الفهرس 
Title : Effect of intracanal cryotherapy on postoperative pain in molar teeth with symptomatic irreversible and apical periodontitis pulpitis (randomized clinical trial ).
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Abstract
Aim : was to evaluate the effect of cryotherapy using cold saline irrigation as a final irrigant on postoperative pain in molar teeth with symptomatic irreversible pulpitis and apical periodontitis.Methodology : Thirty patients, aged 20-40 years with no gender predilection, diagnosed with symptomatic irreversible pulpitis and apical periodontitis in their mandibular first molars, were included. Each patient had a vital mandibular first molar with moderate to severe pain with pain on percussion , and had a prolonged response to cold testing with ethyl chloride spray. After completion of biomechanical preparation using Mpro Rotary system in a single visit and irrigation with 2.5% sodium hypochlorite for cleaning and shaping .Patients were randomly assigned into one of two groups: In group A : final irrigation was done using 15 ml cold saline (2.5{u00B0}C) for 6 mins at three successive times .The solution was stored in refrigerator until use and then its tempreture is checked using digital thermometer . In group B : final irrigation was done using 15 ml room tempreture saline for 6 mins. vii In both groups irrigation procedures were done using 27-gauge side-vented needle fit to a 5ml disposable plastic syringe placed 2-3 mm away from apex in the canal space without binding.Obturation was then done using cold lateral condensation. Pain was assessed postoperatively after 6, 12, 24, 48 and 72 hours. Numerical Rating Scale (NRS) was used as the primary outcome measure. Patients were given an analgesic (Ibuprofen 200 mg) in case of severe pain. All demographic data and NRS scores were collected from the patients and statistically analyzed . Results: showed that there was a statistically significant decrease in postoperative pain in the cryotherapy group compared to the control group at each time interval, also cryotherapy reduced postoperative analgesic intake at all tested intervals (p < 0.05)