The success of the sandwich technique depends on the bond strength of composite to glass-ionomer cement (GIC)/resin-modified glass-ionomer cement (RMGIC). Currently used adhesives employ the total-etch and the self-etch techniques. The total-etch system is technique sensitive, whereas the self-etch system is popular for its ease of use. The aim of this systematic review is to compare the effect of total-etch and self-etch adhesives (SEAs) on the bond strength of composite to GIC/(RMGIC) in the sandwich technique. A literature search was conducted using electronic databases (PubMed, Web of Science, Ebscohost, and Scopus) limiting the year of publications from January 1, 2000, to September 30, 2018, to identify the relevant studies. All the cross-references of the selected studies were also screened. In vitro studies on extracted human teeth were selected. A total of 10 articles were included in this review. A conclusion was drawn that SEAs when used in the sandwich technique resulted in greater bond strength in comparison to total-etch adhesives. Moreover, increased bond strength was achieved when the primer was employed on unset GIC as compared to set GIC. Furthermore, the application of SEAs over uncured RMGIC (co-curing technique) resulted in better bond strengths as compared to their application over cured RMGIC.
There is an increasing population of apparently well, but in fact medically compromised people in the community. Most will require dental treatment at some stage and will usually seek it away from a hospital environment. In a recent survey of a general dental practice in Australia it was found that up to 55 per cent of some age groups had concurrent medical problems. Thus there is a real risk that adverse interactions between medical conditions and dental treatment may occur on some occasions, even fatal ones. It is not possible for any individual to know the details of all medical conditions, their treatment and the possible interactions with dental treatment. However, by the application of some sound general principles the risks of any potential interactions can be evaluated. The essential steps for a clinician are: knowledge of the medical history of all patients, potential drug interactions and management of medical emergencies. These principles will be discussed and illustrated by examples of medically compromised patients who may experience common or potentially serious sequelae as a result of dental treatment.
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