title: Therapeutic efficacy of bromelain in impacted third molar surgery: a randomized controlled clinical study.
abstract: OBJECTIVE
  Bromelain is the name given to a family of proteolytic enzymes obtained from Ananas comosus, the pineapple plant. It is considered a potent anti-inflammatory and antiedematous substance. Surgery of impacted third molars in the outpatient setting is one of the procedures most often associated with postoperative pain and swelling. The aim of this study was to evaluate the efficacy of bromelain in reducing postoperative pain and swelling.
  
  
  METHODS
  80 patients were recruited to the study from patients attending the Maxillofacial Surgery Unit of the Istituto Stomatologico Italiano, Milan, Italy, for impacted third molar surgery. At time 0 when surgery was performed, patients started simultaneous antibiotic and analgesic therapy. On the following day, patients were divided into two groups. Patients in group 1 were prescribed bromelain. Patients in group 2 were prescribed only the analgesic if required. Three parameters were evaluated: pain, edema, and erythema. The first evaluation visit was performed 3 hours after surgery, the second 48 hours after surgery, and the final evaluation 7 days after surgery.
  
  
  RESULTS
  Postoperative pain, edema, and erythema were significantly lower in the study group than in the control group. Analgesic consumption, both in terms of days of treatment and number of tablets taken, was slightly lower in the study group. Only one adverse event was recorded, which occurred in a patient in the control group.
  
  
  CONCLUSIONS
  The present study demonstrates an important anti-inflammatory and anti-edematous effect of bromelain. Statistical analysis shows that in the group treated with bromelain the inflammatory response was significantly less than in the control group.
authors.forename: Paolo
authors.initials: P
authors.lastname: Ordesi
authors.forename: Luca
authors.initials: L
authors.lastname: Pisoni
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Nannei
authors.forename: Maurizia
authors.initials: M
authors.lastname: Macchi
authors.forename: Roberto
authors.initials: R
authors.lastname: Borloni
authors.forename: Sandro
authors.initials: S
authors.lastname: Siervo
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001963:Bromelains / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008964:Molar, Third / Q000601:surgery*; D014095:Tooth, Impacted / Q000601:surgery*; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001963:Bromelains