THE EFFECT OF DIFFERENT MODALITIES OF CRYOTHERAPY ON POST-OPERATIVE PAIN LEVEL IN PATIENTS WITH SYMPTOMATIC IRREVERSIBLE PULPITIS RANDOMIZED CLINICAL TRIAL

Background: The study aims to evaluate the effects of various cryotherapy treatment techniques on inflammatory
mediators and post-operative pain.
Materials and Methods: The study was established on single rooted premolars exhibiting symptomatic pulpitis and
apical periodontitis. 45 patients were assigned randomly into three groups (n = 15). The first group (the control group
n=15) patients did not receive any cryotherapy treatment, The second group(n=15) submucosal infiltration of cold
saline 2-5 °C was given before the treatment. The third group(n=15) intracanal irrigation of cold saline 2.5 °C was
given after chemomechanical preparation. 3 samples were taken from the periapical fluid with paper point extended 2
mm past the apex as follows: the first sample was taken after pulp extirpation, the second sample was taken after
mechanical preparation and the third sample was taken after 24 hours before obturation. The ELISA test was utilized
to determine the substance P levels (neuropeptide released by nociceptors that plays a central role in initiating
neurogenic inflammation). Taking analgesics with the existence, duration, and severity of pain using the VAS at 12,24
and 48 hours were recorded. Any adverse events were recorded. The data was examined using Friedman test and
Kruskal Wallis test.
Results: The Second and The Third Group revealed a statistically significant variation having the lowest substance P
level scores and the lowest post-operative pain in contrast with the control group that showed the highest level of
substance p and post-operative pain (P ≤ 0.05).
Conclusion: Submucosal and intracanal cryotherapy decreased substance p level and post-operative pain. This
randomized, controlled, double -blinded, Phase IV clinical trial was registered at www.clinicaltrials.gov
(NCT06090500). Date: 25/3/2024.