Operative Dentistry - Best Practices
Dentin and Enamel Bonding
(last modified May 11, 2016)
Current evidence-based recommendation for direct restoration placement includes:
- Etch-and-rinse 3-step adhesives (ER3)
- Self-etch 2-step adhesives (SE2)
- Know and understand adhesive usage instructions
- Etchant, primer and adhesive coverage must be placed beyond final intended margin of resin-based composite restoration
- Etch (ER3) or selectively etch (SE2) enamel 20-30 seconds
- Etch dentin < 15 seconds (ER3)
- (ER3) Moist etched dentin for primer application best obtained by sponge/cotton pellet drying.
Do not desiccate etched dentin before primer application.
- Prolong primer application on dentin using gentle agitation with microbrush.
- Thoroughly but gently dry primer to remove all solvents and water.
- Thin the adhesive resin with brush or microbrush. Do not air-thin adhesive.
- Adequately light cure adhesive before resin-based composite placement (eg. 18 J for Optibond FL)