Effectiveness of oral bromelain on third molar surgery patients: A systematic review of systematic reviews

This review aimed to evaluate the current evidence on the effectiveness of bromelain in controlling postoperative pain, swelling, and trismus associated with third the molar surgery. The search strategy produced 26 articles. After reading the abstracts, 8 articles were excluded and the full-text articles in English of the remaining 18 studies were separately examined for eligibility by 2 authors, with 12 studies being excluded because they did not fit the inclusion criteria. Finally, 6 systematic reviews satisfied the criteria for inclusion and were processed for critical evaluation, with all the included studies reporting high quality evidence according to the Grading of Recommendations, Assessment, Development, and Evaluation system. Oral Bromelain has been shown to reduce postoperative pain, improve a patient's quality of life and reduce the need for postoperative analgesics after third molar surgery. However, oral bromelain have no effect in reducing postoperative trismus and oedema.