Kjærgaard Larsen Marie, Kofod Thomas, Starch-Jensen Thomas
Department of Oral and Maxillofacial Surgery, Aalborg University HospitalDenmark.
Department of Oral and Maxillofacial Surgery, Copenhagen University Hospital, RigshospitaletDenmark.
J Oral Maxillofac Res. 2021 Dec 31;12(4):e2. doi: 10.5037/jomr.2021.12402. eCollection 2021 Oct-Dec.
Cryotherapy is frequently used to diminish postoperative sequelae following mandibular third molar surgery. The objective of this single-blinded randomized controlled trial was to assess the therapeutic efficiency of 30 minutes continuous cryotherapy on postoperative sequelae following surgical removal of mandibular third molars compared with no cryotherapy.
Thirty patients (14 male and 16 female) including 60 mandibular third molars were randomly allocated to 30 minutes of immediately cryotherapy or no cryotherapy. Outcome measures included pain (visual analogue scale score), maximum mouth opening (trismus) and quality of life (oral health impact profile-14). Outcome measures were assessed preoperatively and one day, three days, seven days and one month following surgical removal of mandibular third molars. Descriptive and generalized estimating equation analyses were made. Level of significance was 0.05.
No cryotherapy following surgical removal of mandibular third molars revealed a statistically significant lower visual analogue scale score of pain compared to thirty minutes of continuous cryotherapy after one day (P < 0.05). However, no statistically significant difference in trismus or oral health-related quality of life were revealed at any time point compared with no cryotherapy.
The therapeutic effect of 30 minutes continuous cryotherapy following surgical removal of mandibular third molars seem to be negligible. Thus, further randomized controlled trials assessing a prolonged application period of cryotherapy, alternative devices or use of intermittent cryotherapy are needed before definite conclusions and evidence-based clinical recommendations can be provided.
冷冻疗法常用于减少下颌第三磨牙手术后的后遗症。本单盲随机对照试验的目的是评估与不进行冷冻疗法相比，持续30分钟的冷冻疗法对下颌第三磨牙手术切除后后遗症的治疗效果。
30例患者（14例男性和16例女性）共60颗下颌第三磨牙被随机分配至立即进行30分钟冷冻疗法组或不进行冷冻疗法组。观察指标包括疼痛（视觉模拟量表评分）、最大开口度（牙关紧闭）和生活质量（口腔健康影响程度量表-14）。在术前以及下颌第三磨牙手术切除后的第1天、3天、7天和1个月对观察指标进行评估。进行描述性分析和广义估计方程分析。显著性水平为0.05。
下颌第三磨牙手术切除后不进行冷冻疗法，与持续30分钟冷冻疗法相比，术后第1天疼痛的视觉模拟量表评分在统计学上显著更低（P<0.05）。然而，与不进行冷冻疗法相比，在任何时间点牙关紧闭或口腔健康相关生活质量方面均未显示出统计学上的显著差异。
下颌第三磨牙手术切除后持续30分钟冷冻疗法的治疗效果似乎微不足道。因此，在得出明确结论并提供基于证据的临床建议之前，需要进一步进行随机对照试验，评估延长冷冻疗法应用时间、使用替代设备或采用间歇性冷冻疗法的效果。
