Analgesic, anti-inflammatory, and wound healing efficacy of Triphala guggulu and ketorolac tromethamine after periodontal flap surgery: A randomized double-blind clinical trial

Background: Ensuring effective pain management following periodontal flap surgery is crucial. Triphala guggulu is an Ayurvedic polyherbal formulation and is used to manage a number of conditions such as Shotha (~inflammation), Arsha (~hemorrhoids), Gulma (~type of lump), etc. Aim: Considering the potential benefits of Ayurvedic medication, this study evaluated the analgesic, anti-inflammatory, and wound-healing properties of Triphala guggulu and ketorolac tromethamine following periodontal flap surgery. Materials and Methods: Two groups of 20 outpatients from the Department of Periodontology, KVG Dental College, Sullia, were selected for this study. Patients scheduled for periodontal surgery were randomly assigned to receive either Triphala guggulu (500 mg) or ketorolac tromethamine (10 mg) at least 30 min before the administration of local anesthesia. Pain intensity was assessed using the Visual Analog Scale (VAS) scale for the first 8 h on the day of surgery and two times (morning and night) for the next 2 days. Tissue response (tissue color and edema), wound healing, and patient discomfort were evaluated on the 7 th day postoperatively. The data was analyzed using the Chi-square test. Results: The VAS pain scale demonstrated a significant pain reduction in both groups, with Triphala guggulu providing slightly greater pain relief than ketorolac tromethamine ( P < 0.05). Both groups showed better tissue response and wound healing after the surgical procedure. Patients reported fewer adverse effects with Triphala guggulu , making it a safer and well-tolerated analgesic for pain management. Conclusion: The present study concluded that both drugs significantly reduced postoperative pain in all subjects following periodontal flap surgery. In addition, tissue color, tissue edema, postoperative discomfort, and wound healing showed marked improvement after 1 week. Both medications significantly reduce pain and enhance tissue response and healing, but Triphala guggulu showed slightly superior pain relief and fewer adverse effects, making it a safer option for patients.