Bromelain vs trypsin-chymotrypsin in management of complications following surgical removal of mandibular third molar

Abstract

Surgical removal of third molars is still the most common routine surgical procedure done by oral and maxillofacial surgeons which is usually associated with postoperative sequelae. In order to avoid or minimize post-surgical complications such as swelling, pain and trismus, patients are advised to use proteolytic enzyme and NSAID’s along with routine antibiotics. 50 patients who have bilateral symmetrical impacted mandibular third molars were included in the study. Post operatively, all patients were given antibiotics and analgesics for 5 days. Patients were given bromelain for 5 days after the procedure on one side and trypsin-chymotrypsin for 5 days on the other side with an interval of 21 days between the two procedures. Patients were recalled on day 1, day 3 and day 7 for assessment of post- operative trismus, pain and swelling based on measuring inter-incisal distance, visual analogue scale and, facial reference points. Data was gathered and statistical assessment was done using SPSS software by using descriptive statistics and chi square test. The conclusion drawn from the study was that bromelain has a significant effect on swelling, mouth opening and pain after surgical removal of impacted third molar than chymotrypsin. We suggest its usage in reduction of swelling and pain post operatively after surgical removal of third molar. However further studies with larger sample size and randomizations are required to confirm the same.