(PR014) Effects of Intracanal Cryotherapy on Postoperative Pain in Necrotic Teeth With Symptomatic Apical Periodontitis: A Randomized Controlled Clinical Trial

Objective: To assess the effects of 2.5°C cold saline solution as the final irrigant on pain following single-visit non-surgical root canal treatment (NSRCT) of molar teeth with pulp necrosis and symptomatic apical periodontitis.

Methods: This parallel-two-arm, single-blind, randomized superiority clinical trial was registered at www.clincaltrials.gov (NCT05611736). Patients referred for NSRCT meeting the inclusion criteria were included. Preoperative radiographs, pulp sensibility tests, and pain scores on the visual analog scale (VAS) were recorded. After the shaping and cleaning procedures were completed, 302 patients were randomly allocated to the two groups (n=151). In the experimental group, final irrigation was done using 0.9% physiologic saline solution at 2.5°C, whereas in the control group, final irrigation was done using the same solution at room temperature. All treatments were performed in a single visit. Patients were asked to record the analgesic intake and presence, duration, and intensity of pain using the VAS at 6 hours, 24 hours, 72 hours, and 1 week. Any adverse event during and immediately after the NSRCT procedure was also recorded. Data was analyzed using the Mann-Whitney U-test and the Student’s t-tests (p <5%).

Results: Patients in the cryotherapy group had significantly less postoperative pain at 6 hours, 24 hours, and 72 hours (p < 0.05). There was no difference in postoperative pain at 1 week (p>0.05). No adverse event was recorded in either group during or immediately after NSRCT.

Conclusion: Cryotherapy reduces postoperative pain in single-visit NSRCT of molars with pulp necrosis and symptomatic apical periodontitis.