by TOM PAGONIS
Published in the April 2019 issue of the Journal of the American Dental Association, the authors attempt to quantify the postoperative benefits of cryotherapy (or application of cold) for patients undergoing third molar extractions. Cold therapy immediately after most or all in-office dental surgical procedures is a mainstay in postoperative instructions and has spawned the development of several commercially available instant cold packs.
The study identifies the lack of an evidence-based approach in assessing the benefits of cold therapy and attempts to quantify the benefits of this clinical intervention via a systematic review and meta-analysis. Let’s first review the meaning and requirements of a systematic review and meta-analysis:
Systematic Review: As the name implies, this type of review utilizes a well-planned system to formulate a research question, the search for and selection of relevant studies related to the research question and the assimilation of data that addresses the research question.
Meta-analysis: This evidence-based tool is a statistical analysis that combines the collective results from a pool of similar scientific studies. The challenge is to identify studies with similar research methodologies.
This is a well designed and comprehensive evidenced-based study. Yet, given the widespread administration of postoperative cryotherapy one assumes this study would provide strong validation of this therapy towards a reduction of pain, trismus, and facial swelling after third-molar surgery. Study results though show only slight benefits towards pain reduction with no effect on trismus and facial swelling. The authors acknowledge that additional high quality randomized clinical trials are necessary in light of the relatively low quality of available evidence. It’s understandable to limit the study research question to third molar extractions but expanding the clinical scope of this research question to other surgical procedures could produce some additional and interesting results
Public access to the study Abstract is available here.