Cryotherapy as an adjunct to inferior alveolar nerve block in Symptomatic Irreversible Pulpitis: A randomised controlled clinical trial

Abstract

: To evaluate and compare the effect of two approaches of cryotherapy for improving the success rate of Inferior alveolar nerve block and reduction of pain during access opening in mandibular molars with symptomatic irreversible pulpitis. : Thirty patients diagnosed with symptomatic irreversible pulpitis were selected based on inclusion and exclusion criteria to participate in the study. 3 groups were designed; Group 1(Control group) - inferior alveolar nerve block(IANB) with lignocaine (2%) adrenaline (1:80000), Group 2(IANB+ small ice pack)-inferior alveolar nerve block with lignocaine (2%) adrenaline (1:80000) + small ice packs (wrapped in sterile gauze); Group 3 (IANB+Endo Ice) -inferior alveolar nerve block with lignocaine (2%) adrenaline (1:80000) + Endo Ice application. Patients were randomly allocated to any one of the groups: The level of preoperative pain was recorded using the Numeric visual analogue scale (VAS). Endodontic therapy was done 15 minutes after the IANB injection. The level of intra operative pain during access opening was recorded again using the same scale. If the patients reported moderate or severe pain during the procedure, the IANB was defined as “unsuccessful,” and a supplementary injection was administered.: There was statistically significant difference found in pain reduction among 3 groups (p=0.01). Post hoc analysis revealed significant difference between Group 1(Control) and Group 2(IANB+ small ice pack) with (p=0.003). Overall success rate of IANB was found to be 66.66 %. : Both the techniques of intraoral cryotherapy exhibited improved pain reduction as well as increased the success rate of IANBs in mandibular molar teeth with SIP. Hence based on the results obtained, it is suggested that cryotherapy can serve as a useful adjunct to anaesthesia during endodontic procedures.