Abstract
Objectives This study aimed to compare the intensity of postoperative pain following the final
rinse using cold saline compared with room temperature saline and occlusal reduction.
Materials and Methods A prospective, parallel, double-blinded randomized controlled trial was conducted
on 69 first mandibular molars diagnosed with symptomatic irreversible pulpitis and
symptomatic apical periodontitis. Single-visit root canal treatment was performed;
access cavity preparations and chemomechanical preparations were carried out using
the ProTaper Gold rotary system under copious irrigation using 3% sodium hypochlorite
and 17% EDTA. The patients were divided into three groups (n = 23): control group: room temperature saline (25°C) final rinse without occlusal
reduction; cryotherapy group: cold saline (2.5–4°C) final rinse without occlusal reduction;
and occlusal reduction group: room temperature saline with occlusal reduction. Pain
scores were recorded using the visual analog scale preoperatively and postoperatively
via telephone at 6, 24, 48, 72 hours, and 7 days intervals. Age data were analyzed
using one-way analysis of variance followed by Tukey's post hoc test. Pain score data
were analyzed using Kruskal–Wallis' test followed by Dunn's post hoc test for intergroup
comparisons and Friedman's test followed by Nemenyi's post hoc test for intragroup
comparisons. Correlations were analyzed using Spearman's rank-order correlation coefficient.
The significance level was set at p < 0.05 within all tests.
Results Cryotherapy reduced postoperative pain compared with the control group with a statistically
significant difference at 24 hours only (p = 0.016). At other intervals, no statistically significant difference in pain score
was measured between all three groups (p > 0.05). After 7 days, all patients recorded a zero pain score.
Conclusion Cryotherapy was as effective as the occlusal reduction in reducing postoperative
pain in cases of symptomatic irreversible pulpitis with symptomatic apical periodontitis,
significantly more than the control group.
Keywords cryotherapy - occlusal reduction - postoperative pain - symptomatic apical periodontitis
- symptomatic irreversible pulpitis
