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Oral Health CareTrypsinNCT07269171

The Effect of Supplementary Foods Containing Trypsin, Chymotrypsin and Serratia Peptidase on Healing After Impacted Wisdom Tooth Surgery

A study testing Pain Assessment, Number of Analgesics Needed and Edema Assessment in people with Oral Health Care, run by Saglik Bilimleri Universitesi at 1 site in Turkey (Türkiye).

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

Introduction: The aim of this study was to determine the effects of a dietary supplement containing trypsin, chymotrypsin, and serratia peptidase (Tripser Forte N30, Incir Pharma, Turkey) on postoperative healing and to determine the differences between the groups. Read more about this study

Who is it for?
Ages 18 to 45 yearsHealthy volunteers can take part
Conditions the study is for
Oral Health Care
What is being tested?
Pain Assessment, Number of Analgesics Needed and Edema Assessment
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
15 participants
Where
1 siteTurkey (Türkiye)
Study dates
1 Dec 2025to 10 Mar 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 45 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Having a mandibular third molar with a unilateral or bilateral Class 2, Position A or B impaction according to the Pell and Gregory classification
  • Being systemically healthy (ASA Class I)
  • Aged between 18 and 45 years (young adult age group)
  • Willingness to participate in the study

Who cannot join

  • Age outside the specified range
  • Pregnancy
  • Currently breastfeeding
  • Presence of infection in the third molar region (e.g., acute pericoronitis)
  • Presence of cystic or tumoral lesions associated with the impacted third molar
  • History of allergic reactions
Show all 10Show fewer
  • Presence of any systemic disease
  • Unwillingness to participate in the study
  • Poor oral hygiene that may negatively affect healing
  • Smoking or alcohol addiction

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Özgün YILDIRIM, Doctor, Assistant Professor contact

+905366687527

ozgunyldrm89@gmail.com

Turkey (Türkiye)1 site
  • Health Sciences University

    Ankara

Other trials in Turkey (Türkiye)

About this study

Official title: Evaluation of the Effects of Dietary Supplements Containing Trypsin, Chymotrypsin and Serratia Peptidase on Postoperative Edema, Pain and Trismus After Mandibular Impacted Third Molar Extraction.

Introduction: The aim of this study was to determine the effects of a dietary supplement containing trypsin, chymotrypsin, and serratia peptidase (Tripser Forte N30, Incir Pharma, Turkey) on postoperative healing and to determine the differences between the groups. The aim was to identify differences between the groups regarding postoperative pain, edema, and trismus levels.

Material and Method: Demographic data before surgery will be recorded on the patient follow-up form (Appendix 1). All surgical procedures will be performed under sterile conditions following the administration of local anesthesia (80 mg articaine hydrochloride and 0.02 mg epinephrine, Maxicaine Fort ampoule, Vem Pharmaceuticals, Istanbul, Turkey) with inferior alveolar block anesthesia and buccal mucosa anesthesia. Procedure monitoring will begin after the incision is made and will conclude with suturing. Osteotomy (bone removal) and, if necessary, root dissection will be performed using a surgical handpiece, accompanied by irrigation with sterile saline solution. Following tooth extraction, the socket will be examined, and any sharp bony prominences will be removed. The area will be closed primarily using non-resorbable silk suture material (3/0 surgical silk suture, Doğsan, Turkey). A sterile tampon will be applied to the procedure area, and the patient will be instructed to bite on the tampon for 20 minutes before removing it and replacing it with another material. As a standard postoperative approach, all patients in group 1 received antibiotics (875 mg Amoxicillin+125 mg clavulonic acid, Augmentin-BID film coated tablets, GlaxoSmithKline, Istanbul, Turkey), analgesics (25 mg dexketoprofen, Arveles tb, UFSA Pharmaceutical Industry and Trade Inc. Davutpasa Cad. No.12 (34473) Topkapi/Istanbul) and mouthwash (100 ml solution containing 120 mg (%0.12) chlorhexidine gluconate and 150 mg (%0.15) benzydamine hydrochloride) for use after surgery. Drogsan Pharmaceutical Industry and Trade Inc. Oguzlar neighborhood, 1370.sokak 7/3 Balgat 06520 Cankaya/Ankara). Patients will be instructed to take antibiotics morning and evening for 5 days, use mouthwash for 7 days starting the day after the procedure, and use mouthwash only when deemed necessary. They will be asked to record the amount they use on the provided home assessment form (Appendix 2). Patients in Group 2 will be given a dietary supplement containing trypsin, chymotrypsin, and serratia peptidase (Tripser Forte N30, Incir Pharma, Turkey) in addition to the medications mentioned above. Patient follow-up procedures will be the same.

All patients will be evaluated on the 1st, 2nd, 3rd, and 7th postoperative days, and pain, edema, and trismus will be recorded.

Read the detailed description

Impacted tooth extractions are the most common clinical procedure in oral and maxillofacial surgery. As with other oral surgical procedures, they are associated with a wide variety of complications, including swelling, pain, limited mouth opening (trismus), bleeding, nerve damage, and delayed healing (1-3). These complications develop following the inflammatory response to the surgical intervention and can be related to factors such as age, gender, systemic condition, position of the impacted tooth, poor oral hygiene, smoking, surgical experience, and duration of the procedure (3). However, the most common complications are pain, swelling, and limited mouth opening. These can lead to a decrease in quality of life, loss of work, and restrictions on social activities (4). To reduce the inflammation that occurs after impacted tooth extraction and to reduce the severity of the aforementioned complications, various medications can be used under the heading of pharmacological methods, or additional non-pharmacological methods such as modified surgical methods, drain placement, low-power laser applications, cold therapy, and physical therapy (5-8). Trypsin, chymotrypsin, and serratia peptidase are proteolytic enzymes and stand out for their various biological functions. The use of these enzymes after surgical interventions such as tooth extraction is being investigated to reduce complications such as postoperative edema, pain, and trismus during the healing process (9).

Proteolytic enzymes such as trypsin, chymotrypsin, and serratia peptidase, when used in conjunction with each other, may contribute to the reduction of postoperative edema, pain, and trismus. Each of these enzymes controls inflammation in different ways, can accelerate the healing process by degrading protein, and promotes faster tissue recovery after surgical trauma (10).

Trypsin is a protease produced by the pancreas and activated in the small intestine. Trypsin contributes to the digestive process by breaking down proteins into peptides and amino acids. Trypsin may help accelerate the healing process, particularly in the body, due to inflammation and tissue damage. This enzyme has effects such as reducing edema, wound healing, and controlling inflammation. It is frequently used after surgical interventions, such as tooth extractions, because it reduces postoperative edema and provides pain relief (11). Studies evaluating the effects of dietary supplements containing trypsin, chymotrypsin, and serratia peptidase after third molar surgery are available in the literature. The primary objective of this study was to clinically evaluate the effects of dietary supplements containing trypsin, chymotrypsin, and serratia peptidase on postoperative edema, pain, and trismus in the postoperative period of mandibular third molar extractions.

Being tested
Pain Assessment, Number of Analgesics Needed, Edema Assessment, Trismus Assessment
Keywords
nutritional supplements, oral and maxillofacial surgery, wisdom teeth, trypsin, chymotrypsin and serratia peptidase

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Pain AssessmentProcedure or surgery

    Pain will be assessed using a VAS on the 1st, 2nd, 3rd, and 7th postoperative days. For this purpose, the patient will be shown a 100-mm line with "0" at the left end and "100" at the right end. They will be instructed to mark the point on this line where their pain corresponds. The distance from the marked point to "0" will be measured with a ruler, and the resulting value will be recorded in mm to obtain the VAS score. Changes in these measurements will be recorded.

  • Number of Analgesics NeededProcedure or surgery

    In addition, the number of analgesics required by the patients up to the 7th postoperative day will be recorded.

  • Edema AssessmentProcedure or surgery

    To assess edema, the tragus, lateral cauntus, corner of the mouth, and soft tissue pogonion points on the patient's face were marked preoperatively. Preoperatively, on the first, second, third, and seventh postoperative day, measurements will be taken and recorded between the Gonion-corner of the mouth, the Tragus-corner of the mouth, and the Gonion-lateral cauntus points.

  • Trismus AssessmentProcedure or surgery

    To assess trismus, the distance between the incisal edges of the upper and lower incisors will be measured and recorded with the mouth maximally open, preoperatively, and on the first, second, third, and seventh postoperative day.

Study groups in NCT07269171
Study groupRoleWhat they receive
Study groupExperimentalPatients undergoing right mandibular third molar surgery will receive standard postoperative medication: painkillers (dexketoprofen 25 mg), antibiotics (amoxicillin 875 mg + clavulanic acid 125 mg), and a chlorhexidine 0.12% + benzydamine 0.15% mouthwash. Demographic data will be recorded preoperatively. All surgeries will be performed under sterile conditions with inferior alveolar nerve block and buccal infiltration using articaine 4% with epinephrine 1:100,000. Operation time will be measured from incision to last suture. Osteotomy and, when necessary, tooth sectioning will be performed with a surgical handpiece and saline irrigation. After extraction, sockets will be smoothed and closed with 3-0 silk sutures. Patients will be reviewed on postoperative days 1, 2, 3, and 7, and pain, edema, and trismus will be recorded.
Receives: Procedure: Pain Assessment; Procedure: Number of Analgesics Needed; Procedure: Edema Assessment; Procedure: Trismus Assessment
Control groupExperimentalPatients undergoing right mandibular third molar surgery will receive standard postoperative medication, including dexketoprofen 25 mg, amoxicillin 875 mg + clavulanic acid 125 mg, and a 0.12% chlorhexidine + 0.15% benzydamine mouthwash. Demographic data will be recorded preoperatively. All operations will be performed under sterile conditions with inferior alveolar nerve block and buccal infiltration using 4% articaine with 1:100,000 epinephrine. Surgical time will be measured from incision to final suture. Osteotomy and, when required, tooth sectioning will be performed with a surgical handpiece and saline irrigation. After extraction, sockets will be smoothed and closed with 3-0 silk sutures. Patients will be evaluated on postoperative days 1, 2, 3, and 7 for pain, edema, and trismus. In addition, the control group will receive a dietary supplement containing trypsin, chymotrypsin, and serratiopeptidase (Tripser Forte N30, Incir Pharma, Türkiye), with identical follow-up.
Receives: Procedure: Pain Assessment; Procedure: Number of Analgesics Needed; Procedure: Edema Assessment; Procedure: Trismus Assessment

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Wound healing status on postoperative day 7

    The surgical site will be clinically evaluated for wound healing on day 7 after surgery using a standardized Early Wound Healing Index (EHI), which assesses clinical signs such as redness, swelling, bleeding, and epithelialization. The EHI is scored on a scale from 0 to 5, where 0 indicates very poor healing and 5 indicates excellent healing. Higher scores reflect better healing outcomes. Unit of Measure: Early Wound Healing Index score (0-5)

    Measured: Postoperative day 7

  2. Change in pain levels after mandibular third molar surgery

    Pain levels will be assessed daily for 7 days following mandibular third molar surgery using the Visual Analog Scale (VAS), a 10-centimeter scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. Patients will complete the VAS form daily, and the average score across the 7-day period will be calculated for each participant. Unit of Measure: Visual Analog Scale score (0-10)

    Measured: From postoperative day 1 to day 7

  3. Change in burning sensation levels after mandibular third molar surgery

    Burning sensation levels will be assessed daily for 7 days following mandibular third molar surgery using the Visual Analog Scale (VAS), a 10-centimeter scale ranging from 0 (no pain) to 10 (worst imaginable pain). Higher scores indicate greater pain intensity. Patients will complete the VAS form daily, and the average score across the 7-day period will be calculated for each participant. Unit of Measure: Visual Analog Scale score (0-10)

    Measured: From postoperative day 1 to day 7

  4. Change in facial edema after mandibular third molar surgery

    Facial edema will be assessed on postoperative days 1, 2, 3, and 7 following mandibular third molar surgery. Swelling will be measured using standardized linear facial measurements obtained with a flexible tape measure between fixed anatomical points (e.g., tragus-oral commissure, tragus-pogonion, and lateral canthus-gonion). The sum of these distances will be recorded at each visit, and the change in facial measurement values over time will be used to evaluate edema. Higher values indicate greater facial swelling.

    Measured: Days 1,2,3 and 7

  5. Change in trismus (maximum mouth opening) after mandibular third molar surgery

    Trismus will be evaluated on postoperative days 1, 2, 3, and 7 by measuring maximum mouth opening using a calibrated ruler or caliper. Maximum interincisal distance (between the incisal edges of the upper and lower central incisors) will be recorded at each time point. The change in maximum mouth opening over time will be used to assess trismus. Lower interincisal distance values indicate greater trismus.

    Measured: Days 1,2,3 and 7

Secondary outcomes (1)
  1. Number of analgesic tablets consumed postoperatively

    Participants will record the number of analgesic tablets taken each day for 7 days after surgery in a home diary. The total number of tablets consumed will be calculated. Unit of Measure: Number of tablets per patient

    Measured: From postoperative day 1 to day 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Dec 2025
  2. Study start1 Dec 2025 (estimated)
  3. Primary completion28 Feb 2026 (estimated)
  4. Study completion10 Mar 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
15 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07269171
Sponsor's protocol ID
15.05.2025-2025/9-9/11
Acronym
Trypsin
Status last verified
Nov 2025
First submitted
25 Nov 2025
Last updated
8 Dec 2025
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Patient information will be kept confidential.

Questions about this trial

What is this clinical trial studying?

A study testing Pain Assessment, Number of Analgesics Needed and Edema Assessment in people with Oral Health Care, run by Saglik Bilimleri Universitesi at 1 site in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 8 Dec 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Özgün YILDIRIM, Doctor, Assistant Professor (+905366687527, ozgunyldrm89@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Wound healing status on postoperative day 7 (time frame: Postoperative day 7). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Dec 2025.

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