Efficacy of Cryotherapy Application on Pain Perception during Greater Palatine Injection: A Randomized Clinical Controlled Trial

Background: The primary aim of this study was to evaluate the efficacy of cryotherapy as a nonpharmacological adjunct to reduce pain perception during greater palatine nerve block injections, which are often associated with significant discomfort due to dense palatal tissue and high nerve density in the area.Secondary aims included comparing the pain-reducing effects of cryotherapy against a standard topical anesthetic (benzocaine gel) and a control group receiving no pre-injection intervention; assessing potential adverse effects such as tissue irritation or frostbite; and exploring clinical implications for enhancing patient comfort, reducing anxiety, and improving treatment compliance in dental procedures.This investigation sought to provide evidence-based support for integrating cryotherapy into routine dental anesthesia protocols, particularly for patients prone to injection-related fear, such as pediatric or anxious individuals, while also identifying limitations for future research directions.Methodology: Ninety adults (18-60 years; 30 per group) requiring greater palatine nerve blocks for dental procedures (e.g., extractions, endodontics) were enrolled after informed consent.Exclusions: Cold hypersensitivity, anesthetic allergies, pain-affecting conditions, recent analgesics, or mucosal issues.Participants were randomized to:• Cryotherapy: Two-minute ice pack (0°C, gauze-wrapped) on the palatal site.• Benzocaine: 20% gel applied for 1-2 minutes.• Control: No intervention; site dried only.Results: Ninety participants (mean age 35.2 ± 8.7 years; 52% female) completed the study.Visual analog scale (VAS) scores differed significantly [Analysis for variance (ANOVA) F (2, 87) = 45.6, p < 0.001]: Control 6.1 ± 0.8 (5-7), cryotherapy 1.5 ± 1.2 (0-3), and benzocaine 2.5 ± 0.7 (2-3).Cryotherapy was superior to control (p < 0.001, d = 2.1) and benzocaine (p = 0.012, d = 0.9); benzocaine was better than control (p < 0.001, d = 1.4).Conclusion: Cryotherapy significantly reduces pain during greater palatine injections, outperforming benzocaine and control, with lower VAS scores and minimal adverse effects.It offers a safe, cost-effective adjunct for patient comfort in endodontics.Limitations: Immediate assessment only; future studies needed for optimization and broader demographics.