Avaliação de um protocolo de crioterapia na ocorrência de dor pós-operatória endodôntica em dentes molares com pulpite irreversível. Um Ensaio Clínico Randomizado

Abstract

This study aimed to compare, through a double-blind, randomized superiority clinical trial, the effect of irrigation with chilled sterile saline solution on postoperative pain in endodontics. Forty-nine patients requiring endodontic treatment in permanent molars were selected at the outpatient clinic of the Faculty of Dentistry at UFAM, diagnosed with irreversible pulpitis. The treatment protocol was performed in a single session by a single operator. Canal instrumentation was conducted using the ProDesign R reciprocating system with 2.5% sodium hypochlorite irrigation. The working length was determined at the apical foramen limit using an electronic apex locator. Before the obturation procedure, patients were randomly assigned to two groups: Group 1 (control) received irrigation with sterile saline solution at room temperature, and Group 2 (intervention) received irrigation with the same solution at a temperature between 1.5°C and 4°C for 2 minutes per canal in both groups. Following the intervention, obturation was performed using the lateral condensation technique with a resin-based endodontic sealer up to 0.5 mm short of the foramen, followed by provisional sealing with restorative glass ionomer cement. Blinding techniques were employed for both the patient and the outcome evaluator. The primary outcome assessed was postoperative pain—its occurrence and intensity—experienced by the patient at intervals of 6, 12, 24, 48, and 72 hours after endodontic treatment, using the Numeric Rating Scale (NRS: 0–10 cm). The prevalence of pain in the control group was 75%, whereas in the intervention group, it was 52%. The pain intensity scores in the control group at the evaluated time points were: 2.12 ± 2.59 at 6h; 2.66 ± 3.04 at 12h; 1.83 ± 2.74 at 24h; 0.91 ± 2.30 at 48h; and 1.20 ± 2.70 at 72h. In the intervention group, the corresponding values were: 1.40 ± 2.02; 1.12 ± 1.66; 0.84 ± 1.62; 0.68 ± 0.59; and 0.72 ± 1.88, respectively. No statistically significant differences were found for either outcome. It was concluded that cryotherapy did not reduce the prevalence of postoperative pain in endodontically treated teeth.