Role of Intracanal Cryotherapy in the Management of Postoperative Pain Following Single-Visit Endodontic Treatment: A Randomized Clinical Trial


Authors : Dr. Rahul Kshirsagar; Dr. Sunil Nirmale; Dr. Sadashiv Daokar; Dr. Nikita Sarate; Dr. Mohit Thakur; Dr. Priyanka Chavan

Volume/Issue : Volume 11 - 2026, Issue 1 - January

Google Scholar : https://tinyurl.com/5n7evaz9

Scribd : https://tinyurl.com/x46n2zk2

DOI : https://doi.org/10.38124/ijisrt/26jan520

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Abstract : Background: Postoperative pain remains a common concern among patients undergoing root canal treatment, despite the procedure’s primary goal of alleviating discomfort caused by pulpal inflammation or infection. The intensity and duration of post-treatment pain can vary significantly among individuals. Aim: This study aimed to evaluate the influence of intracanal cryotherapy using cold normal saline (1.5–2.5°C) on postoperative pain following single-visit root canal therapy in teeth diagnosed with symptomatic irreversible pulpitis. Material and Methodology: Forty-eight patients fulfilling the inclusion criteria were enrolled and randomly allocated into two groups using a sealed-envelope method. Following local anaesthesia and rubber dam isolation, standard access cavity preparation and chemomechanical debridement were completed. Both groups underwent single-visit root canal treatment; however, the final irrigation protocol differed by temperature. The cryotherapy group received a final rinse with cold saline (2.5°C) for five minutes, whereas the control group received saline at room temperature. Postoperative pain was assessed using a visual analogue scale (VAS) at 6 hours, 24 hours, and 7 days. Results: Patients in the cryotherapy group reported significantly lower pain levels at 6 and 24 hours compared with the control group. At the 7-day interval, no statistically significant difference in pain scores was observed between the two groups. Conclusion: Intracanal cryotherapy effectively reduces short-term postoperative pain following single-visit root canal treatment, although it does not appear to influence long-term pain perception.

Keywords : Intracanal Cryotherapy, Postoperative Pain, Single-Visit Endodontics.

References :

  1. Alhilou AM. Factors Reducing Postoperative Pain Related to Root Canal Treatment: A Narrative Review of Systematic Reviews. Dentistry Journal. 2025 Feb 26;13(3):102.
  2. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare‐up in single‐and multiple‐visit endodontic treatment: a systematic review. International endodontic journal. 2008 Feb;41(2):91-9.
  3. Pak JG, White SN. Pain prevalence and severity before, during, and after root canal treatment: a systematic review. J Endod. 2011 Apr;37(4):429-38.
  4. Monteiro LP, Guerreiro MY, de Castro Valino R, Magno MB, Maia LC, da Silva Brandão JM. Effect of intracanal cryotherapy application on postoperative endodontic pain: a systematic review and metaanalysis. Clinical oral investigations. 2021 Jan;25(1):23-35.
  5. Almohaimede A, Al-Madi E. Is intracanal cryotherapy effective in reducing postoperative endodontic pain? An updated systematic review and meta-analysis of randomized clinical trials. International Journal of Environmental Research and Public Health. 2021 Nov 9;18(22):11750.
  6. Belitsky RB, Odam SJ, Hubley-Kozey C. Evaluation of the effectiveness of wet ice, dry ice, and cryogen packs in reducing skin temperature. Phys Ther. 1987 Jul 1;67(7):1080-4.
  7. Knight KL. Cryotherapy in sport injury management. 1995. Champaign, IL: Human Kinetics.:5-11.
  8. Keskin C, Özdemir Ö, Uzun İ, Güler B. Effect of intracanal cryotherapy on pain after single‐visit root canal treatment. Australian endodontic journal. 2017 Aug;43(2):83-8.
  9. Kaya Mumcu A, Tuzcu E, Kurnaz S, Kiraz G. Evaluation of the effect of intracanal cryotherapy on postoperative pain after retreatment: a randomized controlled clinical trial. Clinical Oral Investigations. 2025 Jun 25;29(7):355.
  10. Vera J, Ochoa-Rivera J, Vazquez-Carcaño M, Romero M, Arias A, Sleiman P. Effect of intracanal cryotherapy on reducing root surface temperature. Journal of endodontics. 2015 Nov 1;41(11):1884-7.
  11. Vera J, Ochoa J, Romero M, Vazquez-Carcano M, Ramos-Gregorio CO, Aguilar RR, Cruz A, Sleiman P, Arias A. Intracanal cryotherapy reduces postoperative pain in teeth with symptomatic apical periodontitis: a randomized multicenter clinical trial. Journal of endodontics. 2018 Jan 1;44(1):4-8.
  12. Franz DN, Iggo A. Conduction failure in myelinated and non‐myelinated axons at low temperatures. The Journal of physiology. 1968 Dec 1;199(2):319-45.
  13. Nadler SF, Weingand K, Kruse RJ. The physiologic basis and clinical applications of cryotherapy and thermotherapy for the pain practitioner. Pain physician. 2004;7(3):395.
  14. Banfi G, Melegati G, Barassi A, Dogliotti G, d’Eril GM, Dugué B, Corsi MM. Effects of whole-body cryotherapy on serum mediators of inflammation and serum muscle enzymes in athletes. Journal of thermal biology. 2009 Feb 1;34(2):55-9.
  15. Jain A, Chauhan S, Bahuguna R, Agarwal A, Sharma R, Khan F. Effect of cryotherapy on postoperative pain: randomized controlled trial. Indian Journal of Dental Sciences. 2021 Oct 1;13(4):236-40.
  16. Alharthi AA, Aljoudi MH, Almaliki MN, Almalki MA, Sunbul MA. Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. The Saudi dental journal. 2019 Jul 1;31(3):330-5.
  17. Ajeesh K, Jayasree S, James EP, Pooja KP, Jauhara F. 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. 2023 Sep 1;26(5):555-9.
  18. Iparraguirre Nuñovero MF, Hungaro Duarte MA, Kaled Segato AV, da Silva Neto UX, Portela Ditzel Westphalen V, Carneiro E. The effect of intracanal cryotherapy with and without foraminal enlargement on pain prevention after endodontic treatment: a randomized clinical trial. Scientific Reports. 2024 Aug 28;14(1):19905.
  19. Gupta A, Aggarwal V, Gurawa A, Mehta N, Abraham D, Singh A, Jala S, Chauhan N. Effect of intracanal cryotherapy on postendodontic pain: a systematic review and meta-analysis of randomized controlled trials. Journal of dental anesthesia and pain medicine. 2021 Jan 29;21(1):15.
  20. Hespanhol FG, Guimarães LS, Antunes LA, Antunes LS. Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis. Restorative dentistry & endodontics. 2022 Jul 4;47(3).
  21. Keskin C, Aksoy A, Kalyoncuoğlu E, Keleş A, İlik AA, Kömeç O, Yüzgüleç E, Akgün H, Alak SG, Tokur O. Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial. International endodontic journal. 2023 Aug;56(8):932-42.
  22. Al-Nahlawi T, Hatab TA, Abd Alrazak M, Al-Abdullah A. Effect of intracanal cryotherapy and negative irrigation technique on postendodontic pain. The journal of contemporary dental practice. 2017 May 1;17:990-6.
  23. Bazaid DS, Kenawi LM. The effect of intracanal cryotherapy in reducing postoperative pain in patients with irreversible pulpitis: a randomized control trial. Int J Health Sci Res. 2018 Feb;8(2):83-8.
  24. Sadaf D, Ahmad MZ, Onakpoya IJ. Effectiveness of intracanal cryotherapy in root canal therapy: a systematic review and meta-analysis of randomized clinical trials. Journal of endodontics. 2020 Dec 1;46(12):1811-23.
  25. Todorova MV, Dimitrova SD, Zagorchev PI. In vitro study of temperature changes on the outer root surface of extracted human teeth under different parameters of intracanal cryotherapy. European Journal of General Dentistry. 2023 Jan;12(01):014-9.
  26. Western JS, Zahir AS, Mohainuteen AI, Ping BY, Hui CS, Ru CE, Dicksit DD. Intracanal cryotherapy with two different temperature ranges in reducing postendodontic pain: A double-blind randomized clinical trial. Saudi Endodontic Journal. 2022 Jan 1;12(1):82-9.
  27. Fatima S, Taneja S, Aggarwal V, Dheer A, Taneja P. Effect of cryotherapy, laser therapy and intraligamentary dexamethasone injection on post-treatment pain after single visit RCT–A double-blinded, randomized placebo-controlled trial. Journal of Oral Biology and Craniofacial Research. 2025 Mar 1;15(2):221-7.
  28. Almasoud L, Elsewify T, Elemam R, Eid B. Effect of cryotherapy and occlusal reduction on postoperative endodontic pain in mandibular first molars with symptomatic apical periodontitis: a prospective, parallel, double-blinded randomized controlled trial. European Journal of Dentistry. 2025 May;19(02):472-81.
  29. Solomon RV, Paneeru SP, Swetha C, Yatham R. Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment. Journal of Clinical and Experimental Dentistry. 2024 Mar 1;16(3):e250.
  30. Emad A, Abdelsalam N, Fayyad DM. Influence of intracanal cryotherapy on postendodontic pain and interleukin-6 expression using different irrigation protocols: A randomized clinical trial. Saudi Endodontic Journal. 2021 May 1;11(2):246-51.
  31. Ezzat TM, Ezzat K, Morsy DA. 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: A randomized clinical trial. Advanced Dental Journal. 2023 Jul 1;5(3):581-7.

Background: Postoperative pain remains a common concern among patients undergoing root canal treatment, despite the procedure’s primary goal of alleviating discomfort caused by pulpal inflammation or infection. The intensity and duration of post-treatment pain can vary significantly among individuals. Aim: This study aimed to evaluate the influence of intracanal cryotherapy using cold normal saline (1.5–2.5°C) on postoperative pain following single-visit root canal therapy in teeth diagnosed with symptomatic irreversible pulpitis. Material and Methodology: Forty-eight patients fulfilling the inclusion criteria were enrolled and randomly allocated into two groups using a sealed-envelope method. Following local anaesthesia and rubber dam isolation, standard access cavity preparation and chemomechanical debridement were completed. Both groups underwent single-visit root canal treatment; however, the final irrigation protocol differed by temperature. The cryotherapy group received a final rinse with cold saline (2.5°C) for five minutes, whereas the control group received saline at room temperature. Postoperative pain was assessed using a visual analogue scale (VAS) at 6 hours, 24 hours, and 7 days. Results: Patients in the cryotherapy group reported significantly lower pain levels at 6 and 24 hours compared with the control group. At the 7-day interval, no statistically significant difference in pain scores was observed between the two groups. Conclusion: Intracanal cryotherapy effectively reduces short-term postoperative pain following single-visit root canal treatment, although it does not appear to influence long-term pain perception.

Keywords : Intracanal Cryotherapy, Postoperative Pain, Single-Visit Endodontics.

Paper Submission Last Date
31 - January - 2026

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