Comparative evaluation of clinical efficacy of oral administration of tablet bromelain versus tablet ibuprofen on swelling, pain and trismus after surgical extraction of impacted mandibular third molar – a prospective double–blind randomized controlled split mouth study.

Dr Raj Merchant; Dr Jyotsna Galinde

Volume : VIII, Issue : IV, April - 2019

Comparative evaluation of clinical efficacy of oral administration of tablet bromelain versus tablet ibuprofen on swelling, pain and trismus after surgical extraction of impacted mandibular third molar – a prospective double–blind randomized controlled split mouth study.

Dr Raj Merchant, Dr Jyotsna Galinde

Abstract :

Aim and objective: The aim of this study was to compare and evaluate the efficacies of tablet omelain and ibuprofen administered orally for reducing swelling, pain, and trismus after the extraction of impacted mandibular third molars. Materials and method: Thirty consecutive patients requiring surgical removal of a bilateral mandibular impacted third molar under local anesthesia were randomly assigned to receive postoperatively tablet omelain 500mg ( Group A), and tablet ibuprofen 400mg (Group B) every 8 hours for 7 days. Standardized surgical and analgesic protocols were adopted. Swelling was evaluated using a tape measure method, pain with a visual analogue scale (VAS), and trismus by measuring the maximum interincisal distance (MID). Assessments were made on the day of surgery and on day two, five and seven after surgery. Result: Statistically significant differences were seen in the scores for swelling and trismus determined by tape measure method and MID respectively in the two treatment groups (A and B) on postoperative day two; however, no statistically significant difference was seen in the pain determined by VAS score between the two groups. The swelling seemed to be reduced significantly with omelain group A ( P=0.003) as compared to the ibuprofen group B (P=0.024) on second post operative day; but after seven days of surgery, there was no difference in the degree of edema between both the groups. On post–operative day two and seven, mouth opening was significantly more reduced in the omelain group than in the ibuprofen group (P < .05). At the first six hours, ibuprofen group B had more effective pain relief (p<0.05), but after this time point, both groups reported similar degrees of relief to pain. Hence, the oral administration of tablet omelain was found to be more effective than tablet ibuprofen in reduction of swelling and trismus post surgical extraction of third molar. Conclusion: The present study demonstrates an important anti–inflammatory and anti–edematous effect of omelain. Statistical analysis shows that omelain appears to offer a beneficial effect in the management of swelling and trismus during the postoperative period following impacted third molar surgery. So further studies are necessary to analyze different modes of administration and dosage of omelain for its use after surgical extraction of impacted mandibular third molar.