Future Dental Journal




Aim : This study was designated to evaluate the effect of using intracanal cryotherapy versus ultrasonic activated irrigation on postoperative pain in single visit endodontic treatment of mandibular first molar with symptomatic, irreversible pulpitis using numerical rate scale (NRS) at 6, 12, 24, 48,72 hr and 1 week postoperatively.

Materials and Methods: seventy-eight patients diagnosed with symptomatic irreversible pulpitis in mandibular first molar with no periapical involvement. The cases were randomly divided into three groups according to final irrigation protocol after root canal preparation using Pro Taper Next; Groups A, B and C, twenty-six patients each group (n=26). Group A: final irrigation with room temperature saline using Navi-Tip; double side-port needle (31-gauge,27mm). Group B: final irrigation with room temperature saline with ultrasonic activation using (Ultra-X). Group C: final irrigation with 2.5ºc cold saline using Navi-Tip; double side-port needle (31-gauge,27mm). After a single visit root canal treatment and a specific final irrigation protocol, depending on each group, the patients were given a questionnaire on which the patient would mark the degree of pain in a scale from 0 to 10 at 6, 12, 24, 48, and 72 h and 7 days post-obturation. Data were statistically analyzed with a significance level of p ≤ 0.05.

Results: ultrasonic group (Group B) showed statistically the least incidence and intensity of postoperative pain compared to the other groups after 6, 12 and 24 hours. Cryotherapy group (group B) showed lower Incidence and intensity of postoperative pain after 6,12, 24 and 48 hours. While control group (group A) showed statistically the highest incidence and intensity of post-operative pain compared to the other groups after 6,12, 24,48 and 72 hours. After 1 week there were no significant difference among the three groups where pain scores declined among the groups till it reaches score (0) at day 7. Incidence and number of analgesic intake was significantly higher in patients of the control group compared to ultrasonic and cryotherapy groups.

Conclusion: The least post-operative pain incidence and intensity were associated with ultrasonic irrigation on the first day. The incidence and severity of post-endodontic pain are decreased when cold saline (cryotherapy) is used as the final irrigant during endodontic treatment of teeth with symptomatic irreversible pulpitis.