Effectiveness of Cryptolysis for the Treatment of Halitosis: A Systematic Review

Abstract

Background: Chronic caseous tonsilitis is characterized by caseum retention and halitosis. When other treatments failed, a tonsillectomy was suggested. Cryptolysis is a new conservative treatment that has recently been offered. It is painless and opens the crypt ostium, which prevents caseum retention. Halitometry is a new objective method for determining whether or not someone has halitosis. The number of volatile sulfur compounds breathed in air is measured in parts per billion (ppb). Aim: To investigate the effectiveness of cryptolysis for treating halitosis produced by chronic foetid tonsillitis and to evaluate the tonsils as a source of halitosis. Methods: A literature search was conducted using PubMed, Elsevier science direct, Wiley online library, Ovid Medline, Cochrane library, Lilacs, and Google scholar using the MeSH terms-cryptolysis, halitosis. Of the 91 articles scanned, 23 were full-text papers evaluated for eligibility, and four were chosen for qualitative analysis. The study was reported based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and bias was characterized by Modified Newcastle- Ottawa quality assessment scale. The evaluation process includes four clinical studies. Results: After treatment, all patients improved their halitosis and responded well to cryptolysis. The presence of caseum was detected during testing, and caseum retention was significantly reduced. Finkelstein's tests were all positive before cryptolysis. There were no difficulties or harmful side effects. Conclusion: Chronic foetid tonsillitis remains a common source of halitosis after omitting dental or periodontal diseases, sinonasal, oral, pulmonary, or gastroenterological diseases as causes of halitosis. Cryptolysis is safe, cost-effective, easily applicable, well-tolerated and improves complaints of halitosis in patients with chronic caseous tonsilitis.