Effects of Intracanal Cryotherapy Applications on Postoperative Pain After Nonsurgical Root Canal Retreatment in Teeth with Symptomatic Apical Periodontitis: Randomized Controlled Clinical Trial

Niger J Clin Pract. 2026 Feb 1;29(2):167-172. doi: 10.4103/njcp.njcp_193_25. Epub 2026 Mar 4.

ABSTRACT

BACKGROUND: Cryotherapy significantly reduces pain and inflammation in the short term due to its effectiveness in managing acute soft tissue injuries.

AIM: The aim of this study was to evaluate the effects of intracanal cryotherapy after nonsurgical root canal retreatment on postoperative pain in mandibular premolar teeth with symptomatic apical periodontitis.

METHODS: A total of 60 patients with mandibular premolar teeth in need of nonsurgical endodontic retreatment were included. Preoperative pain and percussion values of teeth were greater than 70 on the visual analog scale. After the routine root canal shaping and cleaning procedures, the teeth in the cryotherapy group were irrigated with 20 ml of sterile cold (2.5°C) saline solution. Room temperature saline solution was applied to the teeth in the control group. The data were analyzed using Chi-square and Mann-Whitney U tests (P = 0.05).

RESULTS: There were no statistically significant differences between the groups with respect to demographic variables (P > 0.05). The cryotherapy group exhibited significantly lower postoperative pain levels than the control group at all time intervals (P < 0.05). Mean pain scores (VAS, mean ± SD) in the cryotherapy and control groups were 31.0 ± 25.34 and 62.67 ± 16.39 on day 1; 18.67 ± 18.14 and 49.33 ± 13.11 on day 3; 9.33 ± 10.15 and 30.67 ± 13.63 on day 5; and 2.67 ± 6.91 and 14.67 ± 11.67 on day 7, respectively.

CONCLUSION: The application of intracanal cryotherapy in teeth that need root canal retreatment with symptomatic apical periodontitis may be an effective method for reducing postoperative pain levels.

PMID:41776799 | DOI:10.4103/njcp.njcp_193_25