Cryotherapy as a non-pharmacological alternative for the management of postoperative endodontic pain: An integrative review of the literature




Cryotherapy; Irrigants; Post-operative endodontic pain; Pulp necrosis; Symptomatic apical periodontitis; Endovac.


Introduction: Pain management is one of the main objectives within dental practice and is one of the most common reasons for patients to seek dental care, it is generally associated with trauma and infections that require endodontic treatment, whose purpose is to preserve the affected tooth, eliminate inflammation and prevent infection; however, it also implies the appearance of postoperative pain that could vary from 1.5% to 53%. Materials and Methods: The present study is an integrative review of the literature in which the existing scientific evidence about cryotherapy as a non-pharmacological alternative for the management of post-endodontic pain was analyzed. To do this, an exhaustive search of the pertinent information was carried out in the Science Direct, Medline, Cochrane, PubMed databases, as well as a manual search, of articles since 2014. Results: The search carried out yielded 112 articles, of which 22 were selected, which were adjusted with the objectives and inclusion criteria of the research. Those that did not contain the keywords in the title and / or abstract were excluded. Conclusions: Current scientific evidence supports the use of cryotherapy as an inexpensive and effective non-pharmacological alternative for the control of inflammation and post-endodontic pain, so it could be considered a valid option for its routine clinical application.


Al-Abdullah, A., Abdullah, A., & Al-Marrawi, K. (2020). Comparative study to investigate the effect of cryotherapy on post-operative pain using two different preparation techniques (In vivo study).

Al-Nahlawi, T., Hatab, T. A., Alrazak, M., & Al-Abdullah, A. (2016). Effect of Intracanal Cryotherapy and Negative Irrigation Technique on Postendodontic Pain. The journal of contemporary dental practice, 17(12), 990-996.

Algafly, A. A., & George, K. P. (2007). The effect of cryotherapy on nerve conduction velocity, pain threshold and pain tolerance. British journal of sports medicine, 41(6), 365-369.

Alharthi, A. A., Aljoudi, M. H., Almaliki, M. N., Almalki, M. A., & Sunbul, M. A. (2019). Effect of intra-canal cryotherapy on post-endodontic pain in single-visit RCT: A randomized controlled trial. The Saudi dental journal, 31(3), 330-335.

Balasubramanian, S. K., & Vinayachandran, D. (2017). “Cryotherapy. A Panacea for Post-Operative Pain Following Endodontic Treatment”. International Journal of Dental Research and Oral Sciences, 2, 10-12.

Bazaid, D. S., & Kenawi, L. M. (2018). The effect of intracanal cryotherapy in reducing postoperative pain in patients with irreversible pulpitis: a randomized control trial. Int J Health Sci, 8, 83-88.

Bergenholtz, G., Horsted-Bindslev, P., & Reit, C. (2011). Endodoncia: Editorial El Manual Moderno.

Castro Moreno, C. C. (2020). Estado actual de la irrigación en endodoncia. Universidad de Guayaquil. Facultad Piloto de Odontología.

ElMubarak, A. H. H., Abu-bakr, N. H., & Ibrahim, Y. E. (2010). Postoperative pain in multiple-visit and single-visit root canal treatment. Journal of endodontics, 36(1), 36-39.

Fayyad, D. M., Abdelsalam, N., & Hashem, N. (2020). Cryotherapy: a new paradigm of treatment in endodontics. Journal of endodontics.

Fernandes, I. A., Armond, A. C. V., & Falci, S. G. M. (2019). The effectiveness of the cold therapy (cryotherapy) in the management of inflammatory parameters after removal of mandibular third molars: a meta-analysis. International archives of otorhinolaryngology, 23(2), 221-228.

Gade, V., Barfiwala, D., Asani, R., Gawande, R., & Gade, J. (2020). Cryotherapy: An Emerging trend in the field of endodontics. International Journal Of Drug Research And Dental Science, 2(3), 70-76.

Greenstein, G. (2007). Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review. Journal of periodontology, 78(5), 790-800.

Gundogdu, E. C., & Arslan, H. (2018). Effects of various cryotherapy applications on postoperative pain in molar teeth with symptomatic apical periodontitis: a preliminary randomized prospective clinical trial. Journal of endodontics, 44(3), 349-354.

Gupta, A., Aggarwal, V., Gurawa, A., Mehta, N., Abraham, D., Singh, A., . . . Chauhan, N. (2021). Effect of intracanal cryotherapy on postendodontic pain: a systematic review and meta-analysis of randomized controlled trials. Journal of Dental Anesthesia and Pain Medicine, 21(1), 15.

Gurucharan, I., Saravana Karthikeyan, B., & Mahalaxmi, S. (2017). Intracanal cryotherapy in endodontics. Australian Endodontic Journal, 43(3), 138-139.

Hargreaves, K. M., & Berman, L. H. (2016). Cohen. Vías de la Pulpa + ExpertConsult: Elsevier Health Sciences Spain.

Herrera, E., Sandoval, M. C., Camargo, D. M., & Salvini, T. F. (2010). Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion. Physical therapy, 90(4), 581-591.

Jain, S., Chokshi, S., Sanghvi, Z., Trivedi, P., Mehta, P., & Parikh, A. (2021). Effect of intracanal cryotherapy on fracture resistance of teeth that have undergone endodontic treatment-An in vitro study. Journal of Advanced Medical and Dental Sciences Research, 9(1), 31-34.

Jaiswal, S., Vagarali, H., Pujar, M., & Kapshe, N. (2020). Effect of cold saline irrigation on postoperative pain–A randomized control trial. IP Indian Journal of Conservative and Endodontics, 5(2), 58-62.

Keskin, C., Özdemir, Ö., Uzun, İ., & Güler, B. (2017). Effect of intracanal cryotherapy on pain after single‐visit root canal treatment. Australian Endodontic Journal, 43(2), 83-88.

Keskin, C., Sariyilmaz, E., Keleş, A., & Güler, D. H. (2019). Effect of intracanal cryotherapy on the fracture resistance of endodontically treated teeth. Acta Odontologica Scandinavica, 77(2), 164-167.

Khuteta, S., Parvez, S., Agarwal, M., & Khatri, R. (2020). Endovac-Pressure Modulated Irrigation in Endodontics. Journal of Advanced Medical and Dental Sciences Research, 8(11), 73-82.

Lobo Cortés, L. A., Rebolledo Cobos, M., & Mejía Fernández, P. P. (2020). A propósito de la crioanestesia dental. Revista Cubana de Estomatología, 57(4).

Malanga, G. A., Yan, N., & Stark, J. (2015). Mechanisms and efficacy of heat and cold therapies for musculoskeletal injury. Postgraduate medicine, 127(1), 57-65.

Monteiro, L. P. B., Guerreiro, M. Y. R., de Castro Valino, R., Magno, M. B., Maia, L. C., & da Silva Brandão, J. M. (2020). Effect of intracanal cryotherapy application on postoperative endodontic pain: a systematic review and metaanalysis. Clinical Oral Investigations, 1-13.

Nayeema, S., & Subha, D. (2013). Cryotherapy–a novel treatment modality in oral lesions. Int J Pharm Pharm Sci, 5, 4-5.

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica.

Products, U. (2021). Ultradent | NaviTip: Sistema de canulas para irrigacion y aplicacion. Retrieved 26 June 2021, from

Products, U. (2021). Ultradent | NaviTip Sideport: Canula de irragacion con perforacion lateral. Retrieved 26 June 2021, from

Sadaf, D., Ahmad, M. Z., & Onakpoya, I. J. (2020). Effectiveness of intracanal cryotherapy in root canal therapy: A systematic review and meta-analysis of randomized clinical trials. Journal of endodontics.

Saravanakarthikeyan, B., & Mahalaxmi, S. (2018). ‘COLD’CURTAILS THE PAIN IN ENDODONTICS.

Vera, J., Ochoa-Rivera, J., Vazquez-Carcaño, M., Romero, M., Arias, A., & Sleiman, P. (2015). Effect of intracanal cryotherapy on reducing root surface temperature. Journal of endodontics, 41(11), 1884-1887.

Vera, J., Ochoa, J., Romero, M., Vazquez-Carcaño, M., Ramos-Gregorio, C. O., Aguilar, R. R., . . . Arias, A. (2018). Intracanal cryotherapy reduces postoperative pain in teeth with symptomatic apical periodontitis: a randomized multicenter clinical trial. Journal of endodontics, 44(1), 4-8.

Vieyra, J., Enriquez, F., Acosta, F., & Guardado, J. (2019). Reduction of postendodontic pain after one‑visit root canal treatment using three irrigating regimens with different temperature. Nigerian journal of clinical practice, 22(1).


Yadav, V., Shreya, V., Samant, P. S., & Chauhan, R. Endodontic cryotherapy: A review of current status, potential sequelae, and call for action.



How to Cite

LEGUISAMO DIAZ, J. A.; VIDAL ALVAREZ, S. R.; ESPINOSA VÁSQUEZ, X. E. Cryotherapy as a non-pharmacological alternative for the management of postoperative endodontic pain: An integrative review of the literature. Research, Society and Development, [S. l.], v. 10, n. 9, p. e2010917762, 2021. DOI: 10.33448/rsd-v10i9.17762. Disponível em: Acesso em: 20 sep. 2021.



Health Sciences