Therapeutic efficacy of cryotherapy on facial swelling, pain, trismus and quality of life after surgical removal of mandibular third molars: A systematic review

Abstract

The objective was to test the hypothesis of no difference in facial swelling, pain, trismus and immediate quality of life after surgical removal of mandibular third molars, with or without post-operative cryotherapy. A MEDLINE (PubMed), EMBASE database and Cochrane library search in combination with a hand search of relevant journals were conducted by including human randomised controlled trials published in English until 17 July 2018. The search identified 37 titles. Six studies with low or unclear risk of bias fulfilled the inclusion criteria. Intermittent cryotherapy for 30 minutes during the first post-operative days significantly diminished facial swelling, pain and trismus compared with no cryotherapy. Patient's satisfaction and perception of recovery were significantly increased with cryotherapy. Therapeutic efficacy of intermittent cryotherapy on post-operative facial swelling, pain and trismus seems to be improved compared with continuous cryotherapy. Considerable variations in study design, diversity of used evaluation methods, outcome measures and various methodological confounding factors posed serious restrictions to review the literature in a quantitative systematic manner. Thus, conclusions drawn from the results of this systematic review should be interpreted with caution. Further well-designed randomised controlled trials including standardised protocol, larger patient sample, blinded outcome assessors, patient-reported outcome measures and three-dimensional volumetric analysis of facial swelling are required before evidence-based recommendations can be provided. K E Y W O R D S cryotherapy, dentistry, mandible, pain, review, third molar, trismus

Postoperative online follow-up improves the quality of life of patients who undergo extraction of impacted madibular third molars: a randomized controlled trial

“…Extraction of impacted mandibular third molars often causes various complications and discomfort to the patients, affecting their quality of life after surgery [26]. Currently, the research on the improvement of this situation has mainly focused on the improvement of tooth extraction techniques [5,6], suture methods [7,8], flapping methods [9,10], choice of implants in the extraction sockets [11,12], irrigation of extraction sockets [13,14], and postoperative care methods [15][16][17]. This study changed the postoperative care mode of the telephone, which was commonly used in the past, to the innovative mode of a mobile app.…”

“…To date, all aspects of the improvement related to impacted mandibular third molar extraction have mainly been focused on the steps during the diagnosis and treatment [5][6][7][8][9][10][11][12][13][14][15][16][17]. However, reports on the postoperative follow-up care of patients after returning home are rare and limited to telephone follow-up [18][19][20].…”

The Use of Cryotherapy in Conjunction with Surgical Removal of Mandibular Third Molars: a Single-Blinded Randomized Controlled Trial

“…Cryotherapy is a non-pharmacologic intervention that is frequently used following SRM3. Though, the therapeutic effect of cryotherapy seems to be controversy, which is emphasized in several systematic reviews [4]. Different techniques and devices are available for application of cryotherapy, including intermittent (applied for a shorter time and is reapplied several times over the duration of treatment) or continuous (applied for the duration of treatment and then removed) cryotherapy [4][5][6].…”

“…Though, the therapeutic effect of cryotherapy seems to be controversy, which is emphasized in several systematic reviews [4]. Different techniques and devices are available for application of cryotherapy, including intermittent (applied for a shorter time and is reapplied several times over the duration of treatment) or continuous (applied for the duration of treatment and then removed) cryotherapy [4][5][6]. Frozen gel packs, ice packs wrapped in a washcloth or Hilotherm device are frequently used to reduce the skin and subcutaneous tissue temperature following SRM3 [5,[7][8][9][10][11].…”

“…Frozen gel packs, ice packs wrapped in a washcloth or Hilotherm device are frequently used to reduce the skin and subcutaneous tissue temperature following SRM3 [5,[7][8][9][10][11]. However, there are no evidence-based clinical recommendations regarding the most optimal technique, device or duration of treatment [4]. Cryotherapy is an easy, simple and nonpharmacologic intervention, which is generally accepted by most patients following SRM3.…”