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Comparative Evaluation of the Effectiveness of Intrapulpal Crushed Ice and Intrapulpal Local Anesthesia during
Snehal D Jagtap1, Nupur Ninawe1, Ritesh R Kalaskar1
1Department of Pediatric and Preventive Dentistry, Government Dental College and Hospital, Nagpur, Maharashtra, India.
Aims And Background:
This study aimed to evaluate the effectiveness of intrapulpal crushed ice compared to intrapulpal lidocaine as a supplementary anesthetic during pulpectomy in primary second molars of children aged 5-10 years. The goal was to assess whether crushed ice could serve as a less painful, effective alternative to intrapulpal local anesthesia when the inferior alveolar nerve block (IANB) alone is insufficient in cases of symptomatic irreversible pulpitis.
Materials And Methods:
A randomized controlled clinical trial was conducted among 52 children fulfilling the inclusion criteria: Frankl Behavior Rating of 3 or 4, vital pulp with bleeding on exposure, and requiring supplementary anesthesia following IANB. Participants were randomly assigned using concealed envelopes to group I (intrapulpal lidocaine, 0.2-0.5 mL under pressure) or group II (intrapulpal crushed ice, placed in the pulp chamber for 3-5 minutes at -4 to 0°C). Pain perception was assessed at access opening and during biomechanical preparation using a visual analog scale (VAS) by the child and a sound, eye, motor (SEM) score by a blinded dentist. Procedure duration was recorded, and cases requiring additional anesthesia were noted.
Results:
The correlation between VAS and SEM scores was not uniform across groups and assessment stages. A statistically significant positive correlation was observed during access opening in Group II and during biomechanical preparation in Group I, whereas the correlations at the other assessment stages were not statistically significant.
Conclusion:
Intrapulpal cryotherapy using crushed ice may be a safe, child-friendly, and effective alternative to intrapulpal lidocaine, providing acceptable pain control with improved behavioral outcomes and clinical efficiency.
Clinical Significance:
This alternative technique helps avoid the pain of intrapulpal anesthesia while providing effective pain control with a positive impact on the child's experience, making it a more child-friendly option.
How To Cite This Article:
Jagtap SD, Ninawe N, Kalaskar RR, et al. Comparative Evaluation of the Effectiveness of Intrapulpal Crushed Ice and Intrapulpal Local Anesthesia during Pulpectomy in Primary Molars. Int J Clin Pediatr Dent 2026;19(8):1017-1022.
