Abstract

Aim: The aim of the present study was to evaluate the effect of cryotherapy using cold saline irrigation as a final irrigant on postoperative pain in molar teeth with symptomatic irreversible pulpitis and apical periodontitis

Methods: A total of 30 patients with symptomatic irreversible pulpitis and apical periodontitis in their mandibular first molars, were included in the study. After completion of biomechanical preparation using Mpro Rotary system in a single visit and irrigation with 2.5% sodium hypochlorite for cleaning and shaping. Patients were randomly assigned into two groups (n = 15). In( group A), final irrigation was done using 15 ml cold saline (2.5°C) for 6 mins at three successive times. The solution was stored in refrigerator until use and then its temperature was checked using digital thermometer. In( group B), final irrigation was done using 15 ml room temperature saline for 6 mins. In both groups irrigation procedures were done using 27-gauge side-vented needle fit to a 5ml disposable plastic syringe placed 2-3 mm away from apex without binding. Pain was recorded postoperatively after 6, 12, 24, 48 and 72 hours by Numerical Rating Scale (NRS). Patients were given an analgesic (Ibuprofen 200 mg) in case of severe pain. All demographic data. NRS scores and number of analgesics taken were collected from the patients and statistically analyzed by chi-square test and Mann-whitney U test.

Results: Results showed a statistically significant decrease in postoperative pain in the cryotherapy group compared to the control group at each time interval, also cryotherapy reduced postoperative analgesic intake at all tested intervals (p < 0.05).

Conclusions: Cryotherapy aids in reducing postoperative pain in both magnitude and time span, also it had satisfactory effect on reduction of post-operative analgesic intake. The use of cryotherapy is a simple, cost-effective, and non-toxic option for postoperative pain control in single visit root canal treatment.

Keywords: Cryotherapy; Irreversible Pulpitis; Postoperative Pain; Single Visit RCT; Symptomatic Apical Periodontitis

References

1. Al-Nahlawi Talal., et al. “Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain”. The Journal of Contemporary Dental Practice12 (2016): 990-996.
2. Alharthi Abdullah Ahmed., et al. “Effect of Intra-Canal Cryotherapy on Post-Endodontic Pain in Single-Visit RCT: A Randomized Controlled Trial”. Saudi Dental Journal3 (2019) : 330-335.
3. Alí Akram., et al. “Influence of Preoperative Pain Intensity on Postoperative Pain after Root Canal Treatment: A Prospective Clinical Study”. Journal of Dentistry2 (2016): 39-42.
4. Ali SyedGufran Gufran., et al. “Prevalence of and Factors Affecting Post-Obturation Pain Following Single Visit Root Canal Treatment in Indian Population: A Prospective, Randomized Clinical Trial”. Contemporary Clinical Dentistry4 (2012): 459-463.
5. Altundasar, Emre., et al. “Debris and Irrigant Extrusion Potential of 2 Rotary Systems and Irrigation Needles”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology4 (2011): 31-35.
6. Alves Vanessa De Oliveira. “Endodontic Flare-Ups: A Prospective Study”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology5 (2010): 68-72.
7. Arias A., et al. “Predictive Models of Pain Following Root Canal Treatment: A Prospective Clinical Study”. International Endodontic Journal8 (2013): 784-793.
8. Attar Sayeed., et al. “Evaluation of Pretreatment Analgesia and Endodontic Treatment for Postoperative Endodontic Pain”. Journal of Endodontics6 (2008): 652-655.
9. Bazaid Duaa S and Laila M M Kenawi. “The Effect of Intracanal Cryotherapy in Reducing Postoperative Pain in Patients with Irreversible Pulpitis: A Randomized Control Trial”. International Journal of Health Sciences and Research 2 (2018): 83.
10. Beaver William T. “Review of the Analgesic Efficacy of Ibuprofen”. International Journal of Clinical Practice 135 (2003): 13-17.
11. Bleakley Chris M., et al. “The PRICE Study (Protection Rest Ice Compression Elevation): Design of a Randomised Controlled Trial Comparing Standard versus Cryokinetic Ice Applications in the Management of Acute Ankle Sprain”. BMC Musculoskeletal Disorders 1 (2007): 125.
12. Bystrom A., et al. “The Antibacterial Action of Sodium Hypochlorite and EDTA in 60 Cases of Endodontic Therapy”. International Endodontic Journal1 (1985): 35-40 .
13. Capps Susan G and Mayberry Brook. “Cryotherapy and Intermittent Pneumatic Compression for Soft Tissue Trauma”. Athletic Therapy Today1 (2009): 2-4.
14. El Mubarak Abdel Hameed H., et al. “Postoperative Pain in Multiple-Visit and Single-Visit Root Canal Treatment”. Journal of Endodontics1 (2010): 36-39.
15. Francisco Simone Scandiuzzi., et al. “Clinical Strategies for Managing Emergency Endodontic Pain”. RSBO3 (2017): 209.
16. Glennon J P., et al. “Prevalence of and Factors Affecting Postpreparation Pain in Patients Undergoing Two-Visit Root Canal Treatment”. International Endodontic Journal1 (2004): 29-37.
17. Gundogdu Eyup Candas and Hakan Arslan. “Effects of Various Cryotherapy Applications on Postoperative Pain in Molar Teeth with Symptomatic Apical Periodontitis: A Preliminary Randomized Prospective Clinical Trial”. Journal of Endodontics3 (2018): 349-354.
18. Harrison J W., et al. “Incidence of Pain Associated with Clinical Factors during and after Root Canal Therapy. Part 2. Postobturation Pain”. Journal of Endodontics10 (1983): 434-438.
19. Hjermstad Marianne Jensen., et al. “Studies Comparing Numerical Rating Scales, Verbal Rating Scales, and Visual Analogue Scales for Assessment of Pain Intensity in Adults: A Systematic Literature Review”. Journal of Pain and Symptom Management6 (2011): 1073-1093.
20. Hou Xiao-Mei., et al. “Post Endodontic Pain Following Single-Visit Root Canal Preparation with Rotary vs Reciprocating Instruments: A Meta-Analysis of Randomized Clinical Trials”. BMC Oral Health1 (2017): 86.
21. Jain Atul., et al. “Role of Cryotherapy in Reducing Postoperative Pain In Patients With Irreversible Pulpitis; An In-Vivo Study”. International Journal Dental and Medical Sciences Research10 (2018): 43-49.
22. Keskin Cangül., et al. “Effect of Intracanal Cryotherapy on Pain after Single-Visit Root Canal Treatment”. Australian Endodontic Journal: The Journal of the Australian Society of Endodontology Inc2 (2017): 83-88.
23. Kullenberg Björn., et al. “Postoperative Cryotherapy after Total Knee Arthroplasty: A Prospective Study of 86 Patients”. The Journal of Arthroplasty8 (2006): 1175-1179.
24. Laureano Filho José Rodrigues., et al. “The Influence of Cryotherapy on Reduction of Swelling, Pain and Trismus after Third-Molar Extraction: A Preliminary Study”. Journal of the American Dental Association 6 (2005): 774-807.
25. Magalhães Manoelita Figueiredo de., et al. “Measurement of Thermophysical Properties of Human Dentin: Effect of Open Porosity”. Journal of Dentistry8 (2008): 588-594.
26. Merrick MA., et al. “A Preliminary Examination of Cryotherapy and Secondary Injury in Skeletal Muscle”. Medicine and Science in Sports and Exercise11 (1999): 1516-1521.
27. Moore Nicholas D. “In Search of an Ideal Analgesic for Common Acute Pain”. Acute Pain3 (2009): 129-137.
28. Nadler Scott F., et al. “The Physiologic Basis and Clinical Applications of Cryotherapy and Thermotherapy for the Pain Practitioner”. Pain Physician3 (2004): 395-399.
29. Nielsen Benjamin A and J Craig Baumgartner. “Comparison of the EndoVac System to Needle Irrigation of Root Canals”. Journal of Endodontics5 (2007): 611-615.
30. Pak Jaclyn G and Shane N White. “Pain Prevalence and Severity before, during, and after Root Canal Treatment: A Systematic Review”. Journal of Endodontics4 (2011): 429-438.
31. Pochapski Márcia Thaís., et al. “Effect of Pretreatment Dexamethasone on Postendodontic Pain”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology5 (2009): 790-795.
32. Sadaf Durre. “Limited Quality Evidence Suggests That Application of Cryotherapy May Be Helpful in Reducing Postoperative Pain in Root Canal Therapy in Patients With Symptomatic Apical Periodontitis”. Journal of Evidence-Based Dental Practice2 (2019): 195-197.
33. Saini Dinesh. “Cryotherapy - An Ineviatable Part of Sports Medicine and It’s Benifits for Sports Injury”. IJAR44 (2015): 324-327.
34. Samborski W., et al. “Intraindividual comparison of whole body cold therapy and warm treatment with hot packs in generalized tendomyopathy”. Zeitschrift für Rheumatologie1 (1992): 25-30.
35. Sathorn C., et al. “The Prevalence of Postoperative Pain and Flare-up in Single- and Multiple-Visit Endodontic Treatment: A Systematic Review”. International Endodontic Journal2 (2007): 91-99.
36. Siqueira José F. “Microbial Causes of Endodontic Flare-Ups”. International Endodontic Journal 7 (2003): 453-463.
37. Siu Chris and J Craig Baumgartner. “Comparison of the Debridement Efficacy of the EndoVac Irrigation System and Conventional Needle Root Canal Irrigation in Vivo”. Journal of Endodontics11 (2010): 1782-1785.
38. Vera Jorge Jorge Ochoa-Rivera., et al. “Effect of Intracanal Cryotherapy on Reducing Root Surface Temperature”. Journal of Endodontics11 (2015): 1884-1887.
39. Vera Jorge Jorge Ochoa., et al. “Intracanal Cryotherapy Reduces Postoperative Pain in Teeth with Symptomatic Apical Periodontitis: A Randomized Multicenter Clinical Trial”. Journal of Endodontic1 (2018): 4-8.
40. Yeter K Y., et al. “Weight of Apically Extruded Debris Following Use of Two Canal Instrumentation Techniques and Two Designs of Irrigation Needles”. International Endodontic Journal9 (2013): 795-799.

Citation

Citation: Magy Essam Elaskary., et al. “Effect of Intracanal Cryotherapy on Postoperative Pain in Molar Teeth with Symptomatic Irreversible Pulpitis and Apical Periodontitis: A Randomized Clinical Trial”. Acta Scientific Dental Sciences 5.2 (2021): 143-149.

Copyright

Copyright: © 2021 Magy Essam Elaskary., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.