Effectiveness of Cold Therapy in Reducing Post-Surgery Oedema, Pain and Trismus after Impacted Mandibular Third Molar Surgery: A Randomized Observer-Blind Split-Mouth Clinical Trial

Pain, swelling, and trismus are the most common undesirable effects seen in the post-op period after impacted mandibular third molar surgeries. To prevent these effects different methods of treatment has been advocated from time to time. Cold therapy is one of the conventional methods used for reducing these undesirable effects after dentoalveolar surgeries. However, there is a lack of knowledge about its effectiveness to prevent these post-op sequelae. This study was aimed to evaluate the effects of local cold application therapy in reducing pain, trismus, and swelling after impacted mandibular third molar surgery. 18 patients (7 males and 11 females) with bilaterally placed symmetrical mandibular impacted third molars were enrolled in this randomized, observer-blind split-mouth clinical trial. The patients were aged between 18-65 years. After surgical removal of the tooth on one side (intervention), ice pack therapy was given for 24 h after surgery; and for the other side (control), no cold therapy was advised. The time interval between the two surgeries was at least 4 weeks and the amount of trismus and facial swelling was measured on day 2 and 7 postoperatively. The pain was measured by VAS scale on day 1, 2, and 7 postoperatively. The amount of pain, and trismus, were not significantly different between the intervention and control sides but the swelling was less with cold therapy. Thus, Cold therapy had some beneficial effects on postoperative swelling, with no effect on pain and trismus after impacted mandibular third molar surgery.