Katyal Setu, Bogra Poonam, Bansal Rajinder Kumar, Grover Vishakha, Gupta Saurabh, Gupta Saru Dhir
Department of Conservative Dentistry and Endodontics, I.T.S Dental College, Murad Nagar, Ghaziabad, Uttar Pradesh 201206, India.
Department of Conservative Dentistry and Endodontics, J N Kapoor D.A.V. Dental College and Hospital, Yamunanagar, Haryana 135001, India.
Med Int (Lond). 2025 Jul 22;5(5):55. doi: 10.3892/mi.2025.254. eCollection 2025 Sep-Oct.
The present study aimed to evaluate the effects of cryotherapy in conjunction with inferior alveolar nerve block (IANB) on intraoperative pain and anaesthesia success in adult patients with symptomatic irreversible pulpitis (SIP) of the mandibular permanent first molars. A total of 60 patients diagnosed with SIP of the mandibular first molars were randomly divided into two groups (n=30) as follows: Group I (the control), in which patients were administered IANB with 3.6 ml 2% lignocaine, and group II (test group), in which patients received the same IANB therapy followed by cryotherapy using an endo-frost spray and intrapulpal ice sticks. Pain scores were recorded during access opening and cleaning/shaping using the Heft-Parker visual analogue scale (VAS). The primary outcome was the success rate of anaesthesia (VAS ≤54 mm). The secondary outcome was mean pain score during the treatment phase. Group II exhibited a higher success rate (79.3%) than group I (65.3%) (P=0.24). The mean pain during access opening was significantly lower in group II (20.60±29.90) than in group I (41.43±43.10) (P=0.04). Although pain scores during cleaning/shaping were lower in group II (17.73±24.06 vs. 26.95±36.72), the difference was not statistically significant (P=0.27). On the whole, the present study demonstrates that cryotherapy improved anaesthetic success and reduced intraoperative pain during access opening in patients with SIP. However, its effect during subsequent treatment stages was limited, suggesting the need for supplemental anaesthesia in some cases.
本研究旨在评估冷冻疗法联合下牙槽神经阻滞（IANB）对下颌第一恒磨牙有症状的不可逆性牙髓炎（SIP）成年患者术中疼痛及麻醉成功率的影响。总共60例被诊断为下颌第一磨牙SIP的患者被随机分为两组（n = 30），如下：第一组（对照组），患者接受含3.6 ml 2%利多卡因的IANB治疗；第二组（试验组），患者接受相同的IANB治疗，随后使用牙髓冷冻喷雾剂和牙髓内冰棒进行冷冻疗法。在开髓和清理/成形过程中，使用赫夫特 - 帕克视觉模拟量表（VAS）记录疼痛评分。主要结局是麻醉成功率（VAS≤54 mm）。次要结局是治疗阶段的平均疼痛评分。第二组的成功率（79.3%）高于第一组（65.3%）（P = 0.24）。第二组开髓时的平均疼痛（20.60±29.90）明显低于第一组（41.43±43.10）（P = 0.04）。尽管第二组在清理/成形过程中的疼痛评分较低（17.73±24.06 vs. 26.95±36.72），但差异无统计学意义（P = 0.27）。总体而言，本研究表明，冷冻疗法提高了SIP患者的麻醉成功率，并减少了开髓时的术中疼痛。然而，其在后续治疗阶段的效果有限，提示在某些情况下需要补充麻醉。
