Comparison of Efficacy of Oral Bromelain and Serratiopeptidase for the Control of Postoperative Sequelae Following Third Molar Surgery - A Comparative Study

BACKGROUND Surgical removal of impacted third molar is widely carried out in general dental practice and is usually associated with postoperative inflammatory sequelae like pain, swelling, and trismus. The objective of the study was to assess and compare the efficacy of oral bromelain and Serratiopeptidase for the control of post-operative sequelae following surgical removal of impacted third molar. METHODS A randomized, comparative clinical study was conducted on sixty patients who were undergoing impacted third molar surgery, and were allocated into two groups each comprising 30 patients. Conventional drugs included Cap amoxicillin 500 mg bid, Tab. metronidazole 200 mg tid, and Tab. diclofenac sodium 50 mg bid that were given to both the groups. Group I was treated with Tab. bromelain 200 mg tid along with conventional treatment for 5 days. Group II received a combination of conventional treatment and Tab. Serratiopeptidase 10 mg bid for 5 days. The parameters such as measurement of pain, facial width and trismus were analysed on postoperative days 1, 2 and 7. RESULTS The study comprised of totally 60 otherwise healthy patients. The group of patients who received bromelain along with diclofenac sodium seemed to be effective in controlling post-operative sequelae like pain (P < 0.05), swelling (P < 0.05) but not trismus (P < 0.05) when compared to the group who received Serratiopeptidase with diclofenac sodium. CONCLUSIONS The intensified anti-inflammatory action of bromelain, was possibly by inhibiting the generation of bradykinin and negative action on the prostaglandin pathway. The present study assessed the clinical effect of bromelain and serratiopeptidase on pain, facial swelling and trismus. KEY WORDS Bromelain, Oral Bromelain, Serratiopeptidase, Proteolytic Enzyme, Third Molar Surgery