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CC BY 4.0 · Eur J Dent
DOI: 10.1055/s-0045-1806934
Original Article

Effect of Submucosal Cryotherapy on Postoperative Pain in Maxillary Premolars with Symptomatic Irreversible Pulpitis: A Prospective, Parallel, Triple-Blinded Randomized Controlled trial

Mai Shalabi
1   Department of Endodontic, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
,
Abeer H. Mahran
1   Department of Endodontic, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
,
Tarek Elsewify 
1   Department of Endodontic, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
2   Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, Ajman, United Arab Emirates
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Abstract

Objective

To compare the effect of submucosal cryotherapy with steroids and nonsteroidal injections on postendodontic pain in maxillary premolars with symptomatic irreversible pulpitis.

Materials and Methods

A total of 52 patients with maxillary premolars diagnosed with symptomatic irreversible pulpitis were randomly allocated into four equal groups (n = 13). Cold saline was injected submucosally in the experimental groups, while the two active comparator groups received dexamethasone sodium phosphate and diclofenac sodium submucosally. The control group did not receive any injections. Preoperative pain level was recorded using a numerical pain scale and subtracted from the postoperative pain level at 6, 24, 48, and 72 hours, to calculate the pain reduction, after single-visit root canal treatment. Data were statistically analyzed at a significance level of p < 0.05.

Results

Pain score reduction did not differ significantly between all the groups at all intervals. All groups showed a significant increase in pain reduction with time. The control and cryotherapy groups showed significantly lower incidence of flare-ups than the diclofenac group.

Conclusion

Submucosal cryotherapy can be used as a safe and conservative alternative to steroids and nonsteroidal anti-inflammatory drugs (NSAIDs) in the management of postoperative pain in cases with symptomatic irreversible pulpitis.

Clinical Relevance

Submucosal cryotherapy reduces postoperative endodontic pain and can be used as a safe and conservative alternative to steroid and NSAID injections for postoperative endodontic pain control in cases with symptomatic irreversible pulpitis.

Keywords

analgesics - cryotherapy - inflammation - postoperative pain

Ethical Approval Statement

The research proposal was approved by the Faculty of Dentistry Ain Shams University ethical committee with approval number FDASU-Rec ID072025.


Supplementary Material



Publication History

Article published online:
30 May 2025

© 2025. 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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