Modified Cryotherapy During Final Irrigation Reduces Postoperative Pain and Anxiety in Pediatric Primary Molar Root...

Postoperative pain and dental anxiety are significant barriers to effective pediatric endodontic treatment. Improving patient comfort and cooperation remains a critical clinical objective in school-age children undergoing primary molar root canal therapy (RCTP). Conventional pharmacologic strategies have limitations in acceptability, safety, and efficacy, prompting the exploration of non-invasive alternatives. The aim of this study is to evaluate the effect of modified cryotherapy using 0°C saline as the final irrigation protocol on postoperative pain levels and anxiety control in school-age children undergoing RCTP.

This single-center, randomized, controlled clinical trial enrolled 104 school-age patients diagnosed with pulp or periapical disease in deciduous molars. Patients were randomly allocated to either a modified cryotherapy group or a control group. Pain levels were assessed using the Wong-Baker FACES Pain Rating Scale (WB Scale) at baseline, 6, 24, 48 h, and 7 days postoperatively. Anxiety and cooperation were evaluated at baseline and 7-day follow-up using the Venham Scale. Statistical analyses included Chi-square and Mann-Whitney U tests, with significance at p < 0.05.

Baseline characteristics were comparable between groups. The cryotherapy group showed significantly lower pain scores at 6 h,24 h, and 48 h (p <  0.001) post-treatment compared to controls. At 7 days, pain levels converged with no significant difference. The cryotherapy group also demonstrated significantly improved anxiety scores (p = 0.005) and clinical cooperation (p  = 0.012) at follow-up compared to the control group.

Modified cryotherapy applied during final root canal irrigation significantly reduces short-term postoperative pain and enhances clinical cooperation in school-age children.