Assessment of Postoperative Pain Following Single-visit Endodontic Treatment using Cold Versus Room-temperature Irrigants: A Randomized Clinical Study
DOI:
https://doi.org/10.48165/ajm.2026.9.01.49Keywords:
Intracanal cryotherapy, Endodontics, Postoperative pain, Cold irrigants, Root canal treatment, Single-visit endodonticsAbstract
Background: Postoperative pain remains a common concern following single-visit root canal treatment despite advances in endodontic techniques and irrigation protocols. Recent studies suggest that intracanal cryotherapy using cold irrigants may reduce postoperative pain by decreasing local inflammation and tissue edema. However, evidence regarding its effectiveness in routine clinical practice remains limited. Aim: To compare the effect of cold irrigants and room-temperature irrigants on postoperative pain following single-visit endodontic treatment. Materials and Methods: A randomized clinical study was conducted on 40 patients requiring single-visit root canal treatment for symptomatic irreversible pulpitis in single-rooted teeth. Participants were randomly allocated into two groups of 20 each. Group I received final irrigation with 5°C saline solution (cold irrigant), while Group II received final irrigation with saline solution at room temperature (25°C). All treatments were performed using a standardized endodontic protocol. Postoperative pain was assessed using a Visual Analog Scale (VAS) at 6, 24, 48, and 72 hours after treatment. Data were analyzed using independent t-test and repeated measures ANOVA, with statistical significance set at p < 0.05. Results: Both groups demonstrated a progressive reduction in pain over time. The cold irrigant group showed significantly lower mean VAS scores compared to the room-temperature irrigant group at 6 hours (3.10 ± 1.12 vs. 4.55 ± 1.23, p = 0.002) and 24 hours (1.95 ± 0.89 vs. 3.10 ± 1.05, p = 0.004). Differences at 48 and 72 hours were not statistically significant. No adverse effects related to the use of cold irrigants were observed. Conclusion: The use of cold irrigants during single-visit endodontic treatment significantly reduced early postoperative pain compared with room-temperature irrigants. Intracanal cryotherapy appears to be a simple, safe, and cost-effective adjunct for improving patient comfort following root canal therapy.
Downloads
References
Levine, M. (1988). Root-canal therapy: A means of treating oral pain and infection. Canadian Family Physician, 34, 1357–1365.
Valente, P., Sbrenna, L., Sbrenna, A., & Valente, F. (2026). Nickel titanium alloys in endodontics: A narrative review. Cureus, 18(3), e105033. https://doi.org/10.7759/cureus.105033
Wong, A. W., Tsang, C. S., Zhang, S., Li, K. Y., Zhang, C., & Chu, C. H. (2015). Treatment outcomes of single-visit versus multiple-visit non-surgical endodontic therapy: A randomized clinical trial. BMC Oral Health, 15, 162. https://doi.org/10.1186/s12903-015-0148-x
Mendes, W. V., Lima, S. N. L., do Nascimento Azevedo, J. V., Leite, H. L. A., Oliveira, P. S., Ferreira, M. C., & Carvalho, C. N. (2025). Postoperative pain and quality of life assessment after endodontic preparation with rotary and reciprocating endodontic instruments: Randomized clinical trial. Trials, 26(1), 68. https://doi.org/10.1186/s13063-025-08725-0
Silva, E. J. (2013). Postoperative pain after foraminal enlargement in anterior teeth with necrosis and apical periodontitis: A prospective and randomized clinical trial. Journal of Endodontics, 39(2), 173–179. https://doi.org/10.1016/j.joen.2012.11.005
Jakhar, A., Vats, A. S., Singh, S., Thind, G., Aga, N., Agwan, M. A. S., & Makkad, R. S. (2024). Investigating the effects of various root canal irrigation solutions on tissue dissolution and microbial control. Journal of Pharmacy and Bioallied Sciences, 16(Suppl. 3), S2306–S2308. https://doi.org/10.4103/jpbs.jpbs_850_23
Mitra, P., Mishra, P., Sharma, S., Pal, A., Banjare, V., & Mondal, J. (2024). Effect of intracanal cryotherapy and Curcuma longa as a final irrigant in reducing postoperative pain: An in vivo study. Journal of Pharmacy and Bioallied Sciences, 16(Suppl. 3), S2925–S2927. https://doi.org/10.4103/jpbs.jpbs_987_23
Gurucharan, I., Saravana Karthikeyan, B., & Mahalaxmi, S. (2017). Intracanal cryotherapy in endodontics. Australian Endodontic Journal, 43, 138–139. https://doi.org/10.1111/aej.12214
de Oliveira Damasceno, C., da Silveira Bueno, C. E., De Martin, A. S., Pelegrine, R. A., Villela, A. M., Ruivo, L. M., & Shoji Kato, A. (2020). Factors associated with post-endodontic treatment pain performed by students in an endodontic graduate program. Iranian Endodontic Journal, 15(4), 221–226. https://doi.org/10.22037/iej.v15i4.28107
Academia Journal of Medicine. (2026). Assessment of postoperative pain following single-visit endodontic… Academia Journal of Medicine, 9(1). https://doi.org/10.48165/ajm.2026.9.01.49
Note: The author(s) and complete article title are missing from the provided information. Please provide the first page (or full citation) for complete APA formatting.
Khallaf, M. E., Aly, Y., & Mohamed, A. I. (2025). Comparison of post-operative pain prevalence after single visit endodontic treatment with two NiTi rotary files: A randomized clinical trial. Scientific Reports, 15(1), 44128. https://doi.org/10.1038/s41598-025-44128-0
Alharthi, A. A., Aljoudi, M. H., Almaliki, M. N., Almalki, M. A., & Sunbul, M. A. (2019). Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. The Saudi Dental Journal, 31(3), 330–335. https://doi.org/10.1016/j.sdentj.2019.03.004
Ajeesh, K., Jayasree, S., James, E. P., Pooja, K. P., & Jauhara, F. (2023). Comparative evaluation of the effectiveness of intracanal and intraoral cryotherapy on postendodontic pain in patients with symptomatic apical periodontitis: A randomized clinical trial. Journal of Conservative Dentistry and Endodontics, 26(5), 555–559. https://doi.org/10.4103/jcd.jcd_367_22
Keskin, C., Özdemir, Ö., Uzun, İ., & Güler, B. (2017). Effect of intracanal cryotherapy on pain after single-visit root canal treatment. Australian Endodontic Journal, 43, 83–88. https://doi.org/10.1111/aej.12179
Vera, J., Ochoa-Rivera, J., Vazquez-Carcaño, M., Romero, M., Arias, A., & Sleiman, P. (2015). Effect of intracanal cryotherapy on reducing root surface temperature. Journal of Endodontics, 41, 1884–1887. https://doi.org/10.1016/j.joen.2015.08.003
