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. 2022 Feb;22(1):29-37.
doi: 10.17245/jdapm.2022.22.1.29. Epub 2022 Jan 24.

Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial

Aishwarya Ashok Gupta  1 , Rajanikanth Kambala  1 , Nitin Bhola  1 , Anendd Jadhav  1
Affiliations

Comparative efficacy of bromelain and aceclofenac in limiting post-operative inflammatory sequelae in surgical removal of lower impacted third molar: a randomized controlled, triple blind clinical trial

Aishwarya Ashok Gupta et al. J Dent Anesth Pain Med. 2022 Feb.

Abstract

Background: Pain, edema, and trismus are predictable sequelae for surgical extraction of impacted mandibular third molars (M3M). The present study aimed to compare the anti-phlogistic potential of bromelain and aceclofenac in the reduction of post-surgical sequalae in the extraction of impacted M3M.

Method: A randomized controlled, triple-blinded clinical study included 72 patients scheduled for surgical removal of impacted M3M under local anesthesia. Randomization was performed and subjects were equally allocated to groups A (control) and B (study), who intended to receive aceclofenac and bromelain, respectively. The primary outcome variables were pain, edema, and trismus evaluated on postoperative days 2 and 7 and compared with baseline values. The secondary variables evaluated were the quantity of rescue analgesics required and the frequency of adverse effects in both groups for 7 postoperative (PO) days. Data were analyzed with a level of significance of P < 0.05.

Results: Group B demonstrated a significant decrease in the severity of edema and trismus compared to group A on both PO days 2 and 7 (P < 0.001). Bromelain demonstrated similar analgesic efficacy with an insignificant difference compared to aceclofenac (P > 0.05).

Conclusion: The present study showed that the efficacy of bromelain was comparable to that of aceclofenac in reducing inflammatory complications following surgical removal of impacted M3M. Bromelain can be considered a safe and potent alternative to routinely used aceclofenac when addressing inflammatory outcomes after surgery.

Keywords: Aceclofenac; Bromelain; Edema; Mandible; Pain; Third Molar; Trismus.

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Conflict of interest statement

DECLARATION OF INTEREST: The authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1. Pre-operative measurements for facial swelling.
Fig. 2
Fig. 2. Preoperative measurement for interincisal mouth opening (frontal view)
Fig. 3
Fig. 3. Consolidated Standards of Reporting Trials flow diagram
Fig. 4
Fig. 4. Comparison of swelling in two groups at days 2 and 7 (*: P < 0.001, #: P = 0.006, repeated measures ANOVA with post hoc pairwise comparison). Group A, aceclofenac; Group B, bromelain; Pre OP, Pre-operative.
Fig. 5
Fig. 5. Comparison of interincisal mouth opening (mm) in two groups at days 2 and 7 (*: P < 0.001, #: P = 0.008, repeated measures ANOVA with post hoc pairwise comparison). Pre OP, Pre-operative.
See this image and copyright information in PMC

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