Effectiveness of cryotherapy versus dexamethasone in reducing postoperative pain in permanent mandibular molars with symptomatic irreversible pulpitis: a randomized controlled clinical trial

Quintessence Int. 2026 Mar 26;0(0):0. doi: 10.3290/j.qi.b6967730. Online ahead of print.

ABSTRACT

OBJECTIVES: This randomized controlled trial compared the effectiveness of dexamethasone and cryotherapy as final irrigation protocols in reducing postoperative pain after root canal preparation in mandibular molars with symptomatic irreversible pulpitis.

METHOD AND MATERIALS: Ninety patients were randomly divided into three groups (n = 30): control, cryotherapy, and dexamethasone. After standard NaOCl and EDTA irrigation, the control group received 20 mL of normal saline, the cryotherapy group received 20 mL of 2°C saline, and the dexamethasone group received 1 mL of dexamethasone solution (4 mg/mL) per canal following a final saline rinse. The participants were asked to rate the intensity of their postoperative pain via a Visual Analog Scale (VAS) at 6 h, 12 h, 24 h, 48 h, and 72 h. The data were statistically evaluated.

RESULTS: At 6 h, the dexamethasone group demonstrated significantly lower VAS scores compared with the cryotherapy and control groups (p < .05), with a mean absolute difference of approximately 1.4 VAS units versus control. At 12 h, pain scores were similar between the dexamethasone and cryotherapy groups, both being significantly lower than the control group (p < .05). At 24 h, the dexamethasone group maintained significantly lower pain scores compared with control (mean absolute difference ≈ 1.1 VAS units; p < .05). No significant differences were observed among the groups at 48 and 72 h.

CONCLUSION: Dexamethasone irrigation was found to be more effective than cryotherapy in reducing postoperative pain in the early postoperative period.

PMID:41885126 | DOI:10.3290/j.qi.b6967730