Intracanal cryotherapy with two different temperature ranges in reducing postendodontic pain: A double-blind randomized clinical trial

• Published in: Saudi endodontic journal 2022-01, Vol.12 (1), p.82-89
• Main Authors: J Sylvia Western, Asiyath Shiuna Zahir, Azra Izzaty Binti Haja Mohainuteen, Beh Yen Ping, Chen Shu Hui, Chew En Ru, Daniel Devaprakash Dicksit
• Format: Article
• Language: English
• Subjects: cryotherapy; pain measurement; root canal irrigants; saline solution; temperature
• ISSN: 2320-1495; 2320-1495
• DOI: 10.4103/sej.sej_122_21

Introduction: The use of intracanal cryotherapy in the reduction of postendodontic pain (PEP) has been investigated in several recent scientific publications. This study aims to compare the effect of intracanal cryotherapy at three different temperature ranges (room temperature, 2°C–4°C and 13°C–15°C) on PEP. Materials and Methods: A parallel, double-blind randomized clinical trial was conducted at SEGi University, Malaysia. This trial included 51 participants who were diagnosed with symptomatic irreversible pulpitis and symptomatic apical periodontitis in single-rooted teeth. The root canal therapy was completed in single visit for all the patients. Prior to the obturation step, they were randomly allocated into three groups of 17 participants each (Group 1: room temperature [control], Group 2: 2°C–4°C, and Group 3: 13°C–15°C). The intracanal cryotherapy was performed over a period of 5 min. The PEP scores were measured using Wong Baker Faces Pain Rating Scale and recorded at different time intervals (6, 24, 48, and 72 h), and the data were statistically analyzed. Results: Kruskal–Wallis test showed statistically significant difference in mean pain ranks between at least two out of three groups studied at 24 and 48 h (P ≤ 0.05). At 24 and 48 h, the pairwise post hoc Dunn test with Bonferroni adjustments showed statistically significant difference in pain scores within the Groups 1 versus 3 (room temperature vs. 13°C–15°C) and Groups 1 versus 2 (room temperature vs. 2°C–4°C) (P ≤ 0.05), while within the Groups 2 versus 3 (2°C–4°C vs. 13°C–15°C), there was no statistically significant difference. Conclusion: Intracanal cryotherapy with 13°C–15°C saline is as effective as 2°C–4°C saline in reducing PEP and can be easily incorporated as one of the steps of root canal therapy.