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CC BY 4.0 · Eur J Dent 2025; 19(02): 472-481
DOI: 10.1055/s-0044-1791219
Original Article

Effect of Cryotherapy and Occlusal Reduction on Postoperative Endodontic Pain in Mandibular First Molars with Symptomatic Apical Periodontitis: A Prospective, Parallel, Double-Blinded Randomized Controlled Trial

Authors

  • Lana Almasoud

    1   Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates

  • Tarek Elsewify 

    1   Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
    2   Department of Endodontic, Faculty of Dentistry, Ain Shams University, Cairo, Egypt

  • Ranya Elemam 

    1   Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates

  • Bassem Eid 

    1   Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
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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

Ethical Approval Statement

The research proposal was approved by the Gulf Medical University Institutional Review Board with approval number IRB/COD/STD/14/May 2022.


Supplementary Material



Publication History

Article published online:
07 November 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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