Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review.

BACKGROUND: Cryotherapy (e.g., ice pack) is prescribed commonly after oral surgery to inhibit swelling and discomfort. However, there is a dearth of data concerning various aspects of cold therapy: optimal delivery mode, best interval for application (time on/time off), and total duration of treatment to attain desired clinical outcomes.

METHODS: The literature was searched for clinical trials that assessed the benefits of cryotherapy after oral surgical procedures. In addition, other studies were reviewed that evaluated physiological responses to cold therapy.

RESULTS: To inhibit signs of inflammation and achieve beneficial results with cryotherapy, skin temperature (normally 33 degrees C) needs to be reduced to 10 degrees C to 15 degrees C. Cold therapy usually decreased skin temperature to 10 degrees C to 15 degrees C within 10 to 20 minutes. Physiological studies indicated cryotherapy resulted in vasoconstriction, reduction of edema, and diminished pain perception. Various methods can be used to lower tissue temperature. Ice or gel packs are easy and efficient techniques to cool tissues. Seven studies published in English were found that addressed the use of cryotherapy after oral surgical procedures. Five investigations demonstrated no clinical benefits from cold therapy, and two studies indicated that cryotherapy reduced post-surgical edema and pain. The time interval for cold applications varied in different studies (10 minutes to continuous for hours). There seemed to be consensus among clinicians that cryotherapy should be applied for 10 to 20 minutes followed by a rest period. The duration of therapy ranged from 2 to 72 hours. No clinical trials were conducted to determine the optimal interval of cold application (time on/off) or extended duration of cryotherapy after surgical procedures to attain the best therapeutic benefits.

CONCLUSIONS: Ice applied after surgical procedures may reduce swelling and discomfort. However, data from studies regarding the benefits of ice therapy after oral surgery are inconclusive. To resolve this ambiguity, additional clinical trials need to be conducted.