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The goals of restorative therapy are not only to restore the tooth to proper form and function, but also to minimize postoperative sensitivity and preserve pulp vitality. Today, thanks to the evolution of adhesive materials and techniques, more conservative tooth preparations are possible. Conservative preparations preserve tooth structure, and adhesive restorations seal the dentin–pulp complex to minimize microleakage and postoperative sensitivity, providing appropriate conditions for the maintenance of pulp vitality. Many pulp protection strategies are currently available, and the choice of treatment is based on the severity of the defect being restored, and the type of restoration being placed. This paper reviews current restorative concepts of pulp protection, with emphasis on a new approach based on total adhesion of restorations to conservative preparations.