CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2019; 23(02): 221-228
DOI: 10.1055/s-0039-1677755
Systematic Review
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

The Effectiveness of the Cold Therapy (cryotherapy) in the Management of Inflammatory Parameters after Removal of Mandibular Third Molars: A Meta-Analysis

1   Section of Oral and Maxillofacial Surgery, Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
,
Anna Catharina Vieira Armond
1   Section of Oral and Maxillofacial Surgery, Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
,
Saulo Gabriel Moreira Falci
1   Section of Oral and Maxillofacial Surgery, Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, MG, Brazil
› Author Affiliations
Further Information

Publication History

11 April 2018

02 December 2018

Publication Date:
13 March 2019 (online)

Abstract

Introduction Cold therapy (cryotherapy) is a common procedure recommended by dental surgeons after surgical removal of third molars, which is an invasive intervention that often deals with an expressive inflammatory response.

Objective To investigate whether cryotherapy interferes with clinical outcomes such as pain, edema, and trismus in the postoperative period of mandibular third molar surgeries.

Data Synthesis An electronic search was conducted in the OVID, PubMed, VHL, Science Direct, Cochrane Library, and Web of Science databases, through March 2018. The eligibility criteria included clinical trials that evaluated the effect of cryotherapy in at least one of the following variables: pain, swelling, and trismus.

Two independent reviewers assessed the studies. The methodological quality of each article was analyzed. The search strategy resulted in 1,088 articles. Following the selection process, 11 studies were included in the systematic review and 4 of them in the meta-analysis. High risk of bias was found in most of the studies according to the Cochrane Handbook assessment. Patients receiving cryotherapy had less edema than patients in the control group at second day follow-up (mean difference [MD]: -0.94; 95%CI [-1.49; -0.39]). There were no statistically significant results when comparing trismus between experimental and control group (MD: 0.43; 95%CI [-0.34;1.20]). There were insufficient available data to support influences in postoperative pain.

Conclusions Cryotherapy applied on the first day after mandibular third molar removal can manage edema in the patients. Well-designed randomized clinical trials to test the efficacy of cryotherapy after surgical removal of third molars are needed to justify its indication.

 
  • References

  • 1 Falci SGM, de Castro CR, Santos RC. , et al. Association between the presence of a partially erupted mandibular third molar and the existence of caries in the distal of the second molars. Int J Oral Maxillofac Surg 2012; 41 (10) 1270-1274
  • 2 Nunn ME, Fish MD, Garcia RI. , et al. Retained asymptomatic third molars and risk for second molar pathology. J Dent Res 2013; 92 (12) 1095-1099
  • 3 Selmani ME, Gjorgova J, Selmani ME, Shkreta M, Duci SB. Effects of lower third molar angulation and position on lower arch crowding. Int J Orthod Milwaukee 2016; 27 (01) 45-49
  • 4 Zandi M, Amini P, Keshavarz A. Effectiveness of cold therapy in reducing pain, trismus, and oedema after impacted mandibular third molar surgery: a randomized, self-controlled, observer-blind, split-mouth clinical trial. Int J Oral Maxillofac Surg 2016; 45 (01) 118-123
  • 5 Braimah RO, Ndukwe KC, Owotade FJ, Aregbesola SB. Oral health related quality of life (OHRQoL) following third molar surgery in Sub-Saharan Africans: an observational study. Pan Afr Med J 2016; 25: 97
  • 6 Colorado-Bonnin M, Valmaseda-Castellón E, Berini-Aytés L, Gay-Escoda C. Quality of life following lower third molar removal. Int J Oral Maxillofac Surg 2006; 35 (04) 343-347
  • 7 Pandurić DG, Brozović J, Susić M, Katanec D, Bego K, Kobler P. Assessing health-related quality of life outcomes after the surgical removal of a mandibular third molar. Coll Antropol 2009; 33 (02) 437-447
  • 8 Steinagel MC. Cryotherapy in sport injury management. J Athl Train 1996; 31 (03) 277
  • 9 Greenstein G. Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review. J Periodontol 2007; 78 (05) 790-800
  • 10 Ernst E, Fialka V. Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy. J Pain Symptom Manage 1994; 9 (01) 56-59
  • 11 Lehmann JF, Warren CG, Scham SM. Therapeutic heat and cold. Clin Orthop Relat Res 1974; (99) 207-245
  • 12 Curl WW, Smith BP, Marr A, Rosencrance E, Holden M, Smith TL. The effect of contusion and cryotherapy on skeletal muscle microcirculation. J Sports Med Phys Fitness 1997; 37 (04) 279-286
  • 13 Forouzanfar T, Sabelis A, Ausems S, Baart JA, van der Waal I. Effect of ice compression on pain after mandibular third molar surgery: a single-blind, randomized controlled trial. Int J Oral Maxillofac Surg 2008; 37 (09) 824-830
  • 14 Rana M, Gellrich NC, Ghassemi A, Gerressen M, Riediger D, Modabber A. Three-dimensional evaluation of postoperative swelling after third molar surgery using 2 different cooling therapy methods: a randomized observer-blind prospective study. J Oral Maxillofac Surg 2011; 69 (08) 2092-2098
  • 15 Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg 2016; 20 (03) 239-247
  • 16 Laureano Filho JR, de Oliveira e Silva ED, Batista CI, Gouveia FM. The influence of cryotherapy on reduction of swelling, pain and trismus after third-molar extraction: a preliminary study. J Am Dent Assoc 2005; 136 (06) 774-778 , quiz 807
  • 17 van der Westhuijzen AJ, Becker PJ, Morkel J, Roelse JA. A randomized observer blind comparison of bilateral facial ice pack therapy with no ice therapy following third molar surgery. Int J Oral Maxillofac Surg 2005; 34 (03) 281-286
  • 18 Sortino F, Messina G, Pulvirenti G. [Evaluation of postoperative mucosa and skin temperature after surgery for impacted third molar]. Minerva Stomatol 2003; 52 (7-8): 393-399
  • 19 Moher D, Liberati A, Tetzlaff J, Altman DG. ; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. Open Med 2009; 3 (03) e123-e130
  • 20 Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21 (11) 1539-1558
  • 21 Patnaik S, Acharya SS, Kumar S. , et al. Effect of cold compression therapy on pain, swelling & trismus following surgical removal of impacted mandibular third molars: a clinical research. Int J Dent Med Res 2015; 1 (06) 18-21
  • 22 Bastian H, Søholm B, Marker P, Eckerdal A. Comparative study of pain control by cryotherapy of exposed bone following extraction of wisdom teeth. J Oral Sci 1998; 40 (03) 109-113
  • 23 Courage GR, Huebsch RF. Cold therapy revisited. J Am Dent Assoc 1971; 83 (05) 1070-1073
  • 24 Forsgren H, Heimdahl A, Johansson B, Krekmanov L. Effect of application of cold dressings on the postoperative course in oral surgery. Int J Oral Surg 1985; 14 (03) 223-228
  • 25 Gelesko S, Long L, Faulk J, Phillips C, Dicus C, White Jr RP. Cryotherapy and topical minocycline as adjunctive measures to control pain after third molar surgery: an exploratory study. J Oral Maxillofac Surg 2011; 69 (11) e324-e332
  • 26 Canavan WH. Drains and dressing in oral surgery and exodontia. Int J Orthod 1936; 22: 420-422
  • 27 Stangel L. The value of cryotherapy and thermotherapy in the relief of pain. Physiother Can 1975; 27: 135-139
  • 28 Osunde OD, Adebola RA, Omeje UK. Management of inflammatory complications in third molar surgery: a review of the literature. Afr Health Sci 2011; 11 (03) 530-537
  • 29 Modabber A, Rana M, Ghassemi A. , et al. Three-dimensional evaluation of postoperative swelling in treatment of zygomatic bone fractures using two different cooling therapy methods: a randomized, observer-blind, prospective study. Trials 2013; 14: 238
  • 30 Glass GE, Waterhouse N, Shakib K. Hilotherapy for the management of perioperative pain and swelling in facial surgery: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2016; 54 (08) 851-856
  • 31 Ho SS, Coel MN, Kagawa R, Richardson AB. The effects of ice on blood flow and bone metabolism in knees. Am J Sports Med 1994; 22 (04) 537-540
  • 32 Pérgola PE, Johnson JM, Kellogg Jr DL, Kosiba WA. Control of skin blood flow by whole body and local skin cooling in exercising humans. Am J Physiol 1996; 270 (1 Pt 2): H208-H215
  • 33 Belli E, Rendine G, Mazzone N. Cold therapy in maxillofacial surgery. J Craniofac Surg 2009; 20 (03) 878-880