Cryotherapy as an Adjunct to Inferior Alveolar Nerve Block in Symptomatic Irreversible Pulpitis: A Randomized Controlled Clinical Trial

Objective: This study aimed to evaluate whether cryotherapy could improve the success of inferior alveolar nerve block (IANB) and reduce pain during root canal access in mandibular molars with symptomatic irreversible pulpitis.Materials and methods: Thirty-three patients diagnosed with irreversible pulpitis were randomly divided into three groups: • Group I (control): Standard IANB with 2% lignocaine and adrenaline (1:2,00,000).• Group II (IANB + endo-frost): Standard IANB with 2% lignocaine and adrenaline (1:2,00,000).Plus cold application using Endo-frost spray.• Group III (IANB + ice pack): Standard IANB with 2% lignocaine and adrenaline (1:2,00,000).Plus a small sterile ice pack placed in the buccal vestibule.Pain levels were recorded before treatment and again during access opening using a 0-10 visual analog scale (VAS).Results: At baseline, all groups were similar.Both cryotherapy groups showed significantly better pain reduction compared to the control group (p < 0.05).There was no significant difference between the endo-frost and ice pack groups (p = 0.858).Conclusion: Cryotherapy used alongside IANB provided greater pain relief than IANB alone.However, in some cases, additional anesthetic techniques may still be required to achieve complete pulpal anesthesia.