Evaluating effect of cryotherapy on injection pain and onset of action of precooled and warmed local anesthetic agent in symptomatic irreversible pulpitis patients: an in vivo study

Vollständiger Abstract

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Background: Pain is one of the main reasons for patients seeking dental treatment, but fear of pain attributed to injection is cited as an obstacle in providing appropriate dental care. Achieving profound pulpal anesthesia is challenging due to several factors but it is mandatory for successful completion of root canal treatment. To enhance the success rate of inferior alveolar nerve block (IANB) in mandibular teeth with SIP several approaches have been considered. Cryotherapy approach has been routinely employed in clinical settings. Therefore, the study aims to assess the pain at site, onset of action of temperature-controlled anesthetics with intraoral cryotherapy in patients with symptomatic irreversible pulpitis. Methods: In this double‑blind, randomized clinical trial, 45 patients with deep carious lesions having moderate‑to‑severe pain in the mandibular first molar teeth were selected. Subjects were allocated randomly into various groups based on precooling agent and temperature of local anesthesia (LA): Group I-Normal LA with Lignocaine spray-control group, Group II: Prewarmed LA with Endo ice, Group III: Prewarmed LA with Ice cubes, Group IV: Precooled LA with Endo ice, Group V: Precooled LA with Ice cubes. All participants underwent an IANB, after which the pain at the site and onset of action were compared and evaluated. Results: Statistical assessment of the data revealed a marked decrease in pain at the site with faster onset of action in Group V. Conclusions: Cryotherapy application boosted the efficacy of IANB in anesthetizing mandibular molars with SIP.