Efektivitas Gel Enzim Bromelain Terhadap Kadar Interleukin-6, Aktivitas Superoxide Dismutase dan Kedalaman Poket pada Pasien Periodontitis

Abstract

Background: Bromelain, a proteolytic enzyme derived from Ananas comosus, has demonstrated both anti-inflammatory and antioxidant properties, indicating its potential as an adjuvant therapy for periodontal inflammation. Periodontitis, a chronic inflammatory disease, is characterized by elevated pro-inflammatory mediators, oxidative stress, and destruction of the tooth-supporting strucures. Among the pro-inflammatory include interleukin-6 (IL-6), which critically regulates inflammation mechanism and osteoclast differentiation, thereby accelerating alveolar bone resorption. Concurrently, superoxide dismutase (SOD) is secreted as a biological response to counteract oxidative stress caused by reactive oxygen species. Objective: This study aimed to evaluate the effectiveness of 1% bromelain enzyme gel on interleukin-6 levels, superoxide dismutase activity, and gum-pocket depth. Methods: A controlled experimental clinical trial with a pre–posttest control group design was carried out. Subjects diagnosed with periodontitis were divided into two groups: the treatment group, which received subgingival application of 1% bromelain enzyme gel, and the control group, which received a placebo gel. The evaluated parameters included salivary IL-6 levels and superoxide dismutase (SOD) activity, as well as the pocket depth, measured before and after the intervention. Results: The treatment group exhibited a reduction in IL-6 levels with a tendency toward decreased SOD activity and pocket depth. In contrast, no significant changes were observed across all parameters in the control group. Correlation analysis revealed weak-to-moderate negative associations among changes in IL-6, SOD, and pocket depth. Conclusion: Subgingival application of 1% bromelain enzyme gel is effective in reducing inflammation and oxidative stress associated with periodontitis.