Effect of intracanal cryotherapy application on postoperative endodontic pain: a systematic review and metaanalysis.

Autor: Monteiro LPB; Department of Endodontics, School of Dentistry, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, Pará, 66075-110, Brazil., Guerreiro MYR; Department of Endodontics, School of Dentistry, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, Pará, 66075-110, Brazil., de Castro Valino R; Department of Endodontics, School of Dentistry, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, Pará, 66075-110, Brazil. robertafdecastro@gmail.com., Magno MB; Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil., Maia LC; Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil., da Silva Brandão JM; Department of Endodontics, School of Dentistry, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, Pará, 66075-110, Brazil.
Jazyk: angličtina
Zdroj: Clinical oral investigations [Clin Oral Investig] 2021 Jan; Vol. 25 (1), pp. 23-35. Date of Electronic Publication: 2020 Nov 21.
DOI: 10.1007/s00784-020-03693-8
Abstrakt: Objectives: To assess the influence of intracanal cryotherapy application on postoperative pain after endodontic treatment.
Materials and Methods: A systematic review (SR) was conducted in seven databases. Articles that were published up to 04 February 2020 were included and randomized clinical trials that used a cold saline solution for final irrigation to manage postoperative endodontic pain were compared with those that used a saline solution at room temperature. Metaanalysis was performed to assess postoperative pain after 6, 24, 48, and 72 h using a random effects model, a confidence interval of 95%, and heterogeneity tested by the I 2 index. The certainty of evidence was rated using GRADE.
Results: Qualitative and quantitative analysis included eight and six studies, respectively. Individuals treated with cryotherapy presented lower means of postendodontic pain than the controls, 6 and 24 h after endodontic treatment (MD - 1.30 [- 2.32, - 0.28] p = 0.01 and SMD - 0.68 [ - 1.21, - 0.16] p = 0.01, respectively, with very low certainty of evidence). After 48 and 72 h, both groups demonstrated similar means of postendodontic pain (MD - 0.06 [- 0.18, 0.07] p = 0.38 and SMD - 0.54 [- 1.18, - 0.11] p = 0.10, with high and low certainty of evidence, respectively).
Conclusions: Based on the limited quality evidence, intracanal cryotherapy application reduced postoperative endodontic pain after 6 and 24 h. New clinical trials are needed to support the result of this review.
Clinical Significance: This SR provides information about the use of intracanal cryotherapy in clinical practice, guides clinicians to make evidence-based decisions and suggests recommendations for further high-quality studies.
Databáze: MEDLINE
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