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1. 4th year undergraduate students, School of Dentistry, European University Cyprus
2. Lecturer, Endodontics, School of Dentistry, European University Cyprus
Introduction: Cryotherapy refers to decreasing tissue temperature for therapeutic purposes by eliminating thermal energy.
Exposing human tissue to cold reduces the electrical conductivity of nerves, controls bleeding, alleviates swelling, mitigates inflammation and decreases metabolism by more than 50%, allowing better oxygen flow to the injured tissues.
It’s been applied in medicine for pain relief and for destroying dysplastic tissue, referred to as cryosurgery. In endodontics cryotherapy has been used after periradicular surgeries, during root canal treatment to minimise postoperative pain and inflammation and more recently it was implemented to achieve haemostasis in vital pulp therapy.
Aim: The purpose of this study is to review the applications of cryotherapy in endodontics including its effects on post-endodontic pain.
Methods: Articles published in English in the last ten years, utilising the keywords “cryotherapy in endodontics” were selected by conducting an electronic search of PubMed. 41 articles were retrieved, 32 of which were deemed relevant.
Results: The most frequently discussed topic was the effect of intracanal cryotherapy on post-operative endodontic pain and among the reviewed papers 5 relevant systematic reviews and metanalyses were retrieved. Their full texts were reviewed and qualitative synthesis of the findings was conducted. Most authors reported a benefit of intracanal cryotherapy on postoperative endodontic pain.
Conclusions: Despite the consistent findings on the effect of intracanal irrigation with a cold irrigant there is no standardisation regarding the cryo-agent’s type or volume, application method and duration needed to determine an optimal protocol. Rigorously conducted trials with precise parameters could validate the integration of cryotherapy into endodontic clinical practice, given its cost-effectiveness and absence of adverse effects when compared to pharmaceutical interventions.
