Published: 2022-09-23

Trypsin, bromelain and rutoside in dental pathologies-synergistic action and qualitative metanalysis of investigator-initiated studies

Shashank Tiwari, Bhushan M. Khemnar, James John, Ganesh H. Divekar


Inflammation, which manifests as pain and swelling, forms the basis of various dental pathologies like dental caries and pulpitis. Inflammation is also associated with tissue injury in cases of surgical processes like tooth extraction, root canal treatment or third molar extraction. Various drugs which help reducing inflammation are used in the treatment of dental pathologies. In this article, the mechanism of action of trypsin, bromelain and rutoside is mapped to show the clinical benefit. To demonstrate comparative benefit of trypsin, bromelain, and rutoside combination, a literature search was carried out for real-world investigator-initiated studies. A qualitative analysis of these studies was carried out. All 7 studies, identified in literature, controlled clinical studies comparing efficacy and safety of combination of trypsin, bromelain, and rutoside with that of non-steroidal anti-inflammatory drugs like diclofenac, versus other anti-inflammatory enzymes like trypsin-chymotrypsin combination or serratiopeptidase. All studies have demonstrated efficacy benefit of combination of trypsin, bromelain and rutoside. Importance and place of trypsin-bromelain-rutoside combination in therapy of dental pathologies, is further emphasized based on the results of this review.


Inflammation, Pain, Swelling, Enzymes, Flavonoids

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