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

To compare the effect of submucosal cryotherapy with steroids and nonsteroidal injections on postendodontic pain in maxillary premolars with symptomatic irreversible pulpitis.A total of 52 patients with maxillary premolars diagnosed with symptomatic irreversible pulpitis were randomly allocated into four equal groups (<i>n</i> = 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 <i>p</i> < 0.05.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.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.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.