Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain

Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain in Lower Molar Teeth With Irreversible Pulpitis and Symptomatic Apical Periodontitis Randomized Clinical Trial

The aim of this study is to clinically compare the efficacy of intraoral cryotherapy versus intracanal cryotherapy after single visit root canal therapy in lower molars with irreversible pulpitis and symptomatic apical periodontitis

Inclusion Criteria:

Systemically healthy patient (ASA I or II).

Mandibular first molar teeth with:

• Preoperative sharp pain and symptomatic apical periodontitis
• Absence or slight widening in the periodontal ligament (PDL).
• Vital response of pulp tissue to cold pulp tester (ethyl chloride spray) .
• Positive response to percussion test

Exclusion Criteria:

1. Medically compromised patients.
2. Pregnant women.
3. Patients reporting bruxism or clenching.
4. Patients allergic to ciprofloxacin or metronidazole.
5. Teeth associated with acute periapical abscess and/or swelling.
6. Greater than grade I mobility or pocket depth greater than 5mm.
7. Size of periapical radiolucency is greater than 8 mm.
8. No restorability: Hopeless tooth.
9. Immature teeth.
10. Radiographic evidence of external or internal root resorption vertical root fracture, perforation, calcification.