Cold sodium hypochlorite may reduce early postoperative pain after endodontic treatment : Study

Written By : Dr. Shravani Dali Published On 2026-05-22T20:15:08+05:30 | Updated On 22 May 2026 8:15 PM IST

Recent randomized trials suggest that cold sodium hypochlorite (NaOCl) may reduce early postoperative pain after endodontic treatment compared with warm or room-temperature NaOCl in some cases, although other studies found no significant difference. While temperature modulation appears promising, evidence remains inconclusive. Further standardized randomized controlled trials and harmonized pooled analyses are needed to establish definitive benefits.

This systematic review thoroughly evaluates the impact of various temperatures of sodium hypochlorite (NaOCl) used during root canal therapy (RCT) on postoperative pain (POP).

After registering with PROSPERO, a search was carried out by using PubMed, Scopus, Web of Science, Cochrane library published in the years 2015 January 1 to 2025 November 16. Randomized clinical trials comparing NaOCl irrigant temperatures and reporting POP outcomes were included. Three randomised Control Trial (total N ≈ 183 patients) assessed NaOCl temperature (cold ≈ 2-2.5 °C, room ≈ 22-25 °C, warm ≈ 40-66 °C). Two trials reported lower postoperative pain with cold NaOCl compared with warmer solutions at early timepoints (notably 6 h or day-1). Another trial (various concentrations and temperatures) found no statistically significant difference across temperatures or concentrations at the timepoints measured. Heterogeneity in diagnosis (vital vs. non-vital teeth), irrigant concentration, scale used for pain measurement (0-10 vs. 0-100), and timepoints limited performing meta-analysis.

Evidence from recent RCTs suggests a short-term reduction in early postoperative pain with cold NaOCl vs. warm NaOCl or room temperature in some settings, while other trials show no difference. Temperature modulation is promising but not conclusively proven; further standardized RCTs (harmonized pain scales, same timepoints, same diagnoses) or pooled analyses with harmonized data are needed.

Reference:

Anna Geevarghis, Maria, et al. "Effect of Sodium Hypochlorite Irrigant Temperature On Postoperative Pain Following Endodontic Treatment: a Systematic Review." Frontiers in Dental Medicine, vol. 7, 2026, p. 1793274.

Keywords:

Cold, sodium, hypochlorit, reduce, early, postoperative pain, endodontic, treatment, Study, Anna Geevarghis, Maria

Coldsodiumhypochloritreduceearlypostoperative painendodontictreatmentStudyFrontiers in Dental Medicine

Source : Frontiers in Dental Medicine

Dr. Shravani Dali

Dr. Shravani Dali has completed her BDS from Pravara institute of medical sciences, loni. Following which she extensively worked in the healthcare sector for 2+ years. She has been actively involved in writing blogs in field of health and wellness. Currently she is pursuing her Masters of public health-health administration from Tata institute of social sciences. She can be contacted at editorial@medicaldialogues.in.