EFFECT OF INTRACANAL CRYOTREATED CHLORHEXIDINE ON POSTOPERATIVE PAIN AFTER ROOT CANAL TREATMENT – A RANDOMIZED CONTROLLED CLINICAL TRIAL

Arjeet Ghosh*, Ajay Kumar Nagpal, Sunil Kumar, Abhishek Sharma, Mutiur Rahman, Juhi Dubey

ABSTRACT

Introduction: Pain management during and after root canal treatment stands as a pivotal aspect of endodontic care.
Post-endodontic pain may stem from microbial, mechanical, or chemical factors, or a combination thereof.
Effectively managing this pain is integral for a practitioner's success. Diverse techniques have been explored to
mitigate postoperative pain, encompassing preprocedural analgesics, prolonged local anaesthesia, optimal
instrumentation, proper irrigant use, occlusal adjustments, and psychological interventions. Cryotherapy, a novel
pain management approach utilized in sports medicine and general surgery, has shown promise in postoperative
care. Using cold materials to reduce tissue temperature and successfully manage pain is known as cryotherapy.
Aim: This study sought to assess the efficacy of intracanal cryotreated chlorhexidine in managing postoperative
pain following single-visit RCT in patients presenting symptomatic irreversible pulpitis/apical periodontitis.
Materials and Methods: 62 patients receiving a single-visit randomized controlled trial were split equally into two
groups (n = 31 each) for the purpose of the study. Group A received room temperature chlorhexidine (20 millilitres
for five minutes per canal), and Group B received cryotreated chlorhexidine (20 millilitres kept between 2℃-4℃
for five minutes per canal). Patients were taught how to complete the VAS scale and record their preoperative VAS
score prior to therapy. Post-treatment, patients were contacted at 6, 24, and 48 hours to assess post-endodontic pain.
Additionally, the number of patients consuming analgesics at these time points was recorded. Statistical analysis
employed Mann-Whitney U Test for inter-group VAS score comparisons, Wilcoxon Signed Ranks Test for intragroup
VAS score comparisons, and Chi-square test for analgesic intake. A significance level of P ≤ 0.05 was
applied. Results: Cryotreated chlorhexidine exhibited superior pain control over room temperature chlorhexidine,
reflected in lower postoperative pain scores at 6, 24, and 48 hours. Both groups displayed a decline in pain trends
throughout the postoperative period. Analgesic consumption decreased over 48 hours in both groups without
significant differences between them. Conclusion: Flushing the canal with cold chlorhexidine proved effective in
controlling post-endodontic pain. This strategy shows potential as an essential step in endodontic therapy for the
relief of pain following endodontic surgery.

Keywords: Additionally, the number of patients consuming analgesics at these time points was recorded.