Bromelina e sua utilização na cirurgia buco-maxilo-facial / Bromelain and its use in oral and maxillofacial surgery / Bromelaína y su uso en cirugía oral y maxilofacial

Os medicamentos ditos naturais, denominados de fitoterápicos, são medicações que buscam atingir os resultados necessários das medicações ditas convencionais, porém sem os efeitos adversos decorrentes de alguns grupos medicamentosos. Em cirurgia Buco-Maxilo-Facial uma linha de pesquisa já consolidada e com importância significativa é o controle da dor e inflamação decorrentes dos procedimentos cirúrgicos Buco-Maxilo-Faciais. Um nutracêutico já descrito e pesquisado na literatura para substituir os anti-inflamatórios alopáticos e seus efeitos colaterais, principalmente os gastrointestinais e renais que são altamente indesejáveis, é a Bromelina. Ainda existe a necessidade de mais estudos relacionados a dose terapêuticas para diferentes tipos de cirurgia e outros nutracêuticos... (AU)

So-called natural medicines, called herbal medicines, are medications that seek to achieve the necessary results of so-called conventional medications, but without the adverse effects resulting from some drug groups. In Oral and Maxillofacial surgery, a line of research that is already consolidated and has significant importance is the control of pain and inflammation resulting from Oral and Maxillofacial surgical procedures. A nutraceutical already described and researched in the literature to replace allopathic anti-inflammatories and their side effects, mainly gastrointestinal and renal side effects, which are highly undesirable, is Bromelain. There is still a need for more studies related to therapeutic doses for different types of surgery and other nutraceuticals... (AU)

Las denominadas medicinas naturales, denominadas hierbas medicinales, son medicamentos que pretenden conseguir los resultados necesarios de los llamados medicamentos convencionales, pero sin los efectos adversos derivados de algunos grupos de fármacos. En cirugía Oral y Maxilofacial una línea de investigación ya consolidada y de gran importancia es el control del dolor y la inflamación resultantes de los procedimientos quirúrgicos Oral y Maxilofacial. Un nutracéutico ya descrito e investigado en la literatura para sustituir los antiinflamatorios alopáticos y sus efectos secundarios, principalmente gastrointestinales y renales, que son altamente indeseables, es la bromelina. Todavía se necesitan más estudios relacionados con las dosis terapéuticas para diferentes tipos de cirugía y otros nutracéuticos... (AU)

Effect of Supplementary Administration of Anaheal on Reducing Pain, Swelling and Trismus after Mandibular Third Molar Surgery: A Splitmouth Controlled Randomized Clinical Trial

Objective: To evaluate the effect of supplementary administration of Anaheal capsule in reducing pain, swelling and trismus after surgical removal of impacted mandibular third molars. Material and Methods: This single-blind controlled randomized clinical trial was conducted on 36 patients referring to Tabriz University of Medical Sciences. Each of the 36 patients had bilateral surgical removal of mandibular third molars in two sessions, with at least a 4-week interval between sessions. In the same individual, one of the sites randomly received a test medication whereas the other site was used as a control. In the test subgroup (test medication side), the first dose of Anaheal capsule was given as a 200-mg dose of bromelain immediately after surgery according to manufacturer's instructions and the subsequent doses were given at 6-hour intervals after the first dose. The medication was administrated for 3 days. In the control subgroup (control side), Anaheal was not administered. The severities of pain, swelling and maximum mouth opening (MMO) were recorded one and three days postoperatively. Paired t-test and t-test for independent samples were used. Statistical significance was defined at p<0.05. Results: A total of 72 surgical extractions were performed; 36 procedures served as control and 36 cases received Anaheal. Pain, swelling and trismus of the patients were at the highest levels one day after surgery, which decreased on day 3. However, independent t-test showed no significant differences in pain, swelling and trismus after surgery between the study subgroups (p>0.05). Conclusion: Supplementary administration of Anaheal (800 mg bromelain daily) had no significant effect on decreasing pain, swelling and trismus at 1- and 3-day intervals after surgical removal of mandibular third molars.

Efect of Anaheal (Bromelain) Drug on the Periodontal Clinical Indices in Nonsurgical Periodontal Treatment of Patients with Chronic Periodontitis

Objective: To evaluate the effect of Anaheal (Bromelain) drug on the periodontal clinical indices in nonsurgical periodontal treatment of patients with chronic periodontitis. Material and Methods: In this double blind clinical trial, 80 patients with chronic moderate periodontitis and a healthy systemic status were chosen, and divided into two 40-subject groups. Thereafter, the standard treatment of periodontitis including scaling and root planning in one session by the unit operator was performed for all patients. Eventually, one group of the patients was administered Bromelain medication (500-mg capsule twice a day) one hour before food, while the other group was given placebo. Four and eight weeks after the treatment, the clinical periodontal indicators were measured and recorded in both groups. The data were assessed using descriptive statistics and analytical test methods (Mann-U-Whitney and Chi-square). P value less than 0.05 was considered statistically significant. Results: Gingival index, probing depth and plaque index before the treatment were similar in both groups (Anaheal and placebo). However, four and eight weeks after the treatment, the three studied indices were significantly lower in the Anaheal group as compared to the placebo (p<0.05). The index of bleeding on probing was also similar before the treatment and four weeks after the treatment in both groups. However, eight weeks after the treatment, this index was significantly lower in the Anaheal group as compared to the placebo group (p<0.05). Conclusion: Administration of oral Anaheal medication after nonsurgical periodontal treatments reduced all the clinical periodontal indices among patients with chronic periodontitis as compared to the control group. Therefore, it can be a suitable substitute for the common oral industrial antibiotics.