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

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Abstract

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 I2 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

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Acknowledgments

The authors of this systematic review thank the following authors who collaborated by answering e-mails with the information requested: Dr Talal Al-Nahlawi, Dr Hakan Arslan and Dr Cangül Keskin.

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Authors and Affiliations

  1. Department of Endodontics, School of Dentistry, Federal University of Pará, Rua Augusto Correa, 1, Guamá, Belém, Pará, 66075-110, Brazil

    Laise Pena Braga Monteiro, Marcella Yasmin Reis Guerreiro, Roberta de Castro Valino & Juliana Melo da Silva Brandão

  2. Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil

    Marcela Baraúna Magno & Lucianne Cople Maia

Authors
  1. Laise Pena Braga Monteiro
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  2. Marcella Yasmin Reis Guerreiro
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  3. Roberta de Castro Valino
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  4. Marcela Baraúna Magno
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  5. Lucianne Cople Maia
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  6. Juliana Melo da Silva Brandão
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Contributions

Laise Pena Braga Monteiro, roles: conceptualization, formal analysis, investigation, methodology, writing—original draft, writing—review and editing. Marcella Yasmin Reis Guerreiro, roles: formal analysis, methodology, writing—original draft, writing—review and editing. Roberta Fonseca de Castro, roles: formal analysis, methodology, writing—original draft, writing—review and editing. Marcela Baraúna Magno, roles conceptualization, methodology, supervision, writing—original draft, writing—review and editing. Lucianne Cople Maia, roles: conceptualization, methodology, supervision, writing—original draft, writing—review and editing. Juliana Melo da Silva Brandão, roles: conceptualization, methodology, supervision, writing—original draft, writing—review and editing.

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Correspondence to Roberta de Castro Valino.

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Monteiro, L.P.B., Guerreiro, M.Y.R., de Castro Valino, R. et al. Effect of intracanal cryotherapy application on postoperative endodontic pain: a systematic review and metaanalysis. Clin Oral Invest 25, 23–35 (2021). https://doi.org/10.1007/s00784-020-03693-8

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  • DOI: https://doi.org/10.1007/s00784-020-03693-8

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