article · Nigerian Dental Journal
Surgical removal of impacted lower wisdom teeth often leads to pain, facial swelling, and jaw stiffness, reducing patient quality of life right after surgery. While corticosteroid medications such as prednisolone control these symptoms well, some practitioners hesitate to prescribe steroids. This clinical trial compared the effectiveness of prednisolone against Kotase, an enzyme-based treatment combining bromelain and trypsin, in eighty-four patients undergoing wisdom tooth extraction. Researchers monitored pain levels, facial swelling across multiple facial measurements, and jaw opening restrictions. In both treatment groups, the severity of symptoms peaked on the first day following surgery. Statistical comparisons revealed no significant differences in pain, facial swelling, or jaw stiffness between the two medications, indicating that Kotase matches the performance of prednisolone in managing post-operative inflammation.
Wisdom tooth removal commonly triggers uncomfortable swelling, stiffness, and pain. Some healthcare providers prefer to avoid steroid medications to manage these issues. Demonstrating that an enzyme-based alternative provides comparable relief gives clinicians and patients a viable non-steroid treatment option for post-operative recovery.
This research provides clinical trial evidence for oral surgeons and dental practitioners seeking alternative therapies for post-operative care. Because Kotase is already formulated as a fixed-dose enzyme combination, the findings support applied, near-market clinical adoption for post-extraction management, offering pharmaceutical distributors and clinics an alternative to steroid-based protocols.
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Background The sequelae of surgical disimpaction of mandibular third molars negatively impact patients' quality of life in the immediate post-operative period. Some clinicians have shown reluctance to use steroids in oral surgery, though they provide excellent control of the postoperative inflammatory triad following third molar disimpaction. Kotase, a fixed-dose combination of two enzymes (Bromelain and Trypsin), has also been effective in reducing postoperative inflammation. Methods We conducted a randomized controlled trial at the General Hospital, Lagos Island. Eighty-four participants were randomized into two treatment groups: Prednisolone and Kotase. Pain was assessed using a visual analogue scale (VAS). Facial swelling was measured using linear distances from the tragus to pogonion, tragus to the angle of the mouth, and gonial angle to the lateral canthus of the eye. Trismus was measured using a pair of dividers. Data were analyzed using SPSS version 20. Chi-square and Student's t-tests were used for comparisons, with p < 0.05 considered significant. Results The socio-demographic and clinical characteristics of participants were similar in both groups. The highest intensity of sequelae occurred on the first postoperative day in both groups. Pain was not statistically significant (t = 0.067, p = 0.946). Facial volumetric variation in the tragus–oral commissure plane (t = 0.369, p = 0.713), tragus–pogonion plane (t = 0.959, p = 0.341), and outer canthus–gonial plane (t = 1.523, p = 0.132) showed no significant differences. Trismus was also not statistically significant (t = 0.890, p = 0.376). Conclusion Kotase was observed to be as effective as prednisolone in mitigating postoperative inflammatory sequelae following mandibular third molar disimpaction
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DOI: 10.61172/5mtab048
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