of Dr. Pasquale Paone and Dr. Roland Malecki
The use of cryotherapy in dentistry is a hitherto little known but highly effective method for treating sick gums. In the past, the treatment has been carried out with an appliance that uses nitrogen in a mixture of liquid and gaseous forms. By means of an applicator, the area of gum to be treated is cooled for a very short time to approx. -40° C. It is this large temperature difference that produces the therapeutic effect.
Fortunately, the moderators of the NETWORK-Cryodent have succeeded in arousing the enthusiasm of a manufacturer to develop a unit that generates the cooling effect using electricity, i.e. without the need for nitrogen and the problems associated with it.
There are various indications for use of the therapy, such as gingivitis, gum proliferation (including that caused by medication), the treatment of gum pockets, and above all as a supplement to classical periodontitis treatment.
In Germany, almost 70% of the population aged over 35 suffer from some form of gum disease on a moderate to severe scale. Ten percent of sufferers even have the most serious form, periodontitis, which without rapid and adequate treatment can result in the loss of some, or in the worst case, all of the teeth.
Information for patients on periodontitis
Today, the causes of periodontitis are known: a mixture of various factors, such as local factors like the bacteria present in the oral cavity, and systemic factors such as genetic predisposition, plaque formation, environmental influences, patient behaviour, parafunctions and so on. One of the main causes of periodontitis is unquestionably plaque which, if it is not regularly removed, can cause chronic inflammation in the tooth socket. This inflammation of the tooth socket is usually a slow process that can develop for years unnoticed, especially as in the early phases it is usually pain-free. Only in the advanced stages does the patient become aware of the condition through bleeding of the gums and, in some cases, teeth becoming loose. Periodontitis can develop significantly faster and more seriously in the case of smokers, people taking some kinds of medication (cortisone, immune suppressants, hormones, calcium antagonists, etc.), and patients with certain systemic conditions such as diabetes, AIDS, some auto-immune diseases, etc.
The conventional therapy for periodontitis is removal of the plaque above and below the gum. Following this pre-treatment, it is also necessary in some cases for the gums to be opened surgically to enable the teeth to be cleaned. These procedures are mostly carried out under local anaesthetic and are usually painful, especially after the actual surgery.
With the aid of cryotherapy, which has been performed by Dr. Madi (France) for 30 years with great success, the plaque can be removed in one or two pain-free treatments both above and below the level of the gums even without a local anaesthetic, as the tissue shows substantially less acute inflammation.
Following thorough cleaning of the teeth and tooth sockets – this is always the basic therapy – the gingiva are treated in cycles of two cryo-applications within a period of 14 days. This is followed by a further cycle two months later, and if the results are satisfactory, the cycle is repeated after a further four months. If no further deterioration in the periodontitis become manifest, a cycle is then carried out every six months in connection with the regular teeth-cleaning sessions.
Healthy tissue such as the gums, nerves and roots are not harmed by the cryotherapy. The application of the cold is too brief to cause damage to healthy tissue, but for inflamed tissue or bacteria, the sudden temperature drop is sufficient to produce a therapeutic effect.
The therapy is absolutely minimal-invasive and can therefore be carried out without problem even on patients with cardiovascular conditions, diabetes, allergies, diseases of the immune system, and above all during pregnancy etc.
The only side-effect that occurs in some patients is a slightly increased sensitivity of the gums at the points of application for a maximum 8 days. After that, given appropriate oral hygiene, newly organised, unswollen and healthy gum tissue develops.
The effect can be explained by the fact that the cryotherapy destroys the outer layer of the gum, so that a new layer subsequently forms and tautens the gingiva – similar to what happens in ablative procedures in the dermatological field. Additionally, the circulation of the blood is intensified in the treated regions, producing a further improvement in the condition of the gums.