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Novel cryotherapy technique for pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis- a randomized controlled trial

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Abstract

Objectives

To assess the effect of cryotherapy on haemostasis, post-operative pain, and the outcome of full pulpotomy performed in mature permanent teeth with symptomatic irreversible pulpitis.

Materials and methods

The study included sixty mature permanent mandibular molar teeth with symptomatic irreversible pulpitis and no periapical rarefaction. After coronal pulp tissue amputation, teeth were randomly allocated to one of two groups (n = 30 each). In group I (conventional pulpotomy), a sterile cotton pellet moistened with 2.5% NaOCl was used for haemostasis. In group II (cryotherapy), the pulp chamber was continuously lavaged with 2.50C normal saline solution for haemostasis using an indigenous portable cryotherapy irrigation unit. Following haemostasis, the pulp was capped with mineral trioxide aggregate and the tooth was restored with resin composite. The time taken to achieve haemostasis was recorded. Preoperative and 24, 48 and 72 h postoperative pain was measured using the Numerical Rating Scale. The pulpotomy outcome was assessed at the 12-month follow-up. Data were analyzed using Fischer’s exact test, two-sample t-test, two-sample Wilcoxon rank-sum test, Friedman Test, and Wilcoxon Signed Rank Test.

Results

The cryotherapy group achieved haemostasis in less time (p < 0.05). There was a significant pain reduction at 24 and 48 h in the cryotherapy group when compared with the conventional pulpotomy group (P < 0.005). The overall success rate of pulpotomy after 12 months was 88% (n = 22) in both study groups(p < 0.05).

Conclusions

Cryotherapy application reduces postoperative pain and has no adverse effect on the outcome of pulpotomy in permanent teeth with symptomatic irreversible pulpitis.

Clinical relevance

The cryotherapy can be incorporated in pulpotomy protocol as an adjunct to minimize post-operative pain.

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Data availability

The data that support the findings of this study are available from the corresponding author [V.K.] upon reasonable request.

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Acknowledgements

The authors are thankful to Indian Council of Medical Research for providing the funding for the study.

Funding

This study was provided financial assistance by the Indian Council of Medical Research (3/2/Dec 2020/PG-thesis-HRD (47D)).

Author information

Authors and Affiliations

  1. Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India

    VS Akhil, Vijay Kumar, Archana Aravind, Radha Sharma, Sidhartha Sharma, Amrita Chawla & Ajay Logani

  2. Clinical Research Unit, All India Institute of Medical Sciences, New Delhi, India

    Ashish Datt Upadhyay

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  1. VS Akhil
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  2. Vijay Kumar
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  3. Archana Aravind
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  7. Ashish Datt Upadhyay
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  8. Ajay Logani
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Contributions

A.V.S.: Conceptualization, Methodology, Investigation, Writing – original draft, Visualization A.A.: Methodology, Data Curation, Writing – original draft. R. S.: Methodology. S.S.: Validation, Writing – review & editing. V.K.:Conceptualization, Methodology, Investigation, Validation, Supervision, Writing – review & editing. A. C.: Validation, Writing – review & editing. A.D.U.: Statistical Analysis, review & editing. A.L.: Validation, Supervision, Writing – review & editing.

Corresponding author

Correspondence to Vijay Kumar.

Ethics declarations

Ethics approval and consent to participate

This study was ethically approved by the Institutional Ethics Committee (letter no IECPG-57/27.01.2021, RT-48/24.02.2021). The study was conducted under the Helsinki Declaration and good clinical practice guidelines. Written informed consent was obtained from all the study participants.

Consent for publication

Written consent was obtained from all the study participants for publication of data without disclosing their identifiable details.

Competing interests

The authors declare that they have no conflict of interest.

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Akhil, V., Kumar, V., Aravind, A. et al. Novel cryotherapy technique for pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis- a randomized controlled trial. Clin Oral Invest 28, 275 (2024). https://doi.org/10.1007/s00784-024-05661-y

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