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Sandwich technique

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Sandwich technique used in Restorative Dentistry

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Sandwich technique

  1. 1. Sandwich Technique 4/26/2016 1
  2. 2. Outline • Introduction • Types • Technique • Indications and Contraindications • Advantages and Disadvantages • Conclusion • References 4/26/2016 2
  3. 3. What is sandwich? • Something resembling a sandwich; especially composite structural material consisting of layers often of high-strength facings bonded to a low strength central core. 4/26/2016 3
  4. 4. • A restoration in a tooth in which two restorative materials are used that are chemically bound together. • Here, a glass-ionomer or flowable composite material is used as a liner under some composite restorations. Introduction 4/26/2016 4
  5. 5. Types • Closed sandwich technique: The underlying material does not come into contact with the oral cavity. 4/26/2016 5
  6. 6. • Open sandwich technique: Usually used for Class II restorations where the underlying material forms part of the axial wall and is exposed to the oral environment. 4/26/2016 6
  7. 7. Glass Ionomer Cement • Benefits as a liner: –Bonds both to the tooth structure and the composite, increasing retention form and providing better seal when used at non- enamel margins. –Fluoride in the GI material reduces potential for recurrent caries. 4/26/2016 7
  8. 8. Flowable Composite • Benefit as a liner: –Acts as a shock absorber, distributing stresses applied to the more rigid composite –May reduce some of the negative effects of polymerization shrinkage. 4/26/2016 8
  9. 9. Indications of Sandwich Technique • Lesions where one or more margins are in dentin-like cervical lesions (class V) • Class II composite restorations • When any part of the gingival margin of class II preparation has been extended past the CEJ, and no longer has an enamel cavo-surface 4/26/2016 9
  10. 10. How to do the Sandwich Technique 4/26/2016 10
  11. 11. 1. Prepare Class I/II cavity 4/26/2016 11
  12. 12. 2. Condition the dentin and enamel surfaces using an acid conditioner (preconditioning) 4/26/2016 12
  13. 13. • Function of conditioner: –Creates stronger bond between tooth and GIC –Removes smear layer and debris from tooth surface • Citric acid and polyacrylic acid have been used as conditioners. 4/26/2016 13
  14. 14. 3. Place an increment of GIC over the cavity floor, extending up DEJ around the perimeter of the preparation, or just short of the cavo- margin at the base of proximal box (In Class II) 4/26/2016 14
  15. 15. 4. Etch the enamel and GIC 4/26/2016 15
  16. 16. 5. Apply bonding agent 4/26/2016 16
  17. 17. 6. Light cure and apply composite resin in increments 4/26/2016 17
  18. 18. 7. After finishing and polishing… 4/26/2016 18
  19. 19. 4/26/2016 19
  20. 20. Conclusion • It is recommended that the sandwich technique be the restoration of choice when proximal gingival margins extend beyond the cementoenamel junction. 4/26/2016 20
  21. 21. References • Art and Science of Operative Dentistry - Studervant – page 304 • http://pocketdentistry.com/9-the-tooth- coloured-restorative-materials-iii-glass-ionomer- cements/ • Liebenberg W.. Return to the Resin-Modified Glass–Ionomer Cement Sandwich Technique; JCDA 2005; 71(10): 743-747. • http://www.merriam- webster.com/dictionary/sandwich 4/26/2016 21

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