Is Intracanal Cryotherapy Effective in Reducing Postoperative Endodontic Pain? An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Amal Almohaimede,Ebtissam Al-Madi

doi:10.3390/ijerph182211750

Amal Almohaimede, Ebtissam Al-Madi

Open Access

https://doi.org/10.3390/ijerph182211750

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Abstract

This research aimed to assess the potency of intracanal cold therapy in diminishing postoperative endodontic pain. PubMed, Scopus, the Cochrane Library, EMBASE, the Web of Science, grey literature, and endodontic journals were used to identify randomized controlled clinical trials evaluating postoperative pain after a final irrigation with a cold irrigant (as an experimental group) and a room temperature irrigant (as a control group). The risk of bias was rated according to the Cochrane Collaboration’s tool and the Grading Recommendation Assessment, Development, and Evaluation (GRADE) system was used to estimate the evidence quality. For the meta-analysis, a random effects model was utilized. The qualitative analysis contained 16 studies and the quantitative analysis contained 9 studies. The experimental groups showed a reduction in postoperative pain at 6 h (mean difference (MD) = −1.11; p = 0.0004; I2 = 72%; low quality evidence), 24 h (MD = −1.08; p = 0.003; I2 = 92%; low quality evidence), 48 h (MD = −0.38; p = 0.04; I2 = 81%; low quality evidence), and 72 h (MD = −0.69; p = 0.04; I2 = 90%; low quality evidence). A higher quality of evidence from more clinical trials is needed.

Highlights

One of the essential parts of endodontic therapy is to prevent and manage postendodontic pain [1]
There was a reduction in the postoppostoperative pain scores in the intracanal cryotherapy group erative pain scores in the intracanal cryotherapy group compared compared with temperature the room temperature group group) this reduction could with the room group
Our results were in contrast with those reported by Gupta et al in their systematic review and meta-analysis where they showed that intracanal cryotherapy did not play a significant role in minimizing postendodontic pain [62]

Summary

Introduction

One of the essential parts of endodontic therapy is to prevent and manage postendodontic pain [1]. Several techniques and treatments have been described in the literature to control postoperative pain in endodontics including the prescription of medication [10,11,12], the use of intracanal therapies [13,14,15], and occlusal reduction [16]. The use of intracanal therapies (such as calcium hydroxide, laser application, and analgesic solutions) and occlusal reduction have contradictory effects on reducing postoperative endodontic pain in the literature [19,20]. Cryotherapy involves reducing the tissue temperature for curative purposes [21] It was first used by the ancient Egyptians circa 3000 BCE to cure injuries and decrease inflammation [22].

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