The importance of isolation in bonding protocols revolves around creating an optimal environment for successful adhesion

Here’s a structured summary:

1. Moisture Control: Moisture is a critical factor in dental bonding as it can weaken the bond between materials and tooth enamel. Effective moisture control ensures that the bonding process remains intact.
2. Rubber Dam Isolation:
   • Effectiveness: Rubber dams are highly effective at maintaining a dry, isolated field during procedures, which enhances adhesion.
   • Limitations: They may not always be feasible, especially with erupting teeth or complex cases where their use is impractical.
3. Alternative Methods:
   • When rubber dams aren’t possible, techniques like using cotton wool rolls combined with suction tips and air/water sprays can provide similar results in terms of moisture control and bond strength.
4. Evidence Considerations: Studies show mixed results regarding the impact of isolation methods on outcomes. While some find no significant difference between rubber dam and alternative methods for certain procedures, others emphasize that a dry field is crucial regardless of the method used.
5. Procedure-Specific Factors: The effectiveness may vary depending on the specific dental procedure (e.g., sealants vs. orthodontic bonding) and patient-specific factors such as tooth eruption stages or clinical accessibility.

In conclusion, while rubber dams are ideal for maintaining a dry field, alternative methods can be effective if executed with skill and attention to detail. The key takeaway is that achieving a dry environment is paramount for successful bonding outcomes.

• Dental caries : the disease and its clinical management / edited by Ole Fejerskov, Bente Nyvad, Edwina Kidd . – Third edition , ISBN 978-1- 118-93582 -8
• Dental Hard Tissues and Bonding Interfacial Phenomena and Related Properties ISBN-10 3-540-23408-X
• Noncarious Cervical Lesions and Cervical Dentin Hypersensitivity: Etiology, Diagnosis, and Treatment Edited by Paulo V. Soares, DDS, MS, PhD John O. Grippo, DDS ISBN 9780867157543