title: Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain.
abstract: OBJECTIVE
  To evaluate the effect of intracanal cryotherapy with negative pressure irrigation (EndoVac) on postendodontic pain after vital single-visit root canal treatment (RCT).
  
  
  METHODS
  A total of 75 single-rooted teeth with single root canal were treated endodontically. After root canal preparation with Protaper Universal rotary system and irrigation, teeth were divided randomly into three groups (n = 25) according to additional irrigation protocol as follows: Group I: No additional irrigation was applied (control); group II: A 20 mL of room temperature saline was irrigated during 5 minutes using EndoVac, and group III: A 20 mL of 2 to 4°C cold saline was irrigated during 5 minutes using EndoVac. Pain levels were assessed by visual analog scale (VAS) and verbal evaluation of pain questionnaire after 6, 12, 24, 48 hours, and 7 days of canal obturation. The data were then analyzed using Statistical Package for the Social Sciences (SPSS) 13.0 using Kruskal-Wallis and Mann-Whitney U tests at p-value of 0.05.
  
  
  RESULTS
  The results showed that pain levels were high in groups I and II after 6 hours that decreased with time to almost diminish after 1 week, and on the other hand, group III showed no pain among different monitoring periods. Also pain levels in groups II were lower compared with group I after only 6 hours, with significance p < 0.05.
  
  
  CONCLUSIONS
  Postendodontic pain presented with highest values after 6 hours of treatment and reduced to almost nil after 1 week. Intracanal cryotherapy eliminated postendodontic pain clinically. Negative pressure reduced postendodontic pain after 6 hours of treatment.
  
  
  CONCLUSIONS
  The outcome of this study indicates that the use of intracanal cryotherapy technique with negative pressure irrigation eliminates postendodontic pain after single-visit RCTs.
authors.affiliation: Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic.
authors.forename: Talal
authors.initials: T
authors.lastname: Al-Nahlawi
authors.affiliation: Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic Phone: +00963932805605, e-mail: drmtkt@yahoo.com.
authors.forename: Talaat Abo
authors.initials: TA
authors.lastname: Hatab
authors.affiliation: Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic.
authors.forename: Mahmoud Abd
authors.initials: MA
authors.lastname: Alrazak
authors.affiliation: Department of Operative Dentistry and Endodontics, Faculty of Dental Medicine, Syrian Private University, Damascus Syrian Arab Republic.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al-Abdullah
mesh_terms: D000328:Adult; D017679:Cryotherapy; D006801:Humans; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy / Q000009:adverse effects*; D016037:Single-Blind Method; D007507:Therapeutic Irrigation / Q000379:methods*; D014092:Tooth Root; D055815:Young Adult
keywords: Cryotherapy; EndoVac; Negative irrigation; Postendodontic pain Randomized clinical trial.