The Role Of Adhesive Systems In Modern Restorative Dentistry: A Comparative Analysis Of Bonding Efficacy Study Based On Saudi

Abstract

Adhesive systems have fundamentally transformed restorative dentistry by enabling reliable bonding to enamel and dentin, supporting minimally invasive treatment philosophies and improving the long-term performance of restorations. Continued advancement has resulted in multiple generations of adhesives, mainly grouped into etch-and-rinse, self-etch, and universal systems. These systems differ in composition, handling, and bonding quality. The present paper provides an updated comparative evaluation of bonding efficacy across adhesive classes, highlighting their strengths, limitations, and clinical implications. Special attention is given to the practical challenges and opportunities for implementation in Saudi Arabia, where increasing dental awareness, expanding workforce diversity, and evolving clinical infrastructure demand evidence-based material selection. A multi-center Saudi research model is proposed to enable standardized assessment under local conditions.

Findings indicate that etch-and-rinse systems demonstrate excellent enamel bonding but require strict moisture control when applied to dentin. Self-etch approaches offer simplified handling with reduced postoperative sensitivity but may struggle with uncut enamel, prompting selective enamel etching. Universal systems, especially those containing MDP monomer, combine versatility and reliable performance when applied with proper protocols. Ultimately, no single adhesive type is ideal for all clinical conditions. A universal system with selective enamel etching is recommended as the default strategy in Saudi practice.