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

The most common postoperative complications after surgical removal of impacted mandibular third molar tooth are edema, pain and trismus. Different types of analgesics and anti-inflammatory agents have been employed for reduction of these complications. The aim of the study was to evaluate the effect of systemic enzymes to control post-operative edema, pain and trismus after surgical removal of impacted lower third molars. The enzyme combination of trypsin, bromelain, 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, 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 was found to be non-significant (p>0.05). 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 post-operative edema, pain and trismus following lower third molar surgery.