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)

Guidelines/clinical hints:

  • 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)