Comparison between Bromelain and Ibuprofen for postoperative pain control following dental implant palecment surgery

Abstract

Introduction: Today, dental implants are one of the most commonly used therapeutic choices for replacing missing teeth. Due to flap and bone preparation during an implant surgery tissue ischemia and acute inflammation, resulting in mild to severe pain following surgery. Typically, non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to control mild to moderate pain after implant surgery. Ibuprofen is the first choice for minimizing the risk of digestive problems. The use of non-steroidal anti-inflammatory drugs, due to their inhibitory effect, can have a negative effect on osseointegration. This may have a major challenge on controlling the pain after an implant surgery. Bromelain contains a combination of proteolytic enzymes extracted from pineapple. This drug is used to block the bradykinin and The onset of prostaglandin synthesis has an anti-inflammatory and analgesic effect. Clinical studies have shown that bromelain is helpful in treating many diseases. Considering the recent contradiction and the fact that a study on the effects of bromelain in the treatment of dental implant surgery (which is one of the most common oral surgeries) has not been performed. The purpose of this study was to investigate the effect of Bromelain on Controling the pain after an implant surgery and to compare its effectiveness with the commonly used drug is ibuprofen. Materials and methods: This cross sectional and single-blind clinical trial was performed in 40 patients requiring placement of implants in the maxillary or mandibular premolar area of the jaw. For each patient who was entered the study, they were examined by an oral and maxillofacial surgeon under local anesthesia with lidocaine 2% and epinephrine 1/80000 according to Standard Two Stage protocol, appropriate diameter and length implants (Daegu-Dentis-Korea) was placed in the edentulous area. After covering the cover screw, the gum tissue was sutured. The patients were randomly divided into two groups of 20. For the first group, Ibuprofen 400mg (Ibuprofen400-Abidi-Iran-Tehran) was prescribed an oral tablet for 5 days every 8 hours.Post-operative pain is initial outcome that will be assessed at 1, 3, 6, days after surgery with using visual analog scale (VAS).For the second group, Bromelin 500 mg (Bromelain500-Parmoon Amin -Iran-Tehran) was prescribed an oral tablet for 5 days every 8 hours. Post-operative pain is initial outcome that will be assessed at 1, 3, 6, days after surgery with using visual analog scale (VAS). Findings: The results showed that bromelain is similar to ibuprofen for pain controling after implant surgery showed. so that these results could explain the reason for taking bromelain as an alternative to non-steroidal anti-inflammatory drugs following implant surgery.

Conclusion: The results of this study showed that oral administration of bromelain is effective in reducing the pain following an implant surgery in comparison with patientsn which treated with ibuprofen is not significant.