OBJECTIVES: Postoperative pain and dental anxiety are significant barriers to effective pediatric endodontic treatment. Improving patient comfort and cooperation remains a critical clinical objective in school-age children undergoing primary molar root canal therapy (RCTP). Conventional pharmacologic strategies have limitations in acceptability, safety, and efficacy, prompting the exploration of non-invasive alternatives. The aim of this study is to evaluate the effect of modified cryotherapy using 0°C saline as the final irrigation protocol on postoperative pain levels and anxiety control in school-age children undergoing RCTP. MATERIAL AND METHODS: This single-center, randomized, controlled clinical trial enrolled 104 school-age patients diagnosed with pulp or periapical disease in deciduous molars. Patients were randomly allocated to either a modified cryotherapy group or a control group. Pain levels were assessed using the Wong-Baker FACES Pain Rating Scale (WB Scale) at baseline, 6, 24, 48 h, and 7 days postoperatively. Anxiety and cooperation were evaluated at baseline and 7-day follow-up using the Venham Scale. Statistical analyses included Chi-square and Mann-Whitney U tests, with significance at p < 0.05. RESULTS: Baseline characteristics were comparable between groups. The cryotherapy group showed significantly lower pain scores at 6 h,24 h, and 48 h (p < 0.001) post-treatment compared to controls. At 7 days, pain levels converged with no significant difference. The cryotherapy group also demonstrated significantly improved anxiety scores (p = 0.005) and clinical cooperation (p = 0.012) at follow-up compared to the control group. CONCLUSION: Modified cryotherapy applied during final root canal irrigation significantly reduces short-term postoperative pain and enhances clinical cooperation in school-age children.
Zhang et al. (Wed,) studied this question.