title: A clinical study of the "open sandwich" technique in pediatric dental practice.
abstract: OBJECTIVE
  This study evaluated the clinical efficacy of the "open sandwich" restoration for pediatric dental practice.
  
  
  METHODS
  Three pediatric dentists used a standardized preparation and restorative technique to place the restorations. The prepared tooth was etched with a phosphoric acid semigel and rinsed. A resin modified glass ionomer (Fuji II LCor Photac-Fil) was placed short of the margins and then light cured. The resin modified glass ionomer was covered with an occlusal layer of a microhybrid flowable composite (Aeliteflo or Flow-it). The same preparation for the experimental restorations was used for the control conventional amalgam (Tytin) restorations. The restorations were evaluated at 6-month intervals and ranked with a modified United States Public Heath Survey (USPHS) scale as follows: Alfa: No discernible marginal opening or stain; Beta: Slight opening of margin discernible with dental explorer, but without stain; Charlie: Open margin and stain; Delta: Recurrent caries or restoration failure. Restoration failures were categorized according to etiology, pulpal necrosis, bruxism, marginal leakage, isthmus fracture, or adhesive failure.
  
  
  RESULTS
  All recalled experimental restorations, except 8, were rated as either Alpha or Beta. Six failed due to isthmus fracture and 2 due to pulpal necrosis. Fifteen restorations had delaminating of the flowable composite from the resin modified glass ionomer. The use of the "open sandwich" technique compared favorably with a similar study using adhesive amalgam restorations.
  
  
  CONCLUSIONS
  The "open sandwich" technique can be successfully used in a pediatric dental practice.
authors.affiliation: Division of Dentistry, Department of Clinical Surgery, Northwestern University Medical School, Chicago, USA. markcannon@attbi.com
authors.forename: Mark L
authors.initials: ML
authors.lastname: Cannon
mesh_terms: D000134:Acid Etching, Dental; D002012:Bruxism / Q000150:complications; D002648:Child; D004396:Coloring Agents; D003188:Composite Resins / Q000737:chemistry; D003723:Dental Amalgam / Q000737:chemistry; D001840:Dental Bonding; D003737:Dental Cavity Preparation / Q000379:methods; D003763:Dental Leakage / Q000145:classification; D018772:Dental Marginal Adaptation; D003790:Dental Pulp Necrosis / Q000150:complications; D019232:Dental Restoration Failure; D003793:Dental Restoration, Permanent / Q000379:methods*; D005500:Follow-Up Studies; D005899:Glass Ionomer Cements / Q000737:chemistry; D006801:Humans; D012008:Recurrence; D019279:Resin Cements / Q000737:chemistry; D013499:Surface Properties
chemical_list: D004396:Coloring Agents; D003188:Composite Resins; D005899:Glass Ionomer Cements; D019279:Resin Cements; D003723:Dental Amalgam