A Clinical Presentation of the Direct Gold/Composite Sandwich Restoration

The intent of this paper is to present a new idea for increasing the life expectancy of class II composite restorations where the proximal marginal seal is compromised by the necessity to rely on dentin bonding. As implied by the Clinical Relevance statement, studies show that bonding to dentin in areas with high levels of bacterial action, combined with sustained high plaque formation, tends to be the "Achilles heel" with regard to sustained long-term restorations. Therefore, this paper will present a thought experiment, combined with clinical evidence, for combining gold foil with composite in these areas for the class two composite restoration. The results, if proven viable, will be to develop a procedure utilizing the properties of gold foil that make it one of the longest-lasting restorative materials with the recent development of modern cosmetic materials for a truly long-lasting and healthy class II restoration.