Advanced glass ionomers are easier to handle and offer improved esthetics
Jeff Brucia, DDS
My father opened his full-time general practice in San Francisco in 1946, which I took over 30 years ago. The practice offers procedures that cover all areas of restorative dentistry, from basic maintenance to advanced full-mouth reconstruction. Over the years, I have had the opportunity to see, through my father's dentistry, a long-term track record of what techniques have worked and what materials and procedures still need improvement.
My experience with numerous materials in restorative dentistry has led me to the conclusion that many dentists have a misunderstanding of glass ionomers. Glass ionomers are bulk-fill materials that chemically bond to the tooth without the need for a bonding agent, providing a better treatment option when working in a compromised clinical environment. Pure glass ionomers are biocompatible, monomer-free, and Bisphenol A–free. These and many other advantages make glass ionomers a great option for restorations, and these restorations are an excellent service to provide to patients at any level of restorative practice.
Glass ionomers are not often taught in North American dental schools, therefore, many general dentists, especially newer practitioners, are not aware of these materials as an option for restorative procedures. This lack of formal education leaves some dentists who do have glass ionomers on their radar with the belief that the material is weak, has poor esthetics, and is difficult to handle. However, after years of experience using glass ionomers in restorative procedures, I disagree.
For more than 28 years, I have used glass ionomers in my practice routinely, almost every day. I reach for glass ionomers, such as the IonoStar Plus or the Ionolux from VOCO, when I have less-than-ideal control over the oral environment. Composites are typically the direct restorative material of choice in North America; however, composites do not perform well if the environment is not healthy. Glass ionomers perform exceptionally well in areas with a high caries rate, such as environments that occur in patients with poor diet, poor oral hygiene, saliva dysfunction, or other factors. Recently, advancements in products such as the IonoStar Plus make glass ionomers easier to handle and more esthetic, which are two of the arguments against their use. As glass ionomers become even more of a quality option, they should be considered as a significant advantage when choosing a material for restorative procedures.