The included studies reported few , if any , endodontic complications .
Little or no differences emerged between teeth restored with  composite resins  and those restored with amalgam .
Composite resin is used extensively for restoration of teeth with vital pulps .
Although cell culture studies have disclosed harmful effects on pulpal cells , any untoward clinical effects , manifest as adverse pulpal responses , have yet to be determined .
This study comprises a systematic review , design ed to address the question of whether the risk of endodontic complications is greater with  composite resin restorations  than with  other restorative material s  , such as  amalgam .
A clinical study of the "open sandwich" technique in pediatric dental practice.
PURPOSE This study evaluated the clinical efficacy of the " open s and wich " restoration for pediatric dental practice . METHODS Three pediatric dentists used a st and ardized 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 s and wich " technique compared favorably with a similar study using adhesive amalgam restorations . CONCLUSIONS The " open s and wich " technique can be successfully used in a pediatric dental practice
The included studies reported few , if any , endodontic complications .
Little or no differences emerged between teeth restored with  composite resins  and those restored with amalgam .
Composite resin is used extensively for restoration of teeth with vital pulps .
Although cell culture studies have disclosed harmful effects on pulpal cells , any untoward clinical effects , manifest as adverse pulpal responses , have yet to be determined .
This study comprises a systematic review , design ed to address the question of whether the risk of endodontic complications is greater with  composite resin restorations  than with  other restorative material s  , such as  amalgam .