Systemic Enzymes and their Role in the Reduction of Post-Operative Edema After Surgical Removal of Lower Third Molars: A Randomized Controlled Double-Blind Study

Abstract

Objectives: The most common postoperative complications after surgical removal of the impacted mandibular third molar tooth are edema, pain, and trismus. Different types of analgesics and anti-inflammatory agents have been employed to the reduction of these complications. The study aimed to evaluate the effect of systemic enzymes in controlling post-operative edema, pain, and trismus after surgical removal of impacted lower third molars. Methods: The enzyme combination of trypsin, bromelain, and rutoside trihydrate was compared with that of serratiopeptidase to control post-operative sequelae following lower third molar surgery. Sixty-eight patients, who required surgical removal of impacted mandibular third molars participated in this study. They were randomly allocated into two groups (n=34 in each group). Group I received 5mg serratiopeptidase orally along with the standard medication and the other group received the enzyme combination with the standard medication. P-value <0.05 was considered to be statistically significant. Results: Five patients were lost to follow-up. The mean swelling measures were found to be non-significant when compared between the two groups (Group I vs. II-54.7 ± 3.4 Vs. 53.2 ± 3.2, p=0.34). Similarly, the differences in mean pain and mouth opening values between the study groups were found to be non-significant (p>0.05). Conclusion: There was no significant difference in the effect of the enzyme combination of rutoside, trypsin, and bromelain when compared to serratiopeptidase in the reduction of postoperative edema, pain, and trismus following lower third molar surgery.