Evaluation of the effect of cryotherapy and dexamethasone applications on postoperative pain in molar teeth with symptomatic irreversible pulpitis: A clinical study

Vital pulp treatments comprise a range of clinical procedures aimed at preserving the vitality and function of either the entire dental pulp or a portion of it. Cryotherapy and dexamethasone administration are considered to contribute to the reduction of postoperative pain that may occur following vital pulp therapy. In this thesis study, it was aimed to evaluate the effect of dexamethasone and cryotherapy (saline solution at 2.5°C) applied into the cavity during the total pulpotomy procedure on postoperative pain using the Visual Analog Scale (VAS). Seventy-two patients with maxillary and mandibular molar teeth diagnosed with irreversible pulpitis were included in this study. After removal of the coronal pulp and achievement of hemostasis, the following protocols were applied according to the study groups: Control group (Group I): The cavity was irrigated with 20 milliliters (mL) of saline solution at room temperature for 5 minutes. Cryotherapy group (Group II): The cavity was irrigated with 20 mL of saline solution at 2.5°C for 5 minutes. Dexamethasone group (Group III): The cavity was irrigated with 1 ampoule of dexamethasone for 1 minute. Patients were provided with a VAS form and were asked to rate their pain levels at 6, 12, 24, 48, and 72 hours postoperatively. According to the results obtained in our study, pain scores in all groups showed a statistically significant decrease from the 6th hour to the 72nd hour (p<0.001). When pain scores between the groups were evaluated at different time intervals, a statistically significant difference was observed between the dexamethasone group (2.16 ± 1.8, 1.2 ± 1.5) and the control group (4.5 ± 2.73, 2.79 ± 2.51) at the 6th and 12th hours (p<0.05). When the cryotherapy and dexamethasone groups were compared in terms of pain scores at the same time intervals, although the dexamethasone group (2.16 ± 1.8, 1.2 ± 1.5) exhibited lower values than the cryotherapy group (3.37 ± 2.91, 1.87 ± 2.32), no statistically significant difference was observed between the two groups (p>0.05). Similarly, although the cryotherapy group (3.37 ± 2.91, 1.87 ± 2.32) showed lower pain scores compared to the control group (4.5 ± 2.73, 2.79 ± 2.51) at the 6th and 12th hours, the difference between these two groups was not statistically significant (p>0.05).