The influence of local controlled hypothermia on the postoperative period in the removal of wisdom teeth

Local hypothermia is used to control inflammation, pain, edema, neuroprotection, and reduce muscle lockjaw. Despite the frequent use of cooling in neurology, cardiology, orthopedic rehabilitation, and physiotherapy, there is little scientific literature on the use of controlled hypothermia in oral and maxillofacial surgery. The aim of our study was to develop and substantiate the clinical effectiveness of the method of controlled cooling of the soft tissues of the parotid-masticatory and buccal areas as an anti-inflammatory physiotherapeutic agent in patients after surgery for the removal of dystopic wisdom teeth. For this, local controlled cooling of the masticatory-buccal and submandibular regions was carried out using the ViThermo apparatus in the study group, and cryotherapy was carried out in the control group. As a result, local controlled hypothermia of the soft tissues of the parotid-masticatory and buccal areas at an external constant temperature of the mask of 18 °С allows you to reach 32–34.2 °С of the soft tissues of the specified area and mucous membrane, which is safe and sufficient to provide anti-inflammatory action in the postoperative period with complex tooth extraction wisdom.

1. Stangel L. The value of cryotherapy and thermotherapy in the relief of pain. Physiotherapy (Canada) 1975: 27: 135–139.

2. Cameron MH. Physical Agents in Rehabilitation – From Research to Practice. Philadelphia: WB Saunders 1999: 129–148.

3. Courage GR, Huebsch RF. Cold therapy revisited. JADA 1971: 83: 1070–1073.

4. Greenstein, Gary. Therapeutic efficacy of cold therapy after intraoral surgical procedures: a literature review. Journal of periodontology vol. 78,5 (2007): 790–800. doi:10.1902/jop.2007.060319.

5. Lateef, Thair A et al. Evaluation the Efficacy of Hilotherm Cooling System in Reducing Postoperative Pain and Edema in Maxillofacial Traumatized Patients and Orthognathic Surgeries. The Journal of craniofacial surgery vol. 29,7 (2018): e697-e706. doi:10.1097/SCS.0000000000004951.

6. Cook, D K, and K Georgouras. Complications of cutaneous cryotherapy. TheMedical journal ofAustralia vol. 161,3 (1994): 210-3. doi:10.5694/j.1326-5377.1994.tb127385.x.

7. Hermann, J. Kryotherapie [Cryotherapy]. Zeitschrift fur Rheumatologie vol. 68,7 (2009): 539-41. doi:10.1007/s00393-009-0446-2.

8. Oneda, Ester et al. Innovative Approach for the Prevention of Chemotherapy-Induced Peripheral Neuropathy in Cancer Patients: A Pilot Study With the Hilotherm Device, the Poliambulanza Hospital Experience. Integrative cancer therapies vol. 19 (2020): 1534735420943287. doi:10.1177/1534735420943287.

9. Moro, Alessandro et al. Hilotherm efficacy in controlling postoperative facial edema in patients treated for maxillomandibular malformations. The Journal of craniofacial surgery vol. 22,6 (2011): 2114-7. doi:10.1097/SCS.0b013e31822e5e06.

10. Hanci, Deniz et al. Evaluation of the Efficacy of Hilotherapy for Postoperative Edema, Ecchymosis, and Pain After Rhinoplasty. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons vol. 78,9 (2020): 1628.e1-1628.e5. doi:10.1016/j.joms.2020.03.032.

11. Kurisu, Kota, and Midori A Yenari. Therapeutic hypothermia for ischemic stroke; pathophysiology and future promise. Neuropharmacology vol. 134,Pt B (2018): 302–309. doi:10.1016/j.neuropharm.2017.08.025.

12. Badjatia, N. Therapeutic hypothermia protocols. Handbook of clinical neurology vol. 141 (2017): 619-632. doi:10.1016/B978-0-444-63599-0.00033-8.

13. Abramson DI, Chu LS, Tuck S, et al: Effect of tissue temperature and blood flow on motor nerve conduction velocity. JAMA 198:1082, 1996.

14. Lehman JF. Therapeutic Heat and Cold. Baltimore: Williams and Wilkins 1990: 590–632.

15. Comroe Jr JH. The Lung: Clinical Physiology and Pulmonary Function Tests. 2nd edn. Chicago: Year Book 1962.

16. Lewis T. Observations upon the reaction of vessels of the human skin to cold. Heart 1930: 15: 177–208.

17. Weston M, Taber C, Casagranda L, Cornwall M. Changes in local blood volume during cold gel application to traumatized ankles. J Orthop Sports Phys Ther 1994: 19: 197–199.

18. Ernst E, Fialka V. Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy. J Pain Symptom Manage 1994: 9: 56–59.

19. Lee JM, Warren MP, Mason SM. Effects of ice on nerve conduction velocity. Physiotherapy 1978: 64: 2–6.

20. Price R, Lehmann JF, Boswell-Bessette S, Burleigh A, deLateur BJ. Influence of cryotherapy on spasticity at the human ankle. Arch Phys Med Rehabil 1993: 74: 300–304.

21. Wolf SL, Letbetter WD. Effect of skin cooling on spontaneous EMG activity in triceps surae of the decerebrate cat. Brain Res 1975: 91: 151–155.

22. Bierman W, Friedlander M. The penetrative effect of cold. Arch Phys Ther 1940: 21: 585–592.

23. LOW J, REED A. Cold therapy. In: Low J, Reed A, eds: Electrotherapy Explained. Principles and Practice. Oxford: Butterworth-Heinemann 1990: 202–220.

24. Oosterveld FGJ, Rasker JJ, Jacobs JWG, Overmars HJA. The effect of local heat and cold therapy on the intraarticular and skin surface temperature of the knee. Arthritis Rheum 1992: 35: 146–151.

25. Album B, Olsen I, Løkken P. Bilateral surgical removal of impacted mandibular third molar teeth as a model for drug evaluation: a test with oxyphenbutazone (Tranderil). Int J Oral Surg 1977: 6: 177– 189.

26. Merrick MA, Jutte LS, Smith ME. Cold modalities with different thermodynamic properties produce different surface and intramuscular temperatures. J Athl Train 2003;38:28-33.