Dental sensitivity after applying cold saline water during endodontic treatment

INTERVENTION: After applying the inclusion criteria, teeth will be selected and treated, which will be distributed into eight groups. 1. HIV‐negative patients treated without foraminal enlargement 2. HIV‐negative patients treated with foraminal enlargement 3. HIV‐negative patients treated without foraminal enlargement and with cryotherapy 4. HIV‐negative patients treated with foraminal enlargement and cryotherapy 5. HIV‐positive patients treated without foraminal enlargement 6. HIV‐positive patients treated with foraminal enlargement 7. HIV‐positive patients treated without foraminal enlargement and with cryotherapy 8. HIV‐positive patients treated with foraminal enlargement and cryotherapy The treatments will be performed in a single session following four different protocols which will be chosen randomly for each case. Patients will be anaesthetized using 1.8 ml of 2% mepivacaine with 1:100,000 epinephrine. The teeth will be isolated and the opening of the pulp chamber will be done using a spherical diamond bur in high speed. After finding the pulp chamber, a truncated conical drill will be used to eliminate the remains of the ceiling and refine the walls of the pulp chamber. With the aid of a type K #10 instrument, the channels will be explored and located. Establishing the working length (CT) will be done using an electronic ape Xlocator, Root Z XII (J Morita), and a K‐type instrument of the most appropriate diameter for the canal anatomy. The CT will be set 1 mm short of the 0.0 mark on the locator display. Root canal preparation will be performed using a Reciproc R50 (50.05) instrument mounted on a Smar CONDITION: Single and bi‐radicular teeth diagnosed with pulpal necrosis ; Oral Health PRIMARY OUTCOME: Pain intensity will be evaluated using a visual analogue scale (VAS), considered valid and reliable, from 0 to 10, where 0, 1–2, 3–7 and 8–10 means complete absence of pain, mild pain, moderate pain. and severe pain, respectively. Prior to the induction of local anesthesia, patients will be asked to record preoperative pain on the VAS to confirm the complete absence of pain. Postoperative pain was verified at 6, 12, 24, 48 and 72 hours and 7 days after endodontic treatment. SECONDARY OUTCOME: There are no secondary outcome measures INCLUSION CRITERIA: Only single or biradicular teeth with a negative response to vitality tests will be considered, but with a diagnosis of pulp necrosis, with or without the presence of images suggestive of periapical lesions.