The Gold Standard of Dental Adhesion: A Clinically Oriented Literature Review with Practical Guidelines

Dental adhesive materials are important to achieve adequate adhesion results. Although, it is not the only factor that contributes to the final bond strength - improper operatory field isolation and contamination also play an important role in the final ad-hesion outcome. Background/Objectives: This article aims to provide a clinical perspec-tive supported by evidence-based arguments to identify the best possible clinical pro-cedures for optimizing the adhesive protocol, including the execution of absolute isolation with a rubber dam, the appropriate steps for cleaning and preparing the dental substrate, as well as a description of the gold standard protocols applicable to total-etch and self-etch techniques. Conclusions: A well-established clinical protocol that encompasses not only the selection of the adhesive material but also the creation of a contamination-free oper-ative field, along with the proper cleaning and preparation of the dental substrate, is essential for achieving optimal outcomes in adhesive dentistry. Although simplified adhesive systems have been developed and offer acceptable bond strength results, gold standard techniques continue to provide superior and more reliable outcomes. Therefore, the establishment of a synergistic protocol involving operative field isolation, substrate cleaning, and surface treatment significantly enhances the reliability of dental adhesion for both direct and indirect restorations, contributing to greater restorative longevity.