Effectiveness of Bromelain in the control of postoperative pain after periodontal surgery: A crossover randomized clinical trial

Abstract

Background. This study aimed to compare the analgesic effects of Ibuprofen and bromelain after periodontal surgery. Methods. A double-blinded crossover clinical trial was conducted on 22 patients needing two crown lengthening surgeries without bone surgery or with limited bone surgery on two quadrants of the maxilla, with control and test sides. Each quadrant was randomly assigned to bromelain (500 GUD) or ibuprofen (400 mg). Immediately after the surgery and 6 hours after it, the first dose of the drugs was packaged in the same capsules in A and B. Postoperative pain was evaluated during the first 8 hours and on the following day using a visual analog scale (VAS). Results. Using the VAS, the Ibuprofen group showed significantly lower mean pain scores than the bromelain group at 4 hours (P=0.047). In contrast, there were no significant differences between the two groups at 2, 6, 8, 10, 12, 24, and 48 hours (P>0.05). Conclusion. The effectiveness of bromelain for pain control following periodontal surgery was comparable to that of Ibuprofen. Therefore, bromelain can be an efficient replacement for ibuprofen in managing pain after periodontal surgery, especially in patients with gastric ulceration and increased bleeding tendency.

Reduction of Post-Surgical Facial Edema Following Bromelain and Coumarin Intake in Traumatology: A Prospective Study with 100 Patients

“…Bromelain showed, through the results of this study, that it has the capacity to minimize postoperative trismus. Other studies have not shown the same results in terms of medication efficacy [16,17].…”

An Evaluation of the Effects of Pineapple-Extract and Bromelain-Based Treatment after Mandibular Third Molar Surgery: A Randomized Three-Arm Clinical Study

“…One of the most interesting nutraceuticals, bromelain, is widely used for the prevention or co-management of numerous diseases that are characterized by the presence of inflammation, edema, and algesia. Although several clinical trials have demonstrated the efficacy of bromelain supplementation in the reduction in pain [ 20 ], inflammation [ 21 ], and edematous components [ 22 ], its commercial cost is high, while the isolation and purification of bromelain from pineapple (fruit, core, stems, and leaves) is an open issue, making up 70–90% of the final extract production cost [ 23 ]. Moreover, notwithstanding the advent of novel and viable protein purification methods such as membrane filtration, reverse micellar systems, aqueous two-phase extraction, and chromatographic techniques, as well as the development of new biotechnological processes aimed at reducing production costs, various limitations persist.…”