Publication:

Cryotherapy in endodontics: a comprehensive review of applications, mechanisms, and future perspectives

Cold temperatures, therapeutically used in cryotherapy, are a valuable adjunct in endodontics. It is reviewed in terms of its history, principles, techniques, clinical uses, and evidence base. Mechanisms include vasoconstriction, reduced metabolism, modulation of nerves (analgesia), and anti-inflammatory effects. Cold saline irrigation, cryoprobes, external cold packs and cryogenic instrument treatment are standard methods. Cold saline irrigation (2.5–4°C) is strongly evidenced to reduce postoperative pain after root canal treatment (RCT). It may also enhance the success of local anaesthesia, especially in inflamed teeth. However, it is encouraging in its role in vital pulp therapy and regenerative endodontics, but more research is needed. The fatigue resistance of NiTi files may be improved by cryogenic treatment. Temperature and duration must be carefully controlled for safety, patient screening (including contraindications such as cold hypersensitivity), and proper technique. For pain, it is effective; however, further research is needed for other applications and protocol optimisation. Cryotherapy overall improves patient comfort and may enhance outcomes, aligning with modern endodontic principles.