Aim: To evaluate the influence of airborne-particle abrasion with aluminum oxide on the adhesion of resin composites to enamel and dentin, focusing on technical parameters, adhesive strategies, and long-term outcomes. Material and Methods: A narrative review was performed according to PRISMA guidelines. PubMed, Scopus, and Web of Science were searched for studies published between 2020 and 2024 reporting bond strength to enamel or dentin after aluminum oxide abrasion. Only peer-reviewed full-text articles with shear or microtensile outcomes were included. Twenty studies were analyzed, comprising in vitro experiments and systematic reviews. Results: For enamel, most studies confirmed improved retention after abrasion, particularly when combined with phosphoric acid etching. The effect was most evident for self-etch adhesives, which otherwise underperform on aprismatic enamel. For dentin, findings were more variable. Abrasion enhanced adhesion with etch-and-rinse protocols and universal adhesives in etch-and-rinse mode but often reduced bond strength with self-etch adhesives, likely due to smear-layer removal without adequate demineralization. Optimal parameters included 50 µm particles, 3–4 bar pressure, and ~5 seconds of application. Higher pressure or prolonged use risked collagen damage. In composite repair, abrasion consistently increased bond strength, especially when combined with silanization and an adhesive. Evidence on long-term durability was mixed; bioactive particles may improve stability and biocompatibility. Conclusions: When applied with optimized parameters, aluminum oxide abrasion improves bonding to enamel and dentin, is particularly useful in etch-and-rinse protocols and composite repair, and should be avoided on dentin with self-etch adhesives. Further in vivo studies are needed to clarify long-term performance.