Adjunctive Irrigation Strategies for Postoperative Pain After Full Pulpotomy

The goal of this clinical trial is to evaluate the effects of cryotherapy and dexamethasone on the intensity of postoperative pain in full pulpotomy procedures in permanent molars with symptomatic irreversible pulpitis. The main questions it aims to answer are: * Does controlled irrigation with cold saline during full pulpotomy reduce the severity of postoperative pain? * Does controlled irrigation with dexamethasone during full pulpotomy reduce the severity of postoperative pain? In the cryotherapy group, unlike the control and dexamethasone groups, the pulp chamber was irrigated with 2°C saline solution during the final irrigation step. In the dexamethasone group, unlike the control and cryotherapy groups, the pulp chamber was irrigated with 2 mL dexamethasone solution during the final irrigation step.

Inclusion Criteria: * Vital permanent molars exhibiting positive responses to both the cold test and the electric pulp test, with a prolonged cold response (\>30 seconds) consistent with symptomatic irreversible pulpitis. * Presence of deep carious lesions in the included teeth (indicated for vital pulp therapy). * No radiographic evidence of periapical pathology (i.e., no periapical radiolucency, root resorption, or pathological widening of the periodontal ligament space). * Patients who had not taken analgesics or antibiotics during the 24 hours preceding the procedure. Exclusion Criteria: * Devital permanent molars that responded negatively to cold tests and electric pulp tests * Permanent molars with poor periodontal status (pocket depth \> 4 mm), * Teeth that exhibited periapical radiolucency, pathological mobility, or were deemed non-restorable * Systemic diseases, pregnancy or lactation, known allergies to dexamethasone or NSAIDs, recent use of analgesics (within 24 hours), and any contraindications for pulpotomy or local anesthesia