A systematic review on cryotherapy and third molar removal

Method: PubMed, Medline, PROSPERO, The Cochrane Library, OpenGrey and the ISRCTN register and reference lists of articles were searched to find studies reporting on the association between cryotherapy and LM3 morbidity.

Result: 5,486 titles and abstracts were reviewed, of which 6 met the inclusion criteria. Methods of cryotherapy applied were ice packs, ice compression, cold dressings, chemical cold packs and the use of a cryotherapy probe. All 6 articles investigated the association of cryotherapy and pain, with the remainder on body temperature, facial swelling, duration of swelling, discomfort, quality of life, inflammation, patient preference and wound healing. Five studies reported on bilateral removal of LM3 and none of the papers accounted for potential confounders.

Conclusion: The included studies suggest a significant effect of cryotherapy to reduce pain and swelling following LM3 removal. However, the quality of most studies is unsatisfactory and the strength of an association is unclear. Evidence for an association between cryotherapy and other postoperative symptoms is extremely limited. Well-designed RCTs are required to establish the association between cryotherapy and postoperative morbidity after lower third molar removal.