The Benefits of Glass Ionomers in Restorative Dentistry
玻璃離子水門汀在修復牙科中的收益
An innovative cement that imitates some characteristics of natural teeth and provides fluoride-ion benefits
作為一種創新型水門汀，它可以模仿天然牙齒某些特性並提供氟離子的益處。
Theodore P. Croll, DDS; and Joel H. Berg, DDS, MS
Glass-ionomer cement systems have gained a prominent place in modern clinical dentistry.1 Today, more than 40 states allow dental assistants to use glass ionomers in various capacities. Glass ionomer has become the common term for glass-polyalkenoate cements. These materials are made of calcium alumino-fluoro-silicate glass powder (base) combined with a water-soluble polymer (acid). When mixed together, the glass and acid components undergo a setting reaction involving neutralization of the acid groups by the powdered solid glass base. To curious patients, the authors describe this reaction as the following: The acid solution chemically melts the glass powder and creates a solid glass-like repair material that actually bonds to the enamel and dentin and, in many ways, resembles tooth structure. Significant amounts of fluoride ions are released from the glass powder during this reaction, without diminution of the hardened cement’s physical properties. The first glass-ionomer compound was invented in 1969, and Wilson and Kent2,3 reported about the new dental material concept in the early 1970s.
玻璃離子水門汀系統在現代臨床牙科中佔有突出地位。1今天，超過40個州允許牙科助理使用不同容量的玻璃離子。玻璃離子已成為玻璃-聚鏈烯烴水門汀的常用術語。這些材料是由鋁-氟-矽酸鈣玻璃粉（鹼)與水溶性聚合物(酸)結合而成。當混合在一起時，玻璃和酸組分經歷了一個固化反應，包括通過粉末固體玻璃鹼離子中和酸基團。對於好奇的患者，作者將這種反應描述為：酸性溶液化學熔化玻璃粉末，並產生一種固體玻璃狀修復材料，實際上與釉質和牙本質結合，在許多方面類似於牙齒結構。在這種反應中，大量的氟離子從玻璃粉末中釋放出來，而不會削弱硬化水門汀的物理性能。第一種玻璃離子化合物是在1969年發明的，Wilson和Kent在20世紀70年代初報導了新的牙科材料概念。2，3
Regardless of the favorable properties of glass ionomers, the initial materials in the 1970s were quite difficult to use and had distinct disadvantages. They had long hardening times and were very susceptible to breakdown or fracture if they became too wet or too dry during the extended setting reaction. Their important physical properties, once set, were inferior to the resin-based composites, even though the glass ionomers were more compatible with, and comparable to, dentin. As time passed, materials scientists continued to work on developing glass-ionomer systems, realizing their potential and searching for ways to improve the products. Alterations in the glass particle sizes and distributions and types of acid formulations have improved handling and physical properties of the cements.
儘管玻璃離子具有良好的性能，但20世紀70年代的初始材料很難使用，而且有明顯的缺點。它們有較長的固化時間，如果在延長的固化反應中變得太溼或太幹，它們很容易破裂或斷裂。一旦固化，它們的重要物理性能，就不如樹脂基複合材料，儘管玻璃離子更具相容性，並可與牙本質相媲美。隨著時間的推移，材料科學家繼續致力於開發玻璃離子系統，發揮其潛力，並尋找改進產品的方法。玻璃顆粒尺寸、分布和酸製劑類型的變化改善了水門汀的操作和物理性能。
In the 1980s and 1990s, metal-modified glass ionomers and those containing a light-polymerized liquid resin component were introduced. Resin-modified glass-ionomer cements have significantly enhanced physical properties along with the great advantage of rapid, 「on command」 hardening by concentrated visible light exposure. Products in this class of glass ionomers have been manufactured and packaged in such ways to enhance handling, delivery of the material in the mouth, overall user convenience, and durability in the mouth.
在1980年代和1990年代，引入了金屬改性的玻璃離子水門汀和含有光聚合液態樹脂組分的玻璃離子水門汀。樹脂改性的玻璃離子水門汀具有顯著增強的物理性能，並具有通過集中可見光照射快速「按需」硬化的巨大優勢。這類玻璃離子的產品已通過以下方式進行製造和包裝，以增強材料在口腔中的操作性，傳遞，以及總體用戶便利性和口內耐久性。
Since the 1960s when glass-ionomer cements were first developed, the variety of tooth-colored restorative materials has caused confusion among dentists. The resin-based composites and glass-ionomer systems are the two major groups of such materials; however, the many variations and overlaps can make it difficult to sort out the product types. McLean et al4 addressed this issue in 1994, and Mount et al5 provided an update in 2009. A true glass-ionomer cement, whether it be used for tooth repair or luting purposes, has a hardening mechanism that involves a significant acid-base reaction—that is, the acid is a water-soluble polymer and the base is a special glass.4-8
自1960年代首次開發玻璃離子水門汀以來，各種牙齒顏色的修復材料引起了牙醫的困惑。樹脂基複合材料和玻璃離子體系是這類材料的兩大類。但是，許多變化和重疊會導致難以分類產品類型。McLean等[4]於1994年解決了這個問題，Mount等[5]在2009年進行了更新。一種真正的玻璃離子水門汀，無論是用於牙齒修復還是用於粘結，都具有一種硬化機制，該機制涉及重大的酸鹼反應， 也就是說，酸是一種水溶性聚合物，而鹼是一種特殊的玻璃。4-8
All glass-ionomer systems share certain properties. Along with their chemical bonding to dentin and enamel, good biocompatibility, and easy handling by syringe injection, the hardened cements have coefficients of thermal expansion quite similar to that of tooth structure. That means when cold or hot foods influence expansion and contraction of enamel and dentin, the cement expands and contracts in concert. That property, along with the chemical bond, helps to maintain marginal integrity and facilitates fluoride-ion dynamics.
所有玻璃離子系統都具有某些特性。與牙本質和牙釉質的化學結合、良好的生物相容性和注射器注射操作方便，其熱膨脹係數與牙齒結構相當相似。這意味著，當冷熱食物影響牙釉質和牙本質的膨脹和收縮時，水門汀就會膨脹和收縮。這種性質，連同化學鍵，有助於保持邊緣完整性和促進氟離子動力學。
Glass-ionomer cement systems can be considered 「therapeutic」 dental materials. Fluoride ions are released by glass ionomers and are taken up by associated enamel and dentin. That tooth structure becomes less susceptible to acid challenge.9-27 In addition, water-based glass-ionomer materials act as fluoride-ion reservoirs by taking in salivary fluoride from dentifrices, mouthwashes, and topical fluoride solutions in the dental office. The fluoride content in true glass-ionomer systems and its ongoing activity is not only beneficial for young patients, but is particularly advantageous for all people with high susceptibilities to dental caries; for example, elderly patients with decreased abilities in personal home care and gingival recession with associated root caries.
玻璃離子水門汀系統可以被認為是「治療性」牙科材料。氟離子由玻璃離子釋放，並被相關的牙釉質和牙本質吸收。這種牙齒結構不太容易受到酸的挑戰。9-27此外，水基玻璃離子材料通過從牙膏、漱口液和牙科診所的局部氟化物溶液中吸收唾液氟化物，充當氟離子庫。真正的玻璃離子系統中的氟化物含量及其持續的活動不僅對年輕患者有利，而且對所有對齲齒高度敏感的人特別有利；例如，老年人在個人家庭護理能力下降和牙齦衰退與相關的根齲。
Another major development in tooth restoration related to resin-modified glass-ionomer systems is that the light-curing resin component of the glass-ionomer cement chemically combines with resin-based composite material. Because certain glass-ionomer cements are the best direct-application dentin replacement materials presently available and resin-based composites closely simulate enamel, using the two in combination makes for biomimetic 「tissue-specific tooth repair.」28,29 The word biomimetic means something imitating nature. This concept has been called layering, the sandwich technique, or stratification.
與樹脂改性玻璃離子體系有關的牙齒修復的另一個主要發展是玻璃離子水門汀的光固化樹脂組分與樹脂基複合材料化學結合。由於某些玻璃離子水門汀是目前可用的最佳直接應用牙本質替代材料，而樹脂基複合材料則密切模擬牙釉質，兩者結合使用可使仿生「組織特異性牙齒修復。這個概念被稱為分層，三明治技術，或層化。
In the past decade, many new glass-ionomer products have been introduced in the dental materials marketplace. These include tooth-repair materials, dentin-replacement liners and bases, and luting cements. Along with their uses in cementing various types of full crowns in both permanent and primary teeth, glass-ionomer luting cements have proven extremely effective in orthodontics. The fluoride content of these cements is helpful to prevent decalcification around bonded brackets and other hardware and stainless steel bands cemented to posterior 「anchor」 teeth. While certain manufacturers have been the main source of glass-ionomer products and innovations, other dental companies have developed and introduced their own brands of glass-ionomer systems.
在過去的十年中，許多新的玻璃離子產品被引入牙科材料市場。這些包括牙齒修復材料，牙本質替代洞襯和墊底，以及粘固水門汀。隨著它們在恆牙和乳牙中各種類型的全冠粘固中的應用，玻璃離子粘固水門汀在正畸中被證明是非常有效的。這些水門汀的氟化物含量有助於防止粘結支架和其他硬體和不鏽鋼帶周圍的脫鈣膠結後「錨」牙齒。雖然某些製造商一直是玻璃離子水門汀產品和創新的主要來源，但其他牙科公司已經開發和引進了自己品牌的玻璃離子系統。
Figures 1 through 10 demonstrate various uses for glass-ionomer cement systems.
圖1至圖10顯示了玻璃離子水門汀系統的各種用途。
Image 1 of 10 Figure 1 A 3-year-old girl with many severe caries lesions.
圖1一個3歲的女孩，有很多嚴重的齲齒病變。
Image 2 of 10 Figure 2 At 26 months after restoration of carious teeth with resin-modified glass-ionomer filling material.
圖2 用樹脂改性玻璃離子填充材料修復齲齒後的26個月。
Image 3 of 10 Figure 3 Restored tooth, 2 years after treatment.
圖3 治療2年後的牙齒修復。
Image 4 of 10 Figure 4 A 7-year-old boy with enamel malformation and caries of permanent first molar.
圖4一個7歲男孩，牙釉質畸形，恆牙第一磨牙齲齒。
Image 5 of 10 Figure 5 At 30 months after repair with resin-modified glass-ionomer liner overlaid with restorative cement.
圖5在修復後30個月，用樹脂改性玻璃離子洞襯覆蓋修復水門汀。
Image 6 of 10 Figure 6 Primary second molar with deep caries lesion.
圖6乳牙第二磨牙有深齲病變。
Image 7 of 10 Figure 7 Resin-modified glass-ionomer liner placed.
圖7 放置了樹脂改性玻璃離子洞襯。
Image 8 of 10 Figure 8 Two primary molars, 5 years after restoration with nano-ionomer material (Ketac™ Nano, 3M ESPE, www.3mespe.com). Bitewing films at 5 years.
圖8 兩個乳牙磨牙，用納米離子材料修復5年後(Ketac™Nano，3MESPE，www.3mespe.com)。5年時的咬合膠片。
Image 9 of 10 Figure 9 A 5-year-old boy with Class V caries lesions.
圖9一名5歲男孩患V類齲病。
Image 10 of 10 Figure 10 One year after treatment using resin-modified glass-ionomer cement.
圖10 使用樹脂改性玻璃離子水門汀處理一年後。
Conclusion/總結
The adhesive dentistry revolution that has propelled clinical dentistry to new heights in the past four decades is not about resin-based composites alone. Even though glass-ionomer systems, including resin-modified glass-ionomers, do not possess certain physical strengths of the resin-based composites, they have other advantages that make them excellent biomimetic materials to replace dentin. Some are good enough to replace both enamel and dentin for use in primary teeth and certain applications in permanent teeth, as well. As materials scientists continue their work, perhaps new direct-application restorative materials will be developed that have the physical properties and handling characteristics of both resin-modified glass-ionomers and resin-based composites.
在過去的四十年中，粘結牙科的革命將臨床牙科推向了新的高度，而不僅僅是樹脂基複合材料。儘管包括樹脂改性的玻璃離子水門汀在內的玻璃離子水門汀體系不具備樹脂基複合材料的某些物理強度，但它們還有其他優勢，使其成為替代牙本質的優秀仿生材料。其中一些足以替代牙釉質和牙本質，可用於乳齒和某些永久性牙齒。隨著材料科學家的繼續工作，也許將開發出具有樹脂改性玻璃離子水門汀和樹脂基複合材料的物理性能和操作特性的新型直接應用修復材料。
Authors』 Note/作者的注意事項
This article is a modified version of Croll TP, Berg JH. Glass-ionomer cement systems. Inside Dentistry. 2010;6(8):82-87.
About the Authors/關於作者
Theodore P. Croll, DDS
Private practice, pediatric dentistry
Doylestown, Pennsylvania
Joel H. Berg, DDS
Dean
University of Washington School of Dentistry
Seattle, Washington
References(omitted)
參考文獻（略）
來源https://www.aegisdentalnetwork.com/ida/2014/08/the-benefits-of-glass-ionomers-in-restorative-dentistry
附錄：
Glass Ionomer Fillings
玻璃離子充填
Glass Ionomer Fillings are a material made from acrylic and a component of glass – 『flouroaluminosilicate』. They can be bonded to your tooth using a chemical reaction which makes the bond very strong. The filling is bonded straight onto the tooth, and no real preparation is required before you are fitted with one. Some dentists maintain that glass ionomer fillings are not very strong and last only 5 years or so.
玻璃離子充填材料是由丙烯酸和一種玻璃的成分–氟鋁矽酸鹽製成的材料。它們可以通過化學反應粘結到您的牙齒上，從而使結合非常牢固。填充物直接粘結在牙齒上，在您安裝牙齒之前，不需要進行真正的準備。一些牙醫認為玻璃離子填充物不是很堅固，只能使用5年左右。
Glass Ionomer Filling Use
玻璃離子充填用途
As a base or cement for other forms of fillings if the cavity is particularly big or the cavity reaches below the gum line.
For babies and small children, no drilling or preparation is needed and so the pain is minimal
For front teeth and areas that aren’t used to bite or chew, i.e. around the necks of the teeth.
當窩洞特別大或窩洞達到牙齦線以下時，作為其他形式充填的墊底或粘結劑。
對於嬰兒和小孩子來說，不需要鑽孔或準備，所以疼痛是最小的
用於門牙和不被用來咬或咀嚼的區域，即用在牙齒的頸部。
Glass Ionomer Filling Advantages
玻璃離子填充優點
Closely matches the colour of your teeth.
Often no preparation is needed before you are fitted with a glass ionomer filling. This means that it is a popular choice for use when children have cavities that need filling.
They release fluoride over time, thus strengthening your tooth and maintaining good dental health.
They bond exceptionally well to the tooth, so preventing any further decay or leaking.
與你牙齒的顏色緊密匹配。
通常在玻璃離子填充之前不需要任何預備。這意味著它是一個流行的選擇，當兒童有蛀牙需要填補時。
隨著時間的推移，它們會釋放氟化物，從而加強你的牙齒，保持良好的牙齒健康。
它們與牙齒的結合非常好，因此防止了任何進一步的腐爛或滲漏。
Glass Ionomer Filling Disadvantages
玻璃離子填充缺點
The material is a lot weaker than other filling materials and is prone to quick wear and tear.
Although the colour is close, it is not a perfect match to your original tooth colour.
It takes a long time to complete Glass Ionomer, treatment as each layer has to be bonded individually.
材料比其他填充材料弱很多，容易發生快速磨損。
雖然顏色很接近，但它並不完全匹配你原來的牙齒顏色。
完成玻璃離子體需要很長時間，因為每一層都必須單獨粘合。
來源 https://www.healthcentre.org.uk/dentistry/glass-ionomer-fillings.html
【注】本文僅供相關專業人員參考，中文部分由本人翻譯，實際內容以英文部分為準。