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Postoperative pain remains a common concern after root canal treatment of teeth with pulpitis.
Intracanal dexamethasone irrigation provides greater early postoperative pain reduction than cryotherapy following root canal preparation in mandibular molars with pulpitis.
Postoperative pain remains a common concern after root canal treatment of teeth with pulpitis. Various adjunctive irrigation protocols have been investigated to minimize post-treatment discomfort. This randomized controlled trial explored the potency of intracanal dexamethasone and cryotherapy as final irrigation protocols for alleviating postoperative pain in permanent mandibular molars.
A total of 90 patients with symptomatic irreversible pulpitis in permanent mandibular molars were randomly assigned to three groups (n=30 per group):
All patients underwent standard root canal preparation with sodium hypochlorite and ethylenediaminetetraacetic acid irrigation. The degree of postoperative pain was determined via a visual analog scale (VAS) at 6, 12, 24, 48, and 72 hours after the intervention. Statistical analyses were carried out to check pain scores among groups.
All 90 patients completed the trial. At 6 hours postoperatively, the dexamethasone group reported considerably lower visual analog scale (VAS) pain scores than both the cryotherapy and control groups (P<0.05), with an approximate mean absolute reduction of 1.4 VAS units compared with the control group. At 12 hours, pain scores were comparable between the dexamethasone and cryotherapy groups. Both interventions resulted in reduced pain levels vs. the control group (P<0.05).
By 24 hours, dexamethasone continued to yield superior pain relief, maintaining lower VAS scores than the control group, with an approximate mean absolute difference of 1.1 VAS units (P<0.05). However, no prominent differences were noted among the three groups at 48 or 72 hours, indicating that the analgesic advantage of dexamethasone was primarily limited to the early postoperative period.
In patients undergoing root canal treatment for symptomatic irreversible pulpitis, final irrigation with dexamethasone resulted in better pain relief during the first 24 hours than cryotherapy or saline. The benefit diminished over time, with no vital differences observed after 48 hours.
Quintessence International
Effectiveness of cryotherapy versus dexamethasone in reducing postoperative pain in permanent mandibular molars with symptomatic irreversible pulpitis: a randomized controlled clinical trial
Kübra Gürler et al.
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