Evaluation of the effectiveness of ice pack therapy on pain after extraction of mandibular third molar

Ahmet Taylan Cebi 1 * , Metin Berk Kasapoglu 2
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1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karabuk University, Karabuk, Turkey
2 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
* Corresponding Author
J CLIN MED KAZ, Volume 5, Issue 59, pp. 24-27. https://doi.org/10.23950/1812-2892-JCMK-00794
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Aim: The aim of this study was to evaluate the efficacy of ice pack therapy on pain after mandibular third molar extraction.
Material and methods: Thirty patients who required extraction of mandibular third molars and satisfied the inclusion criteria were included in the study. Bilateral full erupted mandibular third molars were extracted under local anesthesia. Routine medication and ice pack therapy (directly over the masseteric region of the surgery region for 12 hours, intermittently for 20 minutes) were performed after one side mandibular third molar extraction and only routine medication was applied after other side mandibular third molar extraction. The pain was evaluated with Visual Analog Scale. The Student t-test was applied to compare pain levels between groups.
Results: The study was carried out in 30 patients, 15 female and 15 male with a mean age of 21.53±2.22 years. There was a statistically significant difference in the evaluation of VAS levels in postoperative 4, 6, 8, 12, 24 hours between the groups. Pain levels of female were found to be higher than male at 2nd, 4th, 6th and 24th hours in the non-ice pack therapy group and found to be higher than male at 4th, 6th and 8th hours in the ice pack therapy group.
Conclusion: Pain levels after mandibular third molar extraction were significantly lower who had an ice pack therapy. Ice pack therapy is a viable alternative mode of improving the quality of life of patients after the extraction of third molars.


Cebi AT, Kasapoglu MB. Evaluation of the effectiveness of ice pack therapy on pain after extraction of mandibular third molar. J Clin Med Kaz. 2020;5(59):24-7. https://doi.org/10.23950/1812-2892-JCMK-00794


  • Nazir A, Akhtar MU, Ali S. Assessment of different patterns of impacted mandibular third molars and their associated pathologies. J Adv Med Dent Sci Res. 2014; 2(2):14-22.
  • Çebi AT. Effects of Transcutaneous Electrical Nerve Stimulation on Pain After Impacted Third Molar Surgery. Med Oral Patol Oral Cir Bucal. 2019; 24(3):e404-e408. https://doi.org/10.4317/medoral.22871
  • Wahid A, Mian FI, Bokhan SA, Moazzam A, Kramat A, Khanet F. Prevalence of impacted mandibular and maxillary third molars: A study in patients reporting Madina teaching hospital, Faisalabad. JUMDC. 2013; 4(2):22-31.
  • Gelesko S, Long L, Faulk J, Phillips, C, Dicus, C, White, RP. Cryotherapy and topical minocycline as adjunctive measures to control pain after third molar surgery: an exploratory study. J Oral Maxillofac Surg. 2011; 69(11):324-32. https://doi.org/10.1016/j.joms.2011.03.059
  • Negreiros RM, Biazevic MG, Jorge WA, Michel-Crosato E. Relationship between oral health-related quality of life and the position of the lower third molar: postoperative follow-up. J Oral Maxillofac Surg. 2012; 70(4):779-86. https://doi.org/10.1016/j.joms.2011.09.034
  • Koyuncu BO, Zeytinoglu M, Tetik A, Gomel MM. Effect of tube drainage compared with conventional suturing on postoperative discomfort after extraction of impacted mandibular third molars. Br J Oral Maxillofac Surg. 2015; 53(1):63-7. https://doi.org/10.1016/j.bjoms.2014.09.021
  • Pouchain EC, Costa FW, Bezerra TP, Soares EC. Comparative efficacy of nimesulide and ketoprofen on inflammatory events in third molar surgery: a split-mouth, prospective, randomized, double-blind study. Int J Oral Maxillofac Surg. 2015; 44(7):876-84. https://doi.org/10.1016/j.ijom.2014.10.026
  • Au AH, Choi SW, Cheung CW, Leung YY. The Efficacy and Clinical Safety of Various Analgesic Combinations for Post-Operative Pain after Third Molar Surgery: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(6):e0127611. https://doi.org/10.1371/journal.pone.0127611
  • Zandi M, Amini P, Keshavarz A. Effectiveness of cold therapy in reducing pain, trismus, and oedema after impacted mandibular third molar surgery: a randomized, self-controlled, observer-blind, split-mouth clinical trial. Int J Oral Maxillofac Surg. 2016; 45(1):118-23. https://doi.org/10.1016/j.ijom.2015.10.021
  • Ibikunle AA, Adeyemo WL. Oral health-related quality of life following third molar surgery with or without application of ice pack therapy. Oral Maxillofac Surg. 2016; 20(3):239-47. https://doi.org/10.1007/s10006-016-0558-1
  • Fang L, Hung CH, Wu SL, Fang SH, Stocker J. The effects of cryotherapy in relieving postarthroscopy pain. J Clin Nurs. 2012; 21(5-6):636-643. https://doi.org/10.1111/j.1365-2702.2010.03531.x
  • Rana M, Gellrich NC, Ghassemi A, Gerressen M, Riediger D, Modabberet A. Three-dimensional evaluation of postoperative swelling after third molar surgery using 2 different cooling therapy methods: a randomized observer-blind prospective study. J Oral Maxillofac Surg. 2011; 69(8):2092-2098. https://doi.org/10.1016/j.joms.2010.12.038
  • Svensson CI, Yaksh TL. The spinal phospholipasecyclooxygenase-prostanoid cascade in nociceptive processing. Ann Rev Pharmacol Toxicol. 2002; 42:553-583. https://doi.org/10.1146/annurev.pharmtox.42.092401.143905
  • Ong KS, Tan JM. Preoperative intravenous tramadol versus ketorolac for preventing postoperative pain after third molar surgery. Int J Oral Maxillofac Surg. 2004; 33(3):274-8. https://doi.org/10.1006/ijom.2003.0515
  • Fisher SE, Frame JW, Rout PG, Mcentegart DJ. Factors af-fecting the onset and severity of pain following the surgical removal of unilateral impacted mandibular third molar teeth. Br. Dent J. 1988; 164(11):351-4. https://doi.org/10.1038/sj.bdj.4806453
  • Eroglu CN, Durmus E, Kiresi D. Effect of low-dose dexketoprofen trometamol and paracetamol on postoperative complications after impacted third molar surgery on healthy volunteers: A pilot study. Med Oral Patol Oral Cir Bucal. 2014; 19(6):622-7. https://doi.org/10.4317/medoral.19835
  • Kozier B, Berman A, Snyder S, Erb G. Fundamentals of nursing concepts, process and practice. 8nd Ed. New Jersey: Prentice Hall. 2008.
  • van der Westhuijzen AJ, Becker PJ, Morkel J, Roelse JA. A randomized observer blind comparison of bilateral facial ice pack therapy with no ice therapy following third molar surgery. Int J Oral Maxillofac Surg. 2005; 34(3):281-6. https://doi.org/10.1016/j.ijom.2004.05.006
  • Herrera E, Sandoval MC, Camargo DM, Salvini TF. Motor and sensory nerve conduction are affected differently by ice pack, ice massage, and cold water immersion. Physical Therapy. 2010; 90(4):581-591. https://doi.org/10.2522/ptj.20090131
  • Bastian H, Soholm B, Marker P, Eckerdal A. Comparative study of pain control by cryotherapy of exposed bone following extraction of wisdom teeth. J Oral Sci. 1998; 40:109-113. https://doi.org/10.2334/josnusd.40.109
  • Laureano Filho JR, de Oliveira e Silva ED, Batista CI, Michener FM. The influence of cryotherapy on reduction of swelling, pain and trismus after third-molar extraction: A preliminary study. J Am Dent Assoc. 2005; 136(6):774-778. https://doi.org/10.14219/jada.archive.2005.0261
  • Nusair YM. Local application of ice bags did not affect postoperative facial swelling after oral surgery in rabbits. Br J Oral Maxillofac Surg. 2007; 45(1):48-50. https://doi.org/10.1016/j.bjoms.2006.01.001
  • Ylipaavalniemi P, Perkki K, Taube S, Oikarinen VJ. The effect of immediate combined cold,ultrasound and diadynamic current therapy on swelling after wisdom tooth removal. Proc Finn Dent Soc. 1984; 80(2):55-57.
  • Mac Auley DC. Icetherapy: how goodisthe evidence? Int J Sports Med. 2001; 22:379-384. https://doi.org/10.1055/s-2001-15656
  • Kuo CC, Lin CC, Lee WJ, Huang WT. Comparing the antiswelling and analgesic effects of three different ice pack therapy durations: a randomized controlled trial on cases with soft tissue injuries. J Nurs Res. 2013; 21(3):186-94. https://doi.org/10.1097/jnr.0b013e3182a0af12