Postoperative healing after surgical removal of mandibular third molar: A comparative study between two proteolytic enzymes

Abstract

A BSTRACT Objective: The postoperative symptoms after third molar removal surgery were commonly uneventful. The aim of this study was to compare two proteolytic enzymes from different origin and to prove which enzyme provides a faster healing. One of the proteolytic enzymes involves a combination with a flavonoid. This involves trypsin, bromelain, along with a flavonoid rutin. Another proteolytic enzyme is serratiopeptidase that helps in degradation of insoluble proteins causing reduced swelling in the operated site. Materials and Methods: In this study, voluntary subjects of clinically indicated bilateral lower third impaction were selected. The subjects were recommended to undergo extraction of impacted teeth in two sittings, one extraction per visit. In the first sitting, subjects were prescribed trypsin, bromelain, and rutin combination after removal of 48 teeth and in the second sitting subjects were prescribed serratiopeptidase after removal of 38 teeth. There was a time interval of 2–3 weeks in between the sittings. The post findings such as mouth opening, swelling, and pain scale were noted. Results: The results showed that the proteolytic enzyme combination of trypsin, bromelain, and rutin is better than serratiopeptidase. Conclusion: It is recommended that trypsin, bromelain, and rutin combination can be used effectively for postoperative purpose to facilitate wound healing.

Comparison of the Efficacy of Corticosteroids With Enzymatic Agents in the Postoperative Sequelae for Lower Third Molar Surgery: A Prospective Study

“…Treatment with corticosteroids was associated with significantly less edema during and late assessments and less trismus (measured as improved jaw movement) at early assessment and late assessment than control treatments. Steroid medication has proved to be well suited to the treatment of postoperative pain, trismus, and swelling after dental surgical procedures [ 7 ]. Adjunctive analgesics include steroids.…”

“…Although their use is primarily not in pain management, they have demonstrated analgesic properties in certain painful situations. These medications are called secondary analgesics, co-analgesics, auxiliary analgesics, and non-indication drugs, all of which have different mechanisms of action [ 6 , 7 ]. As a result, the majority of steroids only function as adjuvants to prevent oral soft tissue edema and inflammation, which aggravate pain.…”

Comparison of Efficacy of Coumarin and Chymotrypsin/Trypsin in Patients Undergoing Surgical Removal of Lower Third Molars: A Prospective Study

“…In all these conditions, the chance of uncontrollable bleeding drastically increases [ 19 ]. Common drugs that can interact with coumarin are thrombolytic agents like streptokinase, heparin, and aspirin; antibiotics like ciprofloxacin; and non-steroidal anti-inflammatory drugs like Ibuprofen or diclofenac [ 20 ]. Hence it should be prescribed after proper history taking and evaluation by the physician.…”

The effect of kaempferol on the dentin bonding stability through matrix metalloproteinases inhibition and collagen crosslink in dentin biomodification

“…Although there is no solid evidence regarding its effects on long-term bonding stability, these agents have been shown to improve the bonding durability in several studies. 10 , 11 , 12 , 13 , 14 …”