Influence of varying dry air temperatures on postoperative sensitivity, penetration depth, and push-out bond strength of an ethanol/water-based adhesive: An in vivo double-blind clinical trial and in vitro analysis

BACKGROUND: Incomplete monomer infiltration into the etched dentin causes postoperative sensitivity (POS) with total-etch adhesives. Increasing the temperature of the air to dry the adhesive has shown to improve its infiltration into the dentin. AIMS: The aim of this research is to evaluate the effectiveness of dry air temperatures of 15°C ± 5°C and 50°C ± 5°C on the POS, depth of penetration, and bond strength of an ethanol/water-based etch-and-rinse (ER) adhesive under in vivo and in vitro conditions. METHODS: Forty-four premolars from 11 patients scheduled for orthodontic extraction were allocated into cold air (Group 1) and warm air (Group 2) groups using a split-mouth design. A 2 mm × 2 mm × 2 mm cavity was prepared on the middle third of the buccal surface of the teeth, acid etched, and two coats of an ethanol/water-based adhesive resin mixed with 0.1% rhodamine B was applied for 10 s. A dental air gun customized to deliver warm and cold air was used to dry the adhesive prior to its light polymerization. The cavities were restored with resin composite incrementally. POS was assessed using visual analog scale at 24 and 72 h using cold test. The teeth were atraumatically extracted and analyzed for depth of adhesive penetration using confocal laser scanning microscope (n = 11) and push-out bond strength (n = 11). STATISTICAL ANALYSIS USED: The data were analyzed using sample t-test and Wilcoxon signed-rank test (P < 0.05). RESULTS: A significantly lower POS and greater adhesive penetration into the dentin was observed in the warm air group compared to cold air (P < 0.05). No significant difference could be elicited between the push-out bond strength of both the groups (P > 0.05). CONCLUSIONS: Warm air alleviated POS and improved the penetration of an ethanol/water-based ER adhesive into the dentin.