An Evaluation of the Effect of Bromelain Drug in the Improvement Process Mouth and Teeth Wounds: A Systematic Review and Meta-analysis

Abstract

Bromelain is a major protease enzyme that is found in pineapple. This enzyme has been used as a natural remedy in the treatment of diseases for years. Over the past few years, due to nonsteroidal drugs’ side effects, the tendency to use bromelain has increased. Therefore, the aim of this study is to systematically review and meta-analysis the clinical evidence of bromelain in minimizing inflammatory problems such as pain, swelling, and trismus after oral surgery. Materials and methods: In this study, a coherent search strategy was designed to retrieve articles in databases such as PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to April 2021. Then, the consequences of pain, swelling, and trismus were considered and a meta-analysis was used to combine the results. Eventually, in order to assess heterogeneity, I2 index was used and to check the heterogeneity, R software was performed for the analysis of data. Conclusion: After selecting studies based on inclusion and exclusion criteria and assessing the quality of studies,6 studies were included in the meta-analysis. Bromelain can have a good effect on reducing the consequences of surgery (pain, swelling, and trismus). In fact, it can be said that, in the first 24 hours, its effect in reducing the consequences is statistically significant. However, for a better certainty in clinical decision-making, there is a need for conducting more rigorous research studies so that more evidence can be obtained