is no need for cavity preparation.
Prophylaxis followed by surface conditioning is mandatory.
 a) Prophylaxis :-
Done using pumice slurry carried in a bristle brush.
This will remove any plaque or salivary pellicle from the tooth surface.

b) Surface conditioning :-
This is an important step in promoting good adhesion of glass ionomers.
Various agents have been tried for conditioning the tooth surface, such as :
10% Citric Acid.
3% Hydrogen Peroxide.
10% EDTA.
25% Tannic Acid.
10% Polyacrylic Acid.
 Of these agents, 10% polyacrylic acid applied for 10 to 25 seconds
is most widely accepted.
  Advantages of conditioning with polyacrylic acid:-
- It lowers the surface energy of the tooth thus increasing the
wettability by glass ionomer cement.
- It removes the smear layer while retaining the smear plugs.
- Being part of the glass ionomer system any residues left over will
not interfere with the setting reaction of the cement.

Proper manipulation of the cement :-

 Glass ionomer cements perform best when manipulated according to
the manufacture’s instructions.

Careful finishing and polishing :-

 This is very important for success of glass ionomer restorations as
discusses below.

Protection of the restoration surface :-

This is the final step in placing a glass ionomer restoration.
Finishing and Polishing of Glass Ionomer Restoration :-

 The best finish for glass ionomer cements is essentially the

matrix finish.
 However, excess material is invariably present beyond the
matrix which requires trimming.
 For autocure glass ionomer cements, the surface must be
immediately protected with low viscosity resin sealant and gross
excess should be trimmed using Bard Parker Blades or sharp carvers.
 Final finishing and polishing is done after 24 hours.
 Finishing diamond points are used to contour the restoration
and Sof-Lex discs from coarse to fine are used for final finishing.
 The finishing has to be done under moist conditions as dry
cutting will dehydrate the cement making it chalky and porous,
damaging its properties.
 Finally the surface has to be protected with the resin bonding
agent.
 An alternative method of surface protection, though no as
effective as the low viscosity resin sealant, would be to apply two
coats of varnish.
 One major advantage with resin-modified glass ionomer
cements is their ability to be finished and polished soon after light
curing is completed.
 They can be finished using fine finishing diamond points, 12-
fluted carbide burs and flexible Sof-Lex discs.
 Surface protection is required for resin-modified glass ionomer
cements also.
Clinical Applications Of Glass Ionomer Cements :-

1.Pit and fissure sealing

 Recommendations for fissure sealing using glass ionomer
cements (McLean and Wilson)
- The pit & fissure should be patent-an explorer tip should be able to
enter the orifice of the fissure.
- Eruption teeth with poor oral hygiene.
- High caries risk where good moisture control is difficult.

Clinical Procedure :-
a) Fissure widening :-
- Done by using fine tapered diamond bur in a high speed
handpiece under air/water spray open the fissure slightly which
ensure better flow and retention of the glass ionomer cement.

b) Conditioning :-
- After isolation, the tooth surface should be conditioned using 10%
polyacrylic acid for 10 to 15 seconds, washed thoroughly and
gently dried.
 c) Cement Placement :-
- A type III conventional glass ionomer cement or a restorative type
resin-modified cement is mixed in the recommended powder-liquid
ratio and syringed into the pit and fissures.
- After setting, the excess material can be trimmed with a sharp
spoon excavator.
- Protected by light cured bonding agents.

Advantages :-
Adhesion to enamel by an ion-exchange mechanism.
Fluoride release.

Disadvantages :-
Cement will not flow into pits and fissures that are not patent.
Retention rates are flow.
2.Tunnel restoration
 First described by Jinks in 1963 as a conservative alternative
for Class II cavity preparation in primary molars.

Indications :-
- Patients with high esthetic demand and low caries rate who exhibit
involvement of the marginal ridge.

Contraindications :-
Large proximal caries involving marginal ridges.
Difficulty in access.
Marginal rides subjected to excess occlusal loads.

Clinical technique :-
- Following rubber dam isolation, access is gained to the proximal
caries through the occlusal aspect 2mm away from the marginal
ridge on the involved side.
- A “tunnel” is prepared diagonally under the marginal ridge into
the proximal carious dentin.
 - Proximal enamel may be preserved or removed depending upon
its status.
- During restoration, a sectional matrix band is adapted and secured
by a wooden wedge.
- Cermet ionomer were originally used to restore cavities.
- After one to two weeks, the occlusal 1.5 to 2mm of the preparation
can be filled with composite resins as they are more wear resistant.

Advantages :-
- Marginal ridge is preserved.
- The perimeter of the restoration is reduced minimizing
microleakage.
- The adjacent tooth is protected.
- If the need arises in future a conventional approach can be adopted
and a regular Class II cavity prepared.

Disadvantages :-
- Poor visibility and lack of control over caries removal.
- Marginal ridge may be undermined.
- Preparation may extend closer to the pulp than desired.
3.The Atraumatic Restorative Technique (ART) technique
 Modern restorative dentistry requires electrically powered
equipment to perform various procedures.
 So, restoration of carious tooth are not possible in the
developing countries especially in remote areas due to lack of water,
electricity and equipment.
 Hand instruments are used to excavate the soft caries followed
by restoring the cavities with a highly viscous version of autocure
glass ionomer cement.

Indications :-
- Occlusal pit and fissure cavities of small to moderate size with
adequate tooth structure to surround the restoration.
- Less industrialized countries.
- Physically or mentally handicapped patients, refugees, children,
patients receiving home care services, etc.
Clinical procedure :-
- Teeth are isolated with cotton rolls.
- Undermined enamel is broken away using hand instruments
such as hatchets.
- Caries is excavated using spoon excavators.
- A highly viscous glass ionomer cement is placed into the
cavity and pressed by means of a gloved finger to fill the adjacent
pits and fissure also.
- Occlusion is checked and excess material is removed before
it hardens.
- The restoration is finally coated with Vaseline or petroleum
jelly.

Advantages :-
- Maximum preservation of the tooth structure.
- Minimal intervention procedure.
- Benefits of glass ionomer cement – adhesion, fluoride release,
biocompatibility.
- No need of sophisticated equipment or electricity.
- Minimal discomfort to patient.
- Low cost of the treatment.

Disadvantages :-
- Hand fatigue during instrumentation.
- Lack of proper access and visibility especially in extreme
posterior region.
4.Glass ionomer cement as liners and bases
 Type III glass ionomer cements are used as liners and bases
under various restorations.

Lining cements :-
- Used in a low powder-liquid ratio (1.5:1).
- Employed under any restoration when the cavity is deep.
- Used in thin section and should not be exposed to the oral
environment.
- Flow easily and fill deeper portions of the cavity.
- Seal the dentinal tubules.
- Prevent thermal insult to the pulp.

Base cements :-
- Used in a high powder-liquid ratio (3:1).
- Employed as bases beneath restorations, has to be placed in bulk.
- Considered as dentin substitutes and form an integral part of final
restoration.
“Sandwich” technique :-

 Developed by McLean to combine the beneficial properties of

glass ionomer cements and composite resins.
 Called the laminate or bilayered technique.
 Clinically employed while restoring large Class III, Class V,
Class I and Class II cavities with direct composite resins.

Clinical steps :-
- After cavity preparation, condition the cavity to develop good
adhesion with the glass ionomer.
- A fast setting type III glass ionomer cement is used to replace the
lost dentin in sufficient bulk.
- Once it has set, cut back to expose the enamel margins and to allow
enough bulk for composite resins.
- Etch the enamel and autocured glass ionomer cements for 15
seconds using phosphoric acid which improve the micromechanical
bond to composite resins.
- Wash and gently dry.
- Apply a thin coat of a low viscosity enamel bonding agent on the
enamel and glass ionomer base and light cure for 20 seconds.
- Proceed with composite resin buildup.
Advantages :-
- Favourable pulpal response due to biocompability of glass ionomer
cement.
- Ion-exchange adhesion of glass ionomer to dentin prevents
microleakage.
- Fluoride release from glass ionomers minimizes recurrent caries.
- Excellent subgingival response.
- By minimizing the bulk of the composite resin, polymerization
shrinkage of the resin is reduced.
- Better strength, finish and esthetics of the overlying composite.

Disadvantages :-
Time consuming procedure.
Technique sensitive.
5.Class III glass ionomer restorations
Indication :-
 Patient with high caries incidence.
 When the labial enamel is intact.
 Low occlusal stress and margins are not in areas of occlusal
contact.

Clinical Procedure :-
a. Local anaesthesia : To increase patient comfort and co-operation.

b. Shade selection : Done to choose appropriate shade of glass ionomer

cement.

c. Isolation : Rubber dam isolation will help in saliva control and

provide good access and visibility during cavity preparation and
restoration.

d. Cavity pre paration :

- A modified design is employed.
- Cavity preparation is done from a lingual removing carious
tooth structure, conserving as much sound tooth structure as
possible.
- The labial enamel is preserved.
 d. Matrix : A mylar strip that extended 1 to 2 mm over the sound
tooth structure is selected, tried, adapted and stabilized with a wedge.

e. Surface conditioning :
- Done using 10% polyacrylic acid applied for 10 to 15 seconds.
- The surface is then rinsed copiously with water and dried gently to
avoid dessication.

f. Manipulation of the cement :

- The glass ionomer cement is dispensed and mixed.
- This mixes can be directly injected into prepare cavity.

g. Finishing :
- Gross excess is trimmed by BP blade and surface is protected with
a resin bonding gent.
- Final finishing is done after 24hrs using finishing diamonds,
tungsten carbide finishing burs and Sof-Lex discs.
6.Class V glass ionomer restorations :-
Indications :-
- Patients with high caries intake.
- Several abrasion and erosion lesions.
- Where esthetics is not of prime concern.
- Root surface lesions as subginvival margins are suitable for glass
ionomer cements.
- Preferred materials for Class V lesions because of their adhesion
and also due to their flexibility-the low modulus of elasticity.

Clinical Preparation :-
a. Local anaesthesia : done to improve patient comfort and co-
operation.

b. Shade selection : Yellow or dark yellow shade is selected.

c. Isolation : Rubber dam isolation is preferred.

 d. Cavity preparation :-
 For Class V carious defects :
The cavity preparation is done using round bur.
Infected dentin is removed while the affected dentin is retained.

For Class V non-carious lesions :

- For abrasion, erosion or abfraction lesions, no cavity preparation is necessary.
- Because surface is smooth and conditioning alone provide good adhesion.
- Pumice prophylaxis is a must.

e. Pumice prophylaxis : Done to remove any deposits, salivary pellicle, etc. so as to

render the surface clean and receptive for conditioning.

f. Matrix : Tin foil matrices are indicated.

g. Surface conditioning :
h. Manipulation : Same as Class III glass ionomer restorations.
I. Finishing :
7.Long-term temporary restorations using glass ionomer cements

Due to its advantage like adhesion, biocompatibility and fluoride release.

Recommendation :
- As part of a caries control programme in acute carious lesions that
are raidly advancing towards the pulp.
- While awaiting the outcome of a pulp capping procedure.
8.Core buildup
 Cermet ionomers are useful as core buildup materials especially
in posterior teeth.

Clinical steps :
- After tooth preparation, isolate using cotton rolls.
- Condition the dentin surfaces using 10% polyacrylic acid for 10
seconds, wash and gently dry.
- Mix cermet ioomers according to manufacturer’s instructions and
place using a syringe or plastic instrument.
- Matrix may or may not be used.
- Coat the cement surface with varnish to protect from moisture while
setting.
- The material sets fast.
- Following setting complete crown preparation and proceed with the
impressions.
Advantages :
- Adhesive properties.
- Caries resistance.
- Low thermal conductivity.
- Cohesive nature which makes placement easy without the need for
a matrix.
- Fast setting time which allow quick crown reparation.
9.Luting with glass ionomer cements :-
 Useful for luting indirect restoration like inlays, onlays, crowns,
bridges as well as orthodontic appliances.

Manipulation :-
- The powder-liquid ratio : 1.5:1.0
- The setting time is 5 to 7 minutes.
- The freshly mixed cement has good thixotropic flow. So no need
for application of pressure after the restoration is fully seated.

Advantages :-
- Good flow characteristics.
- Low film thickness.
- Biocompatibility with the pulp and gingival tissues.
- Low solubility.
- Anticariogenic property due to fluoride release.
- Adhesive property.
- Tensile strength and abrasion resistance similar to zinc phosphate
cement.