Cryotherapy and Post-Treatment Endodontic Pain
Abstract
Introduction: The management and approach of dealing with pain after endodontic treatment is one of the most important fields of endodontics, which has received special attention in recent years. The effect of cryotherapy can be achieved by reducing blood flow and metabolic activity by suppressing neurotransmitters and increasing oxygenation in the damaged tissue. We aimed to conduct a systematic review of randomized clinical trials between 2023 and 2024 regarding the effect of cryotherapy in reducing pain after endodontic treatment.Materials and Methods: This research is prepared and presented based on PRISMA reporting items. The databases used for this research are PubMed, Scopus and Google Scholar. Gray texts were also done by searching the sources of found articles. The time limitation for the search strategy was set for 2023 and 2024. Inclusion criteria were based on the PICOTS definition. To assess the risk of bias, the ROB2 tool was used.Results: Based on the search results in databases, 138 articles were found in 2023 and 2024. Finally, 19 studies were included in this review. Finally, five articles had a mild risk of bias, and six studies had a moderate risk of bias. Other studies were also unbiased based on the evaluation. Finally, we included them all in the review study. For each of the studies included in this review, the name of the first author, age of the participants, sample size, population under study, groups under study, outcome, findings and final interpretation were extracted. The tool used to measure pain in 3 articles was the NRS scale; one used VRS, and other studies used VAS. The range of age groups used in all studies was from a minimum 4 of four to a maximum of 60 years. The sample size was in the range of 20 to 152. Conclusion: It was concluded that cryotherapy can be used as a pain relief method after dental surgery. However, this evidence was accompanied by limitations for the included studies. Keywords: Cryotherapy; Post treatment; Endodontic; Pain; Systematic review.
1. Hespanhol FG, Guimarães LS, Antunes LAA, Antunes LS. Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis. rde. 2022;47(3):e30-0.
2. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41(2):91-9.
3. Sabino-Silva R, Cardoso IV, Vitali FC, Alves AMH, Souza BDM, Bortoluzzi EA, et al. Prevalence of postoperative pain after endodontic treatment using low and high concentrations of sodium hypochlorite: a systematic review and meta-analysis. Clinical Oral Investigations. 2023;27(8):4157-71.
4. Almohaimede A, Al-Madi E. Is Intracanal Cryotherapy Effective in Reducing Postoperative Endodontic Pain? An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials. International Journal of Environmental Research and Public Health. 2021;18(22):11750.
5. Al-Nahlawi T, Hatab TA, Alrazak MA, Al-Abdullah A. Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain. J Contemp Dent Pract. 2016;17(12):990-6.
6. Gundogdu EC, Arslan H. Effects of Various Cryotherapy Applications on Postoperative Pain in Molar Teeth with Symptomatic Apical Periodontitis: A Preliminary Randomized Prospective Clinical Trial. J Endod. 2018;44(3):349-54.
7. Alharthi AA, Aljoudi MH, Almaliki MN, Almalki MA, Sunbul MA. Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. Saudi Dent J. 2019;31(3):330-5.
8. Al Bast A, Abiad RS. CRYOTHERAPY IN THE FIELD OF ENDODONTICS: A LITERATURE REVIEW. BAU Journal-Science and Technology. 2024;5(2):7.
9. Fayyad DM, Abdelsalam N, Hashem N. Cryotherapy: A New Paradigm of Treatment in Endodontics. J Endod. 2020;46(7):936-42.
10. Miranda JP, Silva WT, Silva HJ, Mascarenhas RO, Oliveira VC. Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials. Phys Ther Sport. 2021;49:243-9.
11. Chaudhary D, Sun Y, Gao X. Comparison of Cryotherapy and Topical Salicylic Acid in Common Warts: A Systematic Review and Meta-Analysis. Dermatologic Therapy. 2023;2023(1):4283918.
12. Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458.
13. Abdelbaky MM. Effectiveness of Two Intracanal Irrigation Solutions Delivered Through Cryotherapy on Post-Endodontic Pain Relieve. A Randomized Clinical Trial. Egyptian Dental Journal. 2024;70(3):2965-74.
14. Ajeesh K, Jayasree S, James EP, Pooja K, Jauhara F. Comparative evaluation of the effectiveness of intracanal and intraoral cryotherapy on postendodontic pain in patients with symptomatic apical periodontitis: A randomized clinical trial. Journal of Conservative Dentistry and Endodontics. 2023;26(5):555-9.
15. Akhil V, Kumar V, Aravind A, Sharma R, Sharma S, Chawla A, et al. Novel cryotherapy technique for pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis-a randomized controlled trial. Clinical Oral Investigations. 2024;28(5):1-14.
16. Bashir AF, Jatala UW, ud din Ahmad M, Khan MT, Khan SR, Butt AA. Determining Efficacy of Intracanal Cryotherapy on Post Endodontic Pain in Irreversible Pulpitis: Cryotherapy on Post Endodontic Pain. Pakistan Journal of Health Sciences. 2024:68-72.
17. Elheeny AAH, Sermani DI, Saliab EA, Turky M. Cryotherapy and pain intensity during endodontic treatment of mandibular first permanent molars with symptomatic irreversible pulpitis: A randomized controlled trial. Clinical Oral Investigations. 2023;27(8):4585-93.
18. Elsherbeny MMH, Naguib EAHNE. Effect of Using Intracanal Cryotherapy Versus Ultrasonic Activated Irrigation on Post-Operative Pain in Single Visit Endodontic Treatment of Teeth with Symptomatic Irreversible Pulpitis “Randomized Clinical Trial”. Future. 2024;10(1):1-7.
19. Ezzat TM, Ezzat K, Morsy DA. Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain in Lower Molar Teeth with Irreversible Pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial. Advanced Dental Journal. 2023;5(3):581-7.
20. Hamza EM, Abd El Aziz TM, Obeid MF. The influence of intraoral cryotherapy on postoperative pain and substance P in symptomatic apical periodontitis: randomized clinical study. Scientific Reports. 2024;14(1):13890.
21. Hoseini MS, Ranjbarian P, Mortaheb A, Yousefi E. Evaluating the effect of different cryotherapy methods on postoperative pain in one-visit root canal treatment of mandibular molars with symptomatic irreversible pulpitis. Contemporary Orofacial Sciences. 2023;1(2).
22. Ibrahim EM, Abdel Aziz TM, Obeid MF. The effect of cryotherapy on substance P expression. Ain Shams Dental Journal. 2024;33(1):164-70.
23. Iparraguirre Nuñovero MF, Hungaro Duarte MA, Kaled Segato AV, da Silva Neto UX, Portela Ditzel Westphalen V, Carneiro E. The effect of intracanal cryotherapy with and without foraminal enlargement on pain prevention after endodontic treatment: a randomized clinical trial. Scientific Reports. 2024;14(1):19905.
24. Jasani P, Attur K, Patel N, Jani K, Chhaya P. Effect of Intracanal Cryotherapy Application on Post-Operative Pain After Single Visit Endodontic Treatment in Molars with Symptomatic Irreversible Pulpitis. Journal of Coastal Life Medicine. 2023;11:183-6.
25. Keskin C, Aksoy A, Kalyoncuoğlu E, Keleş A, İlik AA, Kömeç O, et al. Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial. International Endodontic Journal. 2023;56(8):932-42.
26. Kumari N, Kaur H, Choudhary R, Yeluri R. Comparative evaluation of intracanal cryotherapy and curcumin as a final irrigant in reducing post endodontic pain in primary teeth. J Indian Soc Pedod Prev Dent. 2022;40(3):297-301.
27. Lalfakawmi S, Gupta A, Duraisamy AK, Abraham D, Mane AP. Impact of Cryotreated and Warm Sodium Hypochlorite on Post-Operative Pain in Teeth with Symptomatic Irreversible Pulpitis: A Randomized Controlled Trial. Journal of Endodontics. 2024.
28. Patel H, Kapoor S, Arora A, Shah P, Rana H. The role of cryotherapy in the reduction of postoperative pain in patients with irreversible pulpitis and/or apical periodontitis: A randomized controlled clinical study. Turkish Endodontic Journal (TEJ). 2024;9(1):39-46.
29. Pupneja V, Jindal N, Aggarwal R, Sachdeva ADK. Cryotherapy as a non pharmacological alternative for the management of postoperative endodontic pain after one visit root canal treatment using three irrigating regimens at different temperatures. SRM Journal of Research in Dental Sciences. 2024;15(2):51-6.
30. Shah VR, Shah NC, Kishan KV, Kothari MA, Patel JJ, Patel SN. Evaluation of postoperative pain with cryotherapy in teeth with symptomatic irreversible pulpitis with symptomatic apical periodontitis after single-visit endodontics: A randomized clinical study. Endodontology. 2023;35(2):118-23.
31. Solomon R-V, Paneeru S-P, Swetha C, Yatham R. Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment. Journal of Clinical and Experimental Dentistry. 2024;16(3):e250.
2. Sathorn C, Parashos P, Messer H. The prevalence of postoperative pain and flare-up in single- and multiple-visit endodontic treatment: a systematic review. Int Endod J. 2008;41(2):91-9.
3. Sabino-Silva R, Cardoso IV, Vitali FC, Alves AMH, Souza BDM, Bortoluzzi EA, et al. Prevalence of postoperative pain after endodontic treatment using low and high concentrations of sodium hypochlorite: a systematic review and meta-analysis. Clinical Oral Investigations. 2023;27(8):4157-71.
4. Almohaimede A, Al-Madi E. Is Intracanal Cryotherapy Effective in Reducing Postoperative Endodontic Pain? An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials. International Journal of Environmental Research and Public Health. 2021;18(22):11750.
5. Al-Nahlawi T, Hatab TA, Alrazak MA, Al-Abdullah A. Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain. J Contemp Dent Pract. 2016;17(12):990-6.
6. Gundogdu EC, Arslan H. Effects of Various Cryotherapy Applications on Postoperative Pain in Molar Teeth with Symptomatic Apical Periodontitis: A Preliminary Randomized Prospective Clinical Trial. J Endod. 2018;44(3):349-54.
7. Alharthi AA, Aljoudi MH, Almaliki MN, Almalki MA, Sunbul MA. Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. Saudi Dent J. 2019;31(3):330-5.
8. Al Bast A, Abiad RS. CRYOTHERAPY IN THE FIELD OF ENDODONTICS: A LITERATURE REVIEW. BAU Journal-Science and Technology. 2024;5(2):7.
9. Fayyad DM, Abdelsalam N, Hashem N. Cryotherapy: A New Paradigm of Treatment in Endodontics. J Endod. 2020;46(7):936-42.
10. Miranda JP, Silva WT, Silva HJ, Mascarenhas RO, Oliveira VC. Effectiveness of cryotherapy on pain intensity, swelling, range of motion, function and recurrence in acute ankle sprain: A systematic review of randomized controlled trials. Phys Ther Sport. 2021;49:243-9.
11. Chaudhary D, Sun Y, Gao X. Comparison of Cryotherapy and Topical Salicylic Acid in Common Warts: A Systematic Review and Meta-Analysis. Dermatologic Therapy. 2023;2023(1):4283918.
12. Downes MJ, Brennan ML, Williams HC, Dean RS. Development of a critical appraisal tool to assess the quality of cross-sectional studies (AXIS). BMJ Open. 2016;6(12):e011458.
13. Abdelbaky MM. Effectiveness of Two Intracanal Irrigation Solutions Delivered Through Cryotherapy on Post-Endodontic Pain Relieve. A Randomized Clinical Trial. Egyptian Dental Journal. 2024;70(3):2965-74.
14. Ajeesh K, Jayasree S, James EP, Pooja K, Jauhara F. Comparative evaluation of the effectiveness of intracanal and intraoral cryotherapy on postendodontic pain in patients with symptomatic apical periodontitis: A randomized clinical trial. Journal of Conservative Dentistry and Endodontics. 2023;26(5):555-9.
15. Akhil V, Kumar V, Aravind A, Sharma R, Sharma S, Chawla A, et al. Novel cryotherapy technique for pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis-a randomized controlled trial. Clinical Oral Investigations. 2024;28(5):1-14.
16. Bashir AF, Jatala UW, ud din Ahmad M, Khan MT, Khan SR, Butt AA. Determining Efficacy of Intracanal Cryotherapy on Post Endodontic Pain in Irreversible Pulpitis: Cryotherapy on Post Endodontic Pain. Pakistan Journal of Health Sciences. 2024:68-72.
17. Elheeny AAH, Sermani DI, Saliab EA, Turky M. Cryotherapy and pain intensity during endodontic treatment of mandibular first permanent molars with symptomatic irreversible pulpitis: A randomized controlled trial. Clinical Oral Investigations. 2023;27(8):4585-93.
18. Elsherbeny MMH, Naguib EAHNE. Effect of Using Intracanal Cryotherapy Versus Ultrasonic Activated Irrigation on Post-Operative Pain in Single Visit Endodontic Treatment of Teeth with Symptomatic Irreversible Pulpitis “Randomized Clinical Trial”. Future. 2024;10(1):1-7.
19. Ezzat TM, Ezzat K, Morsy DA. Comparative Evaluation of the Efficacy of Intraoral Cryotherapy Versus Intracanal Cryotherapy on Postoperative Pain in Lower Molar Teeth with Irreversible Pulpitis and Symptomatic Apical Periodontitis: A Randomized Clinical Trial. Advanced Dental Journal. 2023;5(3):581-7.
20. Hamza EM, Abd El Aziz TM, Obeid MF. The influence of intraoral cryotherapy on postoperative pain and substance P in symptomatic apical periodontitis: randomized clinical study. Scientific Reports. 2024;14(1):13890.
21. Hoseini MS, Ranjbarian P, Mortaheb A, Yousefi E. Evaluating the effect of different cryotherapy methods on postoperative pain in one-visit root canal treatment of mandibular molars with symptomatic irreversible pulpitis. Contemporary Orofacial Sciences. 2023;1(2).
22. Ibrahim EM, Abdel Aziz TM, Obeid MF. The effect of cryotherapy on substance P expression. Ain Shams Dental Journal. 2024;33(1):164-70.
23. Iparraguirre Nuñovero MF, Hungaro Duarte MA, Kaled Segato AV, da Silva Neto UX, Portela Ditzel Westphalen V, Carneiro E. The effect of intracanal cryotherapy with and without foraminal enlargement on pain prevention after endodontic treatment: a randomized clinical trial. Scientific Reports. 2024;14(1):19905.
24. Jasani P, Attur K, Patel N, Jani K, Chhaya P. Effect of Intracanal Cryotherapy Application on Post-Operative Pain After Single Visit Endodontic Treatment in Molars with Symptomatic Irreversible Pulpitis. Journal of Coastal Life Medicine. 2023;11:183-6.
25. Keskin C, Aksoy A, Kalyoncuoğlu E, Keleş A, İlik AA, Kömeç O, et al. Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post‐operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial. International Endodontic Journal. 2023;56(8):932-42.
26. Kumari N, Kaur H, Choudhary R, Yeluri R. Comparative evaluation of intracanal cryotherapy and curcumin as a final irrigant in reducing post endodontic pain in primary teeth. J Indian Soc Pedod Prev Dent. 2022;40(3):297-301.
27. Lalfakawmi S, Gupta A, Duraisamy AK, Abraham D, Mane AP. Impact of Cryotreated and Warm Sodium Hypochlorite on Post-Operative Pain in Teeth with Symptomatic Irreversible Pulpitis: A Randomized Controlled Trial. Journal of Endodontics. 2024.
28. Patel H, Kapoor S, Arora A, Shah P, Rana H. The role of cryotherapy in the reduction of postoperative pain in patients with irreversible pulpitis and/or apical periodontitis: A randomized controlled clinical study. Turkish Endodontic Journal (TEJ). 2024;9(1):39-46.
29. Pupneja V, Jindal N, Aggarwal R, Sachdeva ADK. Cryotherapy as a non pharmacological alternative for the management of postoperative endodontic pain after one visit root canal treatment using three irrigating regimens at different temperatures. SRM Journal of Research in Dental Sciences. 2024;15(2):51-6.
30. Shah VR, Shah NC, Kishan KV, Kothari MA, Patel JJ, Patel SN. Evaluation of postoperative pain with cryotherapy in teeth with symptomatic irreversible pulpitis with symptomatic apical periodontitis after single-visit endodontics: A randomized clinical study. Endodontology. 2023;35(2):118-23.
31. Solomon R-V, Paneeru S-P, Swetha C, Yatham R. Comparative evaluation of effect of intracanal cryotherapy and corticosteroid solution on post endodontic pain in single visit root canal treatment. Journal of Clinical and Experimental Dentistry. 2024;16(3):e250.
| Files | ||
| Issue | Vol 11, No 4 (Autumn 2024) | |
| Section | Original Article(s) | |
| Keywords | ||
| Cryotherapy; Post treatment; Endodontic; Pain; Systematic review. | ||
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How to Cite
1.
Khayamzadeh M, Taghizadeh A. Cryotherapy and Post-Treatment Endodontic Pain. J Craniomaxillofac Res. 2025;11(4):240-248.
