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Intracanal cryotherapy emerges as a game-changer, thwarting the rise of certain biomarkers, and offering respite from agonizing tooth pain.
A novel study published in the 'International Endodontic Journal' made a thrilling discovery that could revolutionize pain management in people suffering from asymptomatic apical periodontitis. Intracanal cryotherapy effectively reduced intensity of post-operative pain in the short term in periodontitis teeth. By examining alterations in biomarker levels associated with inflammation and tissue damage, C. Keskin et al. unveiled the astonishing benefits of intracanal cryotherapy for those with inflammation of the periodontium.
The trial involved 44 patients (age 18-35 years) with asymptomatic apical periodontitis in their mandibular premolar teeth. Half of the volunteers were treated with intracanal cryotherapy. The remaining half served as the control arm. The cryotherapy group received irrigation with chilled distilled water, while the control group received room-temperature water. After the root canal treatment and subsequent visits, researchers assessed biomarker levels [interleukin (IL)-1β, IL-2, IL-6, IL-8, tumor necrosis factor (TNF)-α, prostaglandin E2 (PGE2), and matrix metalloproteinase-8 (MMP-8)], using ELISA testing.
Pain levels after surgery were assessed for a duration of 6 days during both visits, utilizing a visual analogue scale. The data obtained were subjected to analysis employing statistical methods such as correlation tests, Mann-Whitney U test, and t-test. Fascinatingly, pain scores following the first visit showed a significant correlation with IL-1β and PGE2 levels, suggesting their potential use as predictors for postoperative pain severity.
Cryotherapy application inhibited the levels of IL-1β, IL-2, and IL-6. On the other hand, the levels of these biomarkers escalated in the control group. Although there was a drop in levels of IL-8, TNF-α, PGE2, and MMP-8 with cryotherapy, the difference was not statistically noteworthy. The most exciting finding was that the cryotherapy group experienced significantly lower pain scores for the first three days following the procedure, demonstrating the short-term effectiveness of intracanal cryotherapy in alleviating postoperative pain.
These results offer newfound hope to those battling asymptomatic apical periodontitis. The positive correlation between inter-appointment pain and specific biomarker levels opens up possibilities for predicting pain severity, leading to personalized and proactive pain management in the future.
International Endodontic Journal
Effect of intracanal cryotherapy on the inflammatory cytokine, proteolytic enzyme levels and post-operative pain in teeth with asymptomatic apical periodontitis: A randomized clinical trial
C. Keskin et al.
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