REVISITING GLASS IONOMER
CASE REPORT: CLASS V RESTORATION
A 59-year-old male presented with a Class V carious lesion ( figure 1).
Based upon the patient’s risk assessment, it was determined that the
best treatment plan was to restore the lesion with a glass ionomer
restorative material such as IonoStar Plus (Voco), due to its handling
characteristics, esthetics, and fluoride release. The nonsticky, composite-like handling and immediate packability of the material were desirable
characteristics for treating the lesion. The material had the added
benefit of a new direct-activation application capsule without the need
for an adhesive, reducing the chair time required. The finished restoration ( figure 2) provided desirable esthetics as well as a reduction in
CLASS II RESTORATIONS
Figure 3 shows a well-sealed Class II restoration using IonoStar Plus.
IonoStar Plus features ease of placement, along with the benefit of a
two-stage consistency, which allows for packability. It has high com-
pressive strength and wear resistance, making it well suited in the
posterior region of the mouth.
Figure 1: Patient presented with Class V
Figure 2: Completed
Figure 3: Class II
using IonoStar Plus
In recent years, there has been much progress in the development of new
restorative adhesive materials, including both resin composites and glass
ionomers. While some writers have argued that resin composites have
advanced sufficiently such that there is no longer a need to use glass
ionomers, the dental profession has seen recent developments in glass
ionomers that call that view into question. A defining characteristic of
new glass ionomer restorative materials is the chemical composition,
which is beneficial for patients with high caries susceptibility.
1. Niederman R. Glass ionomer and resin-based fissure sealants—equally
effective? Evid Based Dent. 2010; 11( 1): 10.
2. Mickenautsch S, Yengopal V. Caries-preventive effect of glass ionomer and
resin-based fissure sealants on permanent teeth: An update of systematic review
evidence. BMC Res Notes. 2011;4: 22.
3. Mickenautsch S, Yengopal V. Caries-preventive effect of high-viscosity glass
ionomer and resin-based fissure sealants on permanent teeth: A systematic
review of clinical trials. PLoS One. 2016; 11( 1). https://doi.org/10.1371/journal.
pone.0146512. Accessed June 30, 2017.
4. Baroudi K, Rodrigues JC. Flowable resin composites: A systematic review and
clinical considerations. J Clin Diagn Res. 2015; 9( 6):ZE18-ZE24.
5. Strassler HE. Glass ionomers for direct placement restorations. Dental Academy
of CE website. http://www.ineedce.com/courses/2052/PDF/1104cei_
glassionomer_web.pdf. Published 2011. Accessed June 30, 2017.
6. Graham L. Glass ionomers in modern clinical practice. Dentistry Today website.
modern-clincial-practice. Published February 28, 2017. Accessed June 30, 2017.
7. Anusavice KJ. Phillips’ Science of Dental Materials. United Kingdom: Elsevier
Health Sciences; 2003:471-472.
8. Ahovuo-Saloranta A, Forss H, Walsh T, et al. Sealants for preventing dental decay
in the permanent teeth (review). Cochrane Database Syst Rev. 2013;( 3):
full. Accessed June 30, 2017.
9. Ngo HC, Mount G, McIntyre J, Tuisuva J, Von Dousse RJ. Chemical exchange
between glass-ionomer restorations and residual carious dentine in permanent
molars: an in vivo study. J Dent. 2006; 34( 8):608-613.
STEVEN EISEN, DMD, has worked 28 years in private
practice. His interests include dental materials and
educational research. Dr. Eisen has been published in the
Journal of Dental Education, the Journal of Cosmetic
Dentistry, and Compendium. He is a reviewer for the Journal
of Dental Education and has authored research abstracts
with the International Association of Dental Research.
GERARD KUGEL, DMD, PhD, MS, is a reviewer for the
New England Journal of Medicine, the Journal of the
American Dental Association, the Journal of Esthetic and
Restorative Dentistry, and Clinicians Report. Dr. Kugel has his
doctorate in dental materials and an executive certificate in
management and leadership from the Massachusetts
Institute of Technology Sloan School of Management.
Glass ionomers release fluoride,
which prevents further enamel
demineralization and promotes