Cryotherapy as a supplementary aid to inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: A randomized controlled trial.

The present study aimed to evaluate the effects of cryotherapy in conjunction with inferior alveolar nerve block (IANB) on intraoperative pain and anaesthesia success in adult patients with symptomatic irreversible pulpitis (SIP) of the mandibular permanent first molars. A total of 60 patients diagnosed with SIP of the mandibular first molars were randomly divided into two groups (n=30) as follows: Group I (the control), in which patients were administered IANB with 3.6 ml 2% lignocaine, and group II (test group), in which patients received the same IANB therapy followed by cryotherapy using an endo-frost spray and intrapulpal ice sticks. Pain scores were recorded during access opening and cleaning/shaping using the Heft-Parker visual analogue scale (VAS). The primary outcome was the success rate of anaesthesia (VAS ≤54 mm). The secondary outcome was mean pain score during the treatment phase. Group II exhibited a higher success rate (79.3%) than group I (65.3%) (P=0.24). The mean pain during access opening was significantly lower in group II (20.60±29.90) than in group I (41.43±43.10) (P=0.04). Although pain scores during cleaning/shaping were lower in group II (17.73±24.06 vs. 26.95±36.72), the difference was not statistically significant (P=0.27). On the whole, the present study demonstrates that cryotherapy improved anaesthetic success and reduced intraoperative pain during access opening in patients with SIP. However, its effect during subsequent treatment stages was limited, suggesting the need for supplemental anaesthesia in some cases.