Aesthetics, Polishability, and Patient Perception

Alan welcomes Dr. Zach Meiners, co-host of the Very Clinical podcast and restorative dentist extraordinaire, back to the Very Dental podcast. They dive deep into their shared passion for glass ionomer (GI) restorative materials. Sparked by Alan's recent solo episode on using glass ionomer for groove restorations the guys talk GI in depth. 

• Glass Ionomer (GI) as a Primary Restorative: Both doctors advocate for GI (like Fuji 9 or Equia) as a legitimate, permanent restorative material for specific classes of restorations, moving past its traditional use as only a provisional or base.

• Ideal Clinical Applications: GI is highly effective for:

  • Class I, III, and V restorations, particularly on posterior teeth where aesthetics are less critical.

  • Geriatric and Pediatric patients due to its forgiving nature, minimal technique sensitivity, and fluoride release.

  • Core Build-ups: Zach considers it his main build-up material, noting its reliable adhesion and stability against being pulled out by temporary crowns.

  • Crown Margin Repairs.

• Material Benefits: GI offers several advantages over traditional resin or amalgam:

  • No Post-Operative Sensitivity and Minimal Shrinkage.

  • Forgiving Technique in less-than-ideal isolation situations, sticking particularly well to dentin.

  • Continued Hardening for months after the initial set, leading to excellent longevity and a surprisingly low failure rate.

• Efficiency and Cost: While the initial cost of GI is relatively high, the efficiency gained from eliminating the need for separate etching and bonding steps (using only a cavity conditioner provided in the kit) and the speed of placement makes it a cost-effective choice in terms of time and materials.

• Placement and Setting:

  • Placement Technique: For occlusal restorations (like in grooves), Alan recommends over-squirting the material and using a moist, gloved finger to push it into the grooves, or using an anti-stick agent like Stick Free for metal instruments.

  • Accelerating Set: Though not a light-cure material, applying the curing light can accelerate the chemical setting reaction via heat, cutting the two-and-a-half-minute set time down to about 90 seconds.

• The GI "Dream": The doctors agree that a future GI material with the strength to reliably handle Class II restorations would revolutionize the entire direct restorative market, given GI's unique benefits.

 Some links from the show:

• Fuji IX
• Fuji Equia Forte 

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