Background: Dental adhesive materials are important for achieving adequate adhesion results; however, they are not the only factor contributing to final bond strength, as improper operatory field isolation and contamination also significantly influence clinical outcomes. Objectives: This narrative review aims to provide a clinical perspective, supported by evidence-based arguments, to identify clinical procedures for optimizing adhesive protocols, including the execution of absolute isolation with a rubber dam, appropriate cleaning and preparation of the dental substrate, and protocols applicable to total-etch and self-etch techniques. Methods: The literature included in this review was selected through a structured search in PubMed, Scopus, and Web of Science, prioritizing systematic reviews, meta-analyses, long-term clinical studies, and foundational experimental investigations related to adhesive systems and substrate management. Results: A well-established clinical protocol that integrates proper adhesive selection, contamination-free operative field control, and adequate substrate preparation is essential for achieving predictable outcomes in adhesive dentistry. Conclusions: Although simplified adhesive systems offer acceptable bond strength results, established techniques continue to demonstrate consistent reliability, contributing to restorative longevity.
Agrelli et al. (Mon,) studied this question.