BONDING PROTOCOL
The proper selection and use of products is imperative when offering the available adhesive treatment alternatives to your patients. Dentists are often reluctant to offer direct-bonded composites as a long-term solution due to concerns about postoperative sensitivity issues, margins that may discolor with time, and premature restoration failure. It is my opinion, based on the clinical results that we have observed in our practice, that if adhesive products are chosen and used correctly, we can have tremendous confidence in routinely delivering restorations that are comfortable, aesthetic, conservative, and durable.
To present my bonding protocol, I have chosen a case example that is typical of those found when restoring posterior teeth with direct composite resin restorations. Since my first concern in the protocol is to control the oral environment, I isolate the area to be restored with a rubber dam (Hygienic Medium [Coltène/Whaledent]) when working in the posterior region of the mouth. Placement of the rubber dam should take less than one minute, paying time management dividends while controlling moisture contamination of the replacement materials (Figure 1). I believe that commitment to proper technique will maximize restoration longevity and comfort.
