Analgesic Efficacy of Bromelain and Bromelain Plus Turmeric for Pain Control After Orthodontic Separator Placement: A Triple-Blind Randomized Clinical Trial.

2025-04-01
Clinical and experimental dental research 11(2)
- Shabnam Ajami
- Seyyed Hadi Hosseini
- Neda Babanouri
- Zahra Hashemi

PubMed: 40260785
DOI: 10.1002/cre2.70124

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 135
Population: 135 patients over the age of 15 who required orthodontic treatment
Methods: triple-blind randomized clinical trial; 400 mg Ibuprofen (Group A), 200 mg Bromelain (Group B), 150 mg Bromelain + 300 mg Turmeric (Group C); one tablet immediately after separator placement
Blinding: Triple-blind

Large Human Trial

Objectives

This study aimed to compare the analgesic efficacy of Bromelain, Ibuprofen, and Bromelain plus turmeric for pain control after orthodontic separator placement.

Material and methods

This triple-blind randomized clinical trial included 135 patients over the age of 15 who required orthodontic treatment. The patients were randomly assigned to three groups: 400 mg Ibuprofen (Group A), 200 mg Bromelain (ANAHEAL; Group B), and 150 mg Bromelain + 300 mg Turmeric (ANAHEAL PLUS; Group C). The patients took one tablet immediately after the separator was placed. Four separators were placed at the mesial and distal regions of both maxillary first molars. The degree of pain and discomfort was measured using a visual analog scale (VAS) at the following time points: Immediately after the separator placement (T₀), 2 h posttreatment (T₁), 6 h posttreatment (T₂), 24 h posttreatment (T₃), and 48 h after separator placement (T₄). The data were analyzed using SPSS (version 15.0). Different statistical tests including ANOVA, Tukey's test, and paired t-test were utilized. p < 0.05 was considered statistically significant.

Results

Pain scores at 2 h (T1) and 6 h (T2) after separator placement differed significantly among the three groups (p = 0.006 and p = 0.025, respectively), with the Ibuprofen group experiencing significantly higher pain levels than the Bromelain and Bromelain Plus Turmeric groups. At 48 h (T4), a significant difference was observed only in chewing function (p = 0.024), where patients in the Bromelain group reported higher pain scores than those in the Ibuprofen group. Sex had no significant effect on pain perception (P < 0.05).

Conclusions

Bromelain with or without turmeric might be a useful alternative to Ibuprofen for pain control following orthodontic separator placement.

Research Insights

Bromelain→Reduced Chewing Pain
At 48 h (T4), a significant difference was observed only in chewing function (p = 0.024), where patients in the Bromelain group reported higher pain scores than those in the Ibuprofen group.
Effect
Harmful
Effect size
Small
Dose
200 mg (single dose)
Bromelain→Reduced Pain Intensity
Pain scores at 2 h (T1) and 6 h (T2) after separator placement differed significantly among the three groups (p = 0.006 and p = 0.025, respectively), with the Ibuprofen group experiencing significantly higher pain levels than the Bromelain and Bromelain Plus Turmeric groups.
Effect
Beneficial
Effect size
Moderate
Dose
200 mg (single dose)