Comparing cryotherapy and ketorolac tromethamine against room-temperature saline irrigation using interleukin-8 levels and post-operative pain within single-visit endodontic treatment of symptomatic irreversible pulpitis superimposed by apical period

This comparative randomized controlled trial aimed to compare Cryotherapy and Ketorolac Tromethamine (KT) against a control group of Room-Temperature Saline (RtS) irrigations using Interleukin-8 (IL-8) expression and pain-intensity scale in single-visit endodontic treatment of symptomatic irreversible pulpitis superimposed by apical periodontitis. Forty-eight patients diagnosed with symptomatic irreversible pulpitis superimposed by apical periodontitis, were randomly assigned into three equal groups (n = 16). First group was irrigated using Cryotherapy (2.5 °C saline), second group was irrigated using KT and third group was irrigated using RtS (control). Pulp Chamber Blood samples were collected before irrigation (S1) and periapical fluid samples were collected after completion of irrigation (S2) and analyzed using enzyme-linked immunosorbent assay (ELISA) for IL-8 levels. Pain was assessed pre-operatively, at 6, 12, and 24 h after obturation using a modified visual-analogue scale. No significant differences were found between groups regrading pre-irrigation IL-8 levels or pre-operative pain. Post-irrigation, IL-8 levels showed a significant increase with KT than the other groups. At 6 h post-operatively, KT presented significantly lower pain scores than the other groups. No significant differences were observed at 12–24 h regarding pain scores. Although intra-canal irrigation using KT presented higher levels of IL-8 post-irrigation; it significantly reduced post-operative pain at 6 h following obturation. Cryotherapy reported no significant differences than RtS regarding IL-8 expression or pain levels.