12 January 2021

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Cryotherapy in Endodontics: a new frontier in pain relief

Massimo Gagliani

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An interesting review on Cryotherapy in Endodontics have been recently published on Journal of Endodontics; this simple and easy procedure might be accomplished by different methods and can provide interesting outcomes in terms of post-endodontic side effects, such as pain and swelling.

Firstly introduced by Vera et al it had several followers in the near past.

Vera et al suggested a final rinse with saline solution at 2.5° C degree with Endovac (a negative pressure device for root canal irrigation) for 5 minutes; the aim was to lower the root surface temperature thus acting as the well know effect of cold applications in traumatic injuries and in post-surgery phase in all surgical procedures.

These effects could be achieved also by a positive pressure elementary device, as reported by Keskin et al., simplifying the clinical setting.

A strong reduction in post-operative pain was reported particularly in necrotic pulp root canal treatment and symptomatic pulpitis.

Although other effects have been suggested for instance on NiTi files - improving cyclic fatigue and cutting efficiency - as well as Stainless Steel ones, the main effect was related to the post-operative phase and it should be outlined that cryotherapy might be a simple and cheap supplementary method for minimizing postoperative pain in cases of symptomatic apical periodontitis and for controlling pulpal hemorrhage during vital pulp therapy. 

For additional information: Cryotherapy: A New Paradigm of Treatment in Endodontics.

Additional References
Vera J, Ochoa–Rivera J, Vazquez–Carcano M, et al. Effect of intracanal cryotherapy on reducing 
root surface temperature. J Endod 2015;41:1884–7. 

Keskin C, Ozdemir O2, Uzun I, GUler B. Effect of intracanal cryotherapy on pain after single-visit 
root canal treatment. Aust Endod J 2017;43:83–8. 

Vera J, Ochoa J, Romero M, et al. Intracanal cryotherapy reduces postoperative pain in teeth with symptomatic apical periodontitis: a randomized multicenter clinical trial. J Endod 2018;44:4–8.