Since their introduction in the market, some 30 yrs ago, the biocompatibility aspects of glass-ionomer cements (GICs) have been intensively studied. In general, cytotoxicity of fully set conventional preparations in previous studies was shown to be minimal. However, a resin-modified preparation proved to be cytotoxic under these conditions. This product was also observed to be mutagenic, but data in this area are sparse and difficult to interpret. There is also evidence that certain GICs exert some antibacterial properties which is claimed to be related to the fluoride release; however, the mechanisms for this fluoride release are still unclear. Pulp response studies have shown conflicting results. However, unfavorable initial reactions, if present, resolved with time if a bacterial layer under the restoration and pulp exposures were prevented. Pain reactions after cementation of cast restorations with GICs have been reported in the past but there are no such reports in the more recent literature.
