Efficacy of serratiopeptidase in third molar surgery. A systematic review and meta-analysis

  • Heber Arbildo-Vega Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru.; Faculty of Human Medicine, School of Human Medicine, Universidad San Martín de Porres. Chiclayo - Peru.; Faculty of Human Medicine, School of Stomatology, Universidad Alas Peruanas. Lima – Peru. http://orcid.org/0000-0003-3689-7502
  • Alfredo Rendón-Alvarado Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru. http://orcid.org/0000-0001-9772-4336
  • Tania Castillo-Cornock Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru. http://orcid.org/0000-0001-6135-9277
  • Fredy Cruzado-Oliva Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru. http://orcid.org/0000-0003-1575-0077
  • Alex Vidal-Mosquera Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru. http://orcid.org/0000-0001-7575-8156
  • Hernán Vásquez-Rodrigo Faculty of Dentistry, School of Dentistry, Universidad San Martín de Porres. Chiclayo - Peru.; Faculty of Dentistry, School of Dentistry, Universidad Norbert Wiener. Lima - Peru. http://orcid.org/0000-0002-5926-6837

Abstract

Objective: To determine the efficacy of serratiopeptidase in third molar surgery.
Materials and Methods: A bibliographic search was carried out until April 2022, in the biomedical databases: Pubmed/Medline, Cochrane Central Registry of Clinical Trials, Scopus, Scielo and Google Scholar. Studies reporting the ef-ficacy of serratiopeptidase in third molar surgery, which were randomized clinical trials, in English and without time limits, were included. The RoB 2.0 tool was used to assess the risk of the included studies and the GRADEPro GDT tool to assess
Results: The preliminary search yielded a total of 116 articles, discarding those that did not meet the selection criteria, leaving only 10 articles. Six articles entered a meta-analysis and found that serratiopeptidase reduces trismus but not reduce inflammation and pain after third molar surgery.
Conclusions: The literature reviewed suggests that ser-ratiopeptidase is effective in reducing trismus after third molar surgery.
Keywords: Serratiopeptidase; Molar, Third; Inflammation; Pain; Trismus; Meta-Analysis.

References

1. Sayed N, Bakathir A, Pasha M, Al-Sudairy S. Complications of Third Molar Extraction. Sultan Qaboos Univ Med J. 2019;19(3):e230-5.
2. Xiang X, Shi P, Zhang P, Shen J, Kang J. Impact of platelet-rich fibrin on mandibular third molar surgery recovery: a systematic review and meta-analysis. BMC Oral Health. 2019;19(1):163.
3. Al-Moraissi EA, Al-Zendani EA, Al-Selwi AM. Efficacy of Submucosal Injection of Chymotrypsin, Oral Serratiopeptidase or Oral Dexamethasone in Reducing Postoperative Complications Following Impacted Lower Third Molar Surgery: A Prospective, Randomized, Double-Blind, Controlled Clinical Trial. Front Oral Health. 2020.
4. Chen YW, Chi LY, Lee OKS. Revisit incidence of complications after impacted mandibular third molar extraction: A nationwide population-based cohort study. PLOS ONE. 2021;16(2):e0246625.
5. Civak T, Ustun T, Yilmaz HN, Gursoy B. Postoperative evaluation of Er:YAG laser, piezosurgery, and rotary systems used for osteotomy in mandibular third-molar extractions. J Cranio-Maxillo-fac Surg Off Publ Eur Assoc Cranio-Maxillo-fac Surg. 2021;49(1):64-9.
6. de Barros DD, Dos Santos Barros Catão JS, Ferreira ACD, Simões TMS, Almeida R de AC, de Vasconcelos Catão MHC. Low-level laser therapy is effective in controlling postoperative pain in lower third molar extractions: a systematic review and meta-analysis. Lasers Med Sci. 2022;37(5):2363-77.
7. Cho H, Lynham AJ, Hsu E. Postoperative interventions to reduce inflammatory complications after third molar surgery: review of the current evidence. Aust Dent J. 2017;62(4):412-9.
8. Bao M, Du G, Zhang Y, Ma P, Cao Y, Li C. Application of Platelet-Rich Fibrin Derivatives for Mandibular Third Molar Extraction Related Post-Operative Sequelae: A Systematic Review and Network Meta-Analysis. J Oral Maxillofac Surg Off J Am Assoc Oral Maxillofac Surg. 2021;79(12):2421-32.
9. Jaroń A, Preuss O, Grzywacz E, Trybek G. The Impact of Using Kinesio Tape on Non-Infectious Complications after Impacted Mandibular Third Molar Surgery. Int J Environ Res Public Health. 2021;18(2):399.
10. Wang Y, Zhu X, Guo J, Sun J. Can Kinesio taping improve discomfort after mandibular third molar surgery? A systematic review and meta-analysis. Clin Oral Investig. 2021;25(9):5139-48.
11. Tamimi Z, Al Habashneh R, Hamad I, Al-Ghazawi M, Roqa’a AA, Kharashgeh H. Efficacy of serratiopeptidase after impacted third molar surgery: a randomized controlled clinical trial. BMC Oral Health. 2021;21(1):91.
12. Isola G, Matarese M, Ramaglia L, Cicciù M, Matarese G. Evaluation of the efficacy of celecoxib and ibuprofen on postoperative pain, swelling, and mouth opening after surgical removal of impacted third molars: a randomized, controlled clinical trial. Int J Oral Maxillofac Surg. 2019;48(10):1348-54.
13. Tiwari M. The role of serratiopeptidase in the resolution of inflammation. Asian J Pharm Sci. 2017;12(3):209-15.
14. Jadhav SB, Shah N, Rathi A, Rathi V, Rathi A. Serratiopeptidase: Insights into the therapeutic applications. Biotechnol Rep. 2020;28:e00544.
15. Sharma C, Jha NK, Meeran MFN, Patil CR, Goyal SN, Ojha S. Serratiopeptidase, A Serine Protease Anti-Inflammatory, Fibrinolytic, and Mucolytic Drug, Can Be a Useful Adjuvant for Management in COVID-19. Front Pharmacol. 2021.
16. Panthi VK, Jha SK, Chaubey R, Pangeni R. Formulation and development of Serratiopeptidase enteric coated tablets and analytical method validation by UV Spectroscopy. Int J Anal Chem. 2021;2021:e9749474.
17. Ateia YA, Al-edanni MS, Al-qurtas MI. Impact of Metformin and Serratiopeptidase in obese patients with knee Osteoarthritis. Int J Pharm Pharm Sci. 2018;37-41.
18. Bhagat S, Agarwal M, Roy V. Serratiopeptidase: a systematic review of the existing evidence. Int J Surg Lond Engl. 2013;11(3):209-17.
19. Sivaramakrishnan G, Sridharan K. Role of Serratiopeptidase After Surgical Removal of Impacted Molar: A Systematic Review and Meta-analysis. J Maxillofac Oral Surg. 2018;17(2):122-8.
20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
21. Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898.
22. Tharani Kumar S, Ashok Prasanna R, Kirubanandan JR, Elaveyini U, Prasanna Devi S, Balasubramaniam M. Postoperative Healing after Surgical Removal of Mandibular Third Molar: A Comparative Study between Two Proteolytic Enzymes. J Pharm Bioallied Sci. 2020;12(Suppl 1):S289-94.
23. Menon VD, Muthusekhar MR. Effectiveness of anti-inflammatory properties of combination of bromelain,trypsin and rutoside with combination of diclofenac and serratiopeptidase following surgical removal of impacted mandibular third molar-a randomised double blinded clinical trial. Int J Dent Oral Sci. 2021;8(9):4217-21.
24. Ramasubbu S, U AWP. Comparison of Efficacy of Oral Bromelain and Serratiopeptidase for the Control of Postoperative Sequelae Following Third Molar Surgery --A Comparative Study. J Evol Med Dent Sci. 2021;10(31):2476-81.
25. Krishna BP, Reddy BP, Yashavanth Kumar DS, Ummar M, Shekhar V, Chandra Tiwari RV. Role of Serratiopeptidase and Dexamethasone in the Control of Postoperative Swelling. Ann Maxillofac Surg. 2020;10(1):108-13.
26. Chappi D M, Suresh KV, Patil MR, Desai R, Tauro DP, Bharani K N S S, Parkar MI, Babaji HV. Comparison of clinical efficacy of methylprednisolone and serratiopeptidase for reduction of postoperative sequelae after lower third molar surgery. J Clin Exp Dent. 2015;7(2):e197-202. doi: 10.4317/jced.51868. PMID: 26155332; PMCID: PMC4483323.
27. Kannan R, Kavitha R. Comparative Study of the Anti-Inflammatory Properties of Bromelain/Serratiopeptidase as Add on Therapy to Conventional Treatment Following Impacted Third Molar Surgery. World J Pharm Res. 2015;4(8):2595-2607.
28. Murugesan K, Sreekumar K, Sabapathy B. Comparison of the roles of serratiopeptidase and dexamethasone in the control of inflammation and trismus following impacted third molar surgery. Indian J Dent Res Off Publ Indian Soc Dent Res. 2012;23(6):709-13.
29. Chopra D, Rehan HS, Mehra P, Kakkar AK. A randomized, double-blind, placebo-controlled study comparing the efficacy and safety of paracetamol, serratiopeptidase, ibuprofen and betamethasone using the dental impaction pain model. Int J Oral Maxillofac Surg. 2009;38(4):350-5.
30. Al-Khateeb TH, Nusair Y. Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars. Int J Oral Maxillofac Surg. 2008;37(3):264-8.
31. Zhang Y, Zhuang P, Jia B, Xu J, Cui Q, Nie L, et al. Persistent trismus following mandibular third molar extraction and its management: A case report and literature review. World Acad Sci J. 2021;3(1):1-1.
32. Balakrishnan G, Narendar R, Kavin T, Venkataraman S, Gokulanathan S. Incidence of Trismus in Tran-salveolar Extraction of Lower Third Molar. J Pharm Bioallied Sci. 2017;9(Suppl 1):S222-S227. doi: 10.4103/jpbs.JPBS_161_17. PMID: 29284968; PMCID: PMC5731017.
Published
2023-12-29
How to Cite
ARBILDO-VEGA, Heber et al. Efficacy of serratiopeptidase in third molar surgery. A systematic review and meta-analysis. Journal of Oral Research, [S.l.], v. 12, n. 1, p. 348-361, dec. 2023. ISSN 0719-2479. Available at: <https://joralres.com/index.php/JOralRes/article/view/joralres.2023.030>. Date accessed: 28 feb. 2024. doi: https://doi.org/10.17126/joralres.2023.030.
Section
Reviews