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Operative Dentistry - Best Practices

Dentin and Enamel Bonding

(last modified August 5, 2014)

Current evidence-based recommendation for direct restoration placement = etch-and-rinse 3-step adhesives

Guidelines/clinical hints:

  1. Know and understand adhesive usage instructions
  2. Etchant, primer and adhesive coverage must be placed beyond final intended margin of resin-based composite restoration
  3. Etch enamel 20-30 seconds
  4. Etch dentin < 15 seconds
  5. Moist etched dentin for primer application best obtained by sponge/cotton pellet drying. Do not desiccate etched dentin before primer application.
  6. Prolong primer application on dentin using gentle agitation with microbrush.
  7. Thoroughly but gently dry primer to remove all solvents and water.
  8. Thin the adhesive resin with brush or microbrush. Do not air-thin adhesive.
  9. Adequately light cure adhesive before resin-based composite placement (18 J)