In the endodontic clinical practice, one of the most damaging and unnerving experience for both patient and clinician is the precipitation of pain, during or after the treatment. To control the postoperative pain several strategies have been developed including the use of analgesics, long-standing anesthesia, and different techniques in root canal preparation. Cryotherapy is also one of the methods to reduce post-operative pain. Cold through various methods may decrease the conduction velocity of nerve signals, hemorrhage, edema, and local inflammation and is therefore effective in the reduction of musculoskeletal pain. Patients presenting with a diagnosis of symptomatic apical periodontitis with pulpal necrosis and a preoperative visual analog scale (VAS) score higher than 7 were randomly allocated in the control and experimental group after the completion of shaping and cleaning procedures. The experimental group received final irrigation with a 20 mL sterile cold (2.5◦C) saline solution delivered to the working length with a sterile, cold (2.5◦C) side vented needle for 5 minutes. The same protocol was used in the control group with room temperature saline solution. Patients were instructed to record the presence, duration and level of postoperative pain, and analgesic medication intake. Postoperative pain after 6, 24, and 72 hours recorded in a VAS scale and the need for analgesic medication intake between the 2 groups were assessed. Patients in the control group presented a significantly higher incidence of postoperative pain, intensity, and need for medication intake (P < .05). Cryotherapy reduced the incidence of postoperative pain and the need for medication intake in patients presenting with a diagnosis of necrotic pulp and symptomatic apical periodontitis.
Key words: Endodontic pain, cryotherapy, symptomatic apical periodontitis.