The clinical performance of a glass polyalkenoate (glass ionomer) cement used in a 'sandwich' technique with a composite resin to restore Class II cavities.

The use of glass polyalkenoate (GPA) cement in conjunction with composite resin using an acid etch technique is now well known and a 'sandwich' of tooth/GPA cement/composite resin has been recommended to form the cervical seal at the base of approximal boxes in Class II cavities. This paper reports on the 2-year results of a controlled clinical trial using a commercial GPA lining cement. The trial was designed to evaluate the efficacy of this 'sandwich' technique. Sixty-four restorations in the mouths of 22 patients were evaluated during the 2.5 year period of the trial. The composite resin component of the restorations performed well. Five restorations failed, all in the region of the approximal box. Four failures were related to the exposed GPA cement component of the 'sandwich'. Failure was probably related to placement difficulties of the technique. The use of GPA cement laminated with composite resin when the GPA cement was enclosed within the final restoration appeared to be a successful technique.