Effect of intraoperative and postoperative cryotherapy application on postoperative pain in single-visit endodontically treated symptomatic apical periodontitis cases (randomized clinical study)

Abstract Aim To compare postoperative pain in cases with symptomatic apical periodontitis after using different cryotherapy applications in single-visit endodontic treatment. Methodology A single-visit endodontic treatment of 27 cases with symptomatic apical periodontitis was done, patients were randomly distributed according to the given treatment using a computer random allocation program into three groups: group I: conventional endodontic treatment with palatal relief (control group), group II (intracanal cryotherapy application), group III (Intraoral cryotherapy application). The postoperative pain and pain on percussion levels of the patients were recorded preoperatively and on the first, third, fifth, seventh, and 14 th days postoperatively using the visual analogue scale. The analysis of pain severity across study groups over the 14 days was conducted using the SPSS Statistics program (version 27). Pain scores across groups were expressed as median and interquartile range. Group comparisons were performed using the Kruskal–Wallis test with a significance level set at 0.05, followed by post-hoc Jonckheere–Terpstra pairwise analyses using Bonferroni correction. Results Regarding postoperative pain without percussion, cryotherapy groups exhibited less postoperative pain over the first 7 days ( P < 0.05) compared to the control group. On the percussion test, the cryotherapy groups also exhibited less postoperative pain over the different tested intervals compared to the control group. However, there was no significant difference between the two cryotherapy groups regarding pain operative percussion except on the third day interval, where more patients in group II showed total pain relief than those in group III. However, there was no significant difference among groups after 2 week. Conclusions Cryotherapy application led to faster pain relief compared to conventional root canal treatment.