Intraoral Cryotherapy on Anesthetic Efficacy in Mandibular Incisors

Inclusion Criteria: * Adults aged 18 to 60 years * Classified as ASA Physical Status I or II * Presence of symptomatic irreversible pulpitis in a single-rooted mandibular incisor tooth * Preoperative pain score ≥8 on the Numerical Rating Scale (NRS) and Wong-Baker FACES scale * Positive response to cold test and electric pulp testing * Absence of periapical pathology on preoperative periapical radiograph * No analgesic intake within 6 hours prior to treatment * Ability to understand and complete pain assessment scales * Willingness to provide written informed consent Exclusion Criteria: * Age below 18 years or above 60 years * Pregnancy * Known allergy to local anesthetic agents * Diagnosis of diabetes mellitus * Presence of hypothyroidism * Diagnosis of adrenal insufficiency * Presence of Raynaud disease * Uncontrolled diabetes (HbA1c \>7%) * Presence of periapical pathology detected radiographically * Presence of sinus tract * Presence of intraoral or extraoral swelling * Teeth diagnosed with necrotic pulp * Presence of referred pain from another tooth or anatomical structure