Review: IonoStar Plus (Voco) glass ionomer for dental restorations

In recent years, there have been significant developments in restorative dental materials. The dental profession has seen the introduction of two main types of esthetic direct-restorative materials: glass ionomers and adhesive-based resin composites. Some writers argue that there may no longer be a need for a reliance on glass ionomers, since nowadays composites offer so many advantages - such as excellent esthetics, wear resistance, and strength - and are so much improved over what they were like in the past.^1-4 Their arguments are understandable, as conventional glass ionomer cements tended to exhibit poor physicomechanical properties, making them more susceptible to wear. They also had slow self-setting reactions, such that preliminary finishing could not be done for 10 minutes, and final finishing could not be done for 24 hours or more.⁵

However, new glass ionomers have demonstrated significant improvements. They now have better physical and optical properties, and therefore complement restorative dentistry with special characteristics - ones that seem to guarantee them a continued place in our profession. New glass ionomers offer unique clinical benefits, such as fluoride release, recharging of fluoride, possible dentin remineralization within preparations, moisture tolerance, and chemical self-adhesion, so that clinicians are likely to continue to rely upon them for the foreseeable future.⁶

Some of the improvements in glass ionomers can be attributed to enhancements in resin-modified glass ionomer restorative chemistry, which involves the addition of water-soluble photopolymerizable resin monomers, 2-hydroxyethylmethacrylate (HEMA) to the acidic cement liquid. For powder-liquid resin-modified glass ionomers, some manufacturers have developed proprietary resin formulations. These enhancements allow them to be dual cured - self-setting and light cured. When compared to conventional glass ionomers, these resin-modified glass ionomers display improved physicomechanical properties, resistance to early contamination by moisture, less microleakage, improved adhesion to enamel and dentin, and significant improvement in esthetic properties.