Combination of trypsin, rutoside, bromelain and diclofenac sodium in the management of internal derangement of temporomandibular joint: A randomized clinical trial

Gupta, Prashant; Naik, Shantala R; Ashok, L; Poornima, R; Shetty, Ranjani

doi:10.4103/jiaomr.jiaomr_45_20

Cited by 2 publications

(7 citation statements)

References 1 publication

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“…The studies used a numerical pain scale to evaluate the efficiency of the drug (Table 1). (normal range: 5 mm to 10 mm for tips and contralateral joint movements), TMJ noise, intermittent joint lock, and deflection or deviation of the mandible during mouth opening [15].…”

Section: Resultsmentioning

confidence: 99%

“…For the treatment of internal derangement of the TMJ, we advise combining enzymes and diclofenac [15].…”

Section: Discussionmentioning

confidence: 99%

“…Risk of bias domains evaluated for [14,15] The tool incorporates signaling questions aimed at extracting information regarding critical aspects of the studies, particularly concerning the bias risk. Studies were categorized as having a "low," "moderate," "some concerns," "no information," or "high" bias risk.…”

Section: Figure 2: Risk Of Dias Domainsmentioning

confidence: 99%

“…Additionally, they were advised to perform jaw exercises and apply moist heat. This group served as the comparison group in the study [15].…”

Section: Comparisonmentioning

confidence: 99%

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Anti-inflammatory Role of Trypsin, Rutoside, and Bromelain Combination in Temporomandibular Joint Osteoarthritis: A Systematic Review

Shekhar,

Maddheshiya,

et al. 2024

Cureus

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The objective of this systematic review was to assess the effectiveness, acceptability, and safety of systemic enzyme therapy, consisting of trypsin, bromelain, and rutoside trihydrate, as an anti-inflammatory agent, either when utilized independently or in conjunction with non-steroidal anti-inflammatory drugs (NSAIDs). This systematic review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two studies met the inclusion criteria and were assessed in the review. The bias risk was evaluated using the risk-of-bias tool for randomized trials (RoB 2). Both studies revealed highly significant results for the study population. Individuals receiving oral enzymes and diclofenac sodium combination therapy showed a significant improvement in pain reduction, better eating, and mouth opening, as well as a decrease in joint noise and jerky mandibular motions. Patients receiving systemic enzyme therapy with diclofenac combinations performed better than those receiving NSAIDs alone, and the differences were quite substantial. For the treatment of internal derangement of the temporomandibular joint (TMJ), we recommend combining enzymes and diclofenac. Systemic enzyme therapy can be used in the treatment of TMJ osteoarthritis, as it shows a highly significant result in the study population.

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Section: Resultsmentioning

confidence: 99%

“…For the treatment of internal derangement of the TMJ, we advise combining enzymes and diclofenac [15].…”

Section: Discussionmentioning

confidence: 99%

Section: Figure 2: Risk Of Dias Domainsmentioning

confidence: 99%

“…Additionally, they were advised to perform jaw exercises and apply moist heat. This group served as the comparison group in the study [15].…”

Section: Comparisonmentioning

confidence: 99%

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Anti-inflammatory Role of Trypsin, Rutoside, and Bromelain Combination in Temporomandibular Joint Osteoarthritis: A Systematic Review

Shekhar,

Maddheshiya,

et al. 2024

Cureus

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“…Some other titles/abstracts were also excluded (n = 6) because of not having been published in English (n = 1, 22), being irrelevant to the aim of the study (n = 1, 23), and not being able to retrieve the full text (n = 4, 24-27). Finally, 15 articles were selected for the final assessment (4,21,(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39). These articles mainly examined outcomes such as joint pain, joint stiffness, physical movements and joint range of motion, quality of life (especially in physical dimensions), and indicators related to joint health and abilities related to it.…”

Section: Search Results Study Characteristics Of Selected Studiesmentioning

confidence: 99%

The effects of bromelain on osteoarthritis symptoms: A systematic review

Asgari Savadjani,

Yadollahi,

Khaghani

2023

J Shahrekord Univ Med Sci

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Background and aims: Osteoarthritis (OA) is the most common skeletal and excruciating disease worldwide. This study aimed to investigate bromelain’s effect and underlying mechanism on OA symptoms. Methods: This systematic review was designed according to the PRISMA guidelines. An extensive search was undertaken in various databases, including PubMed, Web of Science, EMBASE, and Scopus. Finally, 14 articles were retrieved considering the inclusion and exclusion criteria of the study. The desired data were extracted and entered into an Excel file, and the outcomes of the studies underwent investigation. Results: Bromelain downregulates inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin 6 (IL-6), IL-8, IL-1β, and interferon γ expression in synovial fibroblasts. In addition, bromelain inserts analgesic effects by decreasing vascular permeability to bradykinin and inhabitation its generation. Bromelain counteracts by increasing the levels of TNF-α, IL-1β, inducible nitric oxide synthase (iONS) levels, and lipid peroxidation while reducing those of superoxide dismutase, catalase, and prolidase. Another main antinociceptive effect property of bromelain is associated with its anti-inflammatory effect by relieving neuroinflammation and synovial membrane inflammation. Conclusion: Bromelain indicated good therapeutic effects on reducing OA symptoms due to its anti-inflammatory and antioxidant effects. Although no specific bromelain-related side effects were not reported in the included studies, it is recommended that more laboratory studies should be conducted with different doses and appropriate methodology.

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Combination of trypsin, rutoside, bromelain and diclofenac sodium in the management of internal derangement of temporomandibular joint: A randomized clinical trial

Cited by 2 publications

References 1 publication

Anti-inflammatory Role of Trypsin, Rutoside, and Bromelain Combination in Temporomandibular Joint Osteoarthritis: A Systematic Review

Anti-inflammatory Role of Trypsin, Rutoside, and Bromelain Combination in Temporomandibular Joint Osteoarthritis: A Systematic Review

The effects of bromelain on osteoarthritis symptoms: A systematic review

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