Effect of Intracanal Cryotherapy on Postoperative Pain Using Two Different Irrigation Systems
Condition: Postoperative Pain
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      this study was conducted to know the effect of intracanal cryotherapy on postoperative pain
      using two different irrigation systems to deliver the cold saline.

      method: A total of 75 patients presenting with a diagnosis of irreversible pulpitis with
      symptomatic apical periodontitis in single rooted teeth were included in the study and
      randomly divided into three groups (n=25) (i.e. Control group, cryotherapy group with needle
      irrigation and cryotherapy group with negative pressure irrigation system). After complete
      root canal cleaning and shaping, final irrigation was done with 2.5°c 0.9% physiological
      saline in cryotherapy groups with needle irrigation (NI) and negative pressure irrigation
      system (NPI) whereas in control group no additional irrigation was done. Root canal treatment
      was completed in single visit. Participants were asked through telephone to rate their
      postoperative pain intensity after root canal treatment by visual analogue scale from day 1
      till day 7 on given proforma.

      two way repeated measures of ANOVA test were applied to know the mean difference between and
      among the groups.
    

Detailed description: 
      Intracanal cryotherapy is one of the methods recently used to reduce the postoperative pain.
      The aim of this randomized control trial was to evaluate the effect of cold saline
      (cryotherapy) as a final irrigant on postoperative pain with two different irrigation systems
      after single visit root canal treatment objective: To find out the effect of cryotherapy as a
      final irrigant after root canal preparation on postoperative pain using needle irrigation and
      negative pressure irrigation system (EndoVac).

      method: the intervention used in this study was intracanal cryotherapy with two different
      irrigation systems i.e. needle irrigation and negative pressure irrigation system(EndoVac).
      for cryotherapy cold saline was used at temperature of 2.5 °c. total sample size was
      calculated was 75 by using PASS version 11.non probability purposive sampling was used for
      patient recruitment. three groups were made with sample size of 25 in each group. group
      allocation was done by computer generated random numbers.according to inclusion and exclusion
      criteria patients were selected and after complete diagnosis patients were thoroughly
      explained about the treatment and informed consent were taken. to record the preoperative
      pain ,patients were provided a proforma. proforma consisted of visual analogue scale for pain
      record. endodontic procedure was performed by the principal investigator and it was same in
      all the three groups.final irrigation protocol was diferent among the groups; control
      group:no final irrigation was done, cryotherapy with needle irrigation: with needle
      irrigation cold saline was delivered,cryotherapy with EndoVac: with EndoVac cold saline was
      delivered. obturation in root canal was done with same protocol in all the groups.and access
      cavity was filled with temporary restoration. postoperative instruction was given to the
      patient and follow up procedure has also been explained to them. follow up was consisted of 7
      days and through phone call by assessor which was blind regarding the groups. at day 7,
      patient were returned with proforma in which they have noted the pain score of 7 days and at
      the same visit temporary filling was replaced by permanent one. the principal investigator
      was blind regarding the postoperative pain,as it was done by some other assessor.

      statistical analysis was done by using SPSS v.16.the two-way ANOVA repeated measures was
      performed for mean comparision among and between the groups.chi-square/fischer exact test
      test was performed for analgesic intake.
    

Intervention name(s): intracanal cryotherapy using needle irrigation and EndoVac system
Intervention type(s): Procedure
Intervention description(s): a cold saline will be used as final irrigant in two groups but with different irrigation systems.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: subject are randomly placed into one of the three groups:control,intracanal cryotherapy with needle irrigation, intracanal cryotherapy with EndoVac system. cold saline will be used in intracanal cryotherapy for five minutes. postoperative pain will be evaluated for 7 days using visual analogue scale.
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment
Keywords: cryotherapy; postoperative pain; single visit; negative pressure irrigation