Restor Dent Endod.  2022 Aug;47(3):e30. 10.5395/rde.2022.47.e30.

Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis

• Hespanhol FG
• Guimarães LS
• Antunes LAA
• Antunes LS

• KMID: 2548134
• DOI: http://doi.org/10.5395/rde.2022.47.e30

Abstract

Objectives
This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment.
Materials and Methods
A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.
Results
Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours.
Conclusions
Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.

Keyword

Cryotherapy; Postoperative pain; Root canal preparation; Systematic review

Figure

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  Figure 1 Modified PRISMA 2009 flow diagram.

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  Figure 2 Quality assessment of the selected studies (The Cochrane Collaboration tool for assessing risk of bias).

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  Figure 3 Forest plots of postoperative pain between intracanal cryotherapy group and control group (saline solution at room temperature). (A) Symptomatic apical periodontitis at 24 hours. (B) Symptomatic apical periodontitis at 72 hours. (C) Normal periapical tissue at 24 hours. (D) Normal periapical tissue at 48 hours.SD, standard deviation; CI, confidence interval.

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