Department of Endodontics, Faculty of Dentistry, Ain Shams University, 2 sixth of October St., Hadayek Al-Ahram-Haram, Giza, Cairo, Egypt.
Sci Rep. 2024 Jun 17;14(1):13890. doi: 10.1038/s41598-024-64071-y.
Cryotherapy is widely utilized in medicine, particularly for pain management. This randomized clinical trial aimed to assess the effect of intraoral cold pack application (cryotherapy) on postoperative pain (POP) and the level of Substance P (SP) in patients with symptomatic apical periodontitis (SAP). Enrolled patients were randomly assigned to either cryotherapy or control group. After adequate anesthesia, access cavity, and biomechanical preparation of the root canal system were completed, the first apical fluid (AF) sample (S1) was obtained. A custom-made intraoral ice-gel pack was applied for 30 min in the cryotherapy group, while no intervention was performed in the control group. The second AF sample (S2) was collected 30 min later in both groups. Patients were asked to complete the Visual Analogue Scale (VAS) questionnaire to assess their POP. Quantification of SP in AF samples was performed using the enzyme-linked immunosorbent assay (ELISA) test. Data were analyzed statistically, revealing a significant reduction in POP and SP levels in the cryotherapy group compared to the control group (P ≤ 0.05). Furthermore, a moderate positive correlation was observed between SP levels and POP (P ≤ 0.05). In conclusion, intraoral cryotherapy represents a simple and cost-effective option for controlling POP and reducing inflammation levels in patients with SAP.
冷冻疗法在医学中广泛应用，特别是在疼痛管理方面。本随机临床试验旨在评估口腔内冷包敷（冷冻疗法）对有症状的根尖周炎（SAP）患者术后疼痛（POP）和 P 物质（SP）水平的影响。纳入的患者被随机分配到冷冻疗法组或对照组。在充分麻醉后，完成了窝洞预备和根管系统的生物力学预备，获得了第一份根尖液（AF）样本（S1）。在冷冻疗法组中，应用定制的口腔冰凝胶包敷 30 分钟，而对照组则不进行任何干预。30 分钟后，两组均收集第二份根尖液样本（S2）。患者被要求完成视觉模拟量表（VAS）问卷，以评估他们的 POP。使用酶联免疫吸附试验（ELISA）测试对 AF 样本中的 SP 进行定量。对数据进行了统计学分析，结果显示冷冻疗法组的 POP 和 SP 水平明显低于对照组（P≤0.05）。此外，还观察到 SP 水平与 POP 之间存在中度正相关（P≤0.05）。总之，口腔内冷冻疗法是一种简单且具有成本效益的选择，可用于控制 SAP 患者的 POP 和减轻炎症水平。
