Comparison of efficacy of combination of proteolytic enzymes with diclofenac sodium versus diclofenac sodium alone in patients undergoing surgical extraction of moderately difficult impacted mandibular third molars

Objectives: Surgical extraction of impacted mandibular third molar in many cases leads to debilitating post-operative complications which are routinely managed with drugs like corticosteroids, NSAID’s and opiods. Unfortunately these drugs carry their share of side effects; hence a natural, effective and safe remedy that lacks undesired side effects is desired. The aim of this study is to evaluate the efficacy of various proteolytic enzymes (trypsin, bromelain, rutoside trihydrate and serratiopeptidase) with diclofenac sodium in comparison with diclofenac sodium alone in reducing the postoperative complications like pain, swelling, trismus. Materials and Methods: This study was conducted in 30 patients randomly selected and divided into 3 groups of 10 patients each. The postoperative complications were recorded and evaluated on 1st, 3rd, 5th and 7th postoperative days. Results: In group II patients, significant improvement in reduction of pain, trismus and quality of life was seen on 1st, 3rd, 5th and 7th postoperative days as compared to group I and III. In group III patients’ significant improvement in mouth opening and reduction of pain was observed on 5th and 7th postoperative days however significant improvement on quality of life was seen on 3rd, 5th and 7th postoperative days. Conclusion: In surgical extraction of moderately difficult impacted teeth ; bromelain, trypsin, rutosidetrihydrate with diclofenac sodium was effective in pain control, increased mouth opening and improved quality of life than seratiopeptidase with diclofenac sodium when comparing with diclofenac sodium alone.