Cryotherapy-Driven Modulation of Postoperative Pain in Single-Visit Endodontic Treatment Across Different Obturation Materials: A Retrospective Study

Background/Objectives: This study aimed to evaluate the effect of intracanal cryotherapy on postoperative pain across obturation materials with different chemical compositions and physical properties in single-visit root canal treatment. Methods: Patients diagnosed with irreversible pulpitis (n = 73), treated in a single visit by the same operator, were categorized based on the obturation material used (AH Plus, TotalFill BC Sealer, and TotalFill BC RRM) and whether intracanal cryotherapy (20 mL of sterile saline at 4 °C for 5 min) was applied. Visual Analog Scale (VAS) scores obtained from patient follow-up forms at 24, 48, and 72 h were evaluated. Results: Cryotherapy (+) groups showed consistently lower pain scores at all time points compared with cryotherapy (−) groups (p < 0.001). Within the cryotherapy (+) groups, both TotalFill BC Sealer and TotalFill BC RRM exhibited significantly lower pain scores than AH Plus at 48 h (p < 0.05). In the cryotherapy (−) groups, TotalFill BC Sealer showed significantly lower pain scores on the third postoperative day (p < 0.05). Conclusions: Intracanal cryotherapy may serve as an effective adjunctive technique associated with lower early postoperative pain scores. Material-related differences became evident at 48 and 72 h, suggesting that obturation material selection may influence postoperative pain patterns and patient comfort during the later postoperative period.