Cryotherapy and Intracanal Medicaments for Postoperative Pain in Apical Periodontitis

Summary

This randomized, participant- and outcome assessor-blinded, 2 × 2 factorial clinical trial evaluated the effects of intracanal cryotherapy and two intracanal medicaments-calcium hydroxide and metformin-on postoperative spontaneous and percussion pain in mandibular premolars with pulpal necrosis and symptomatic apical periodontitis. Eighty participants were randomly assigned to four groups: calcium hydroxide, metformin, cryotherapy plus calcium hydroxide, and cryotherapy plus metformin. All teeth underwent standardized two-visit root canal treatment. In the cryotherapy groups, final irrigation at the first treatment visit was performed using sterile saline at 4 °C. Spontaneous pain was assessed preoperatively and daily for 7 postoperative days using a 100-mm visual analog scale (VAS). Percussion pain was assessed preoperatively and on day 7 immediately before the second treatment visit. The effects of cryotherapy, intracanal medicament type, and their interaction were evaluated using mixed-effects modeling for spontaneous pain and analysis of covariance (ANCOVA) for day-7 percussion pain.

Timeline

Start

2023-03-01

Primary completion

2024-01-01

Completion

2024-01-01

Publications

• Background Tan Y, Chen J, Jiang Y, Chen X, Li J, Chen B, Gao J. The anti-periodontitis action of metformin via targeting NLRP3 inflammasome. Arch Oral Biol. 2020 Jun;114:104692. doi: 10.1016/j.archoralbio.2020.104692. Epub 2020 Mar 4.

Drugs

Indications