Efektivitas Kombinasi Platelet Rich Plasma dan Tetrasiklin Gel 0,5% Berbasis Kitosan terhadap Penyembuhan Pasca Bedah Periodontal pada Periodontitis (Studi In Vivo)

Abstract

Introduction: Tetracycline, as a local antibiotic for periodontitis patients, is widely used to help relieve infections that occur because they have a high antibacterial effect and are also anti-collagenase. It is hoped that the application of tetracycline based on chitosan gel can help increase the work of tetracycline in periodontal treatment because chitosan is an adequate system for local drug release. Chitosan gel can also last a long time, release the drug more slowly and controlled, the solubility and stability of the drug are better, and the toxicity is lower. Platelet-rich plasma (PRP) is increasingly being used in the treatment of periodontal regeneration because it releases many growth factors. Autologous and allogeneic Freeze dried PRP (FD-PRP) was developed from the blood bank so that it is convenient to use for treatments that require many applications. The combination of using tetracycline and FD-PRP based on chitosan gel can help increase periodontal regeneration. Objectives: This study aims to evaluate the effectiveness of the application of chitosan-based 0.5% tetracycline gel, FD-PRP, and its combination on clinical, microbiological, histological, and immunohistochemical parameters. Methods: This study was an experimental laboratory study conducted with a posttest-only control group design on 30 Wistar rats induced by periodontitis with Porphyromonas gingivalis. The sample was divided into five groups, including one negative control group, one positive control group with only periodontal surgery treatment, and three periodontal surgery treatment groups accompanied by drug application. Clinical (Bleeding on Probing/BoP and pocket depth), microbiological (bacterial colony count), histological (fibroblast cell count and collagen density), and immunohistochemical (FGF-2 expression) parameters were evaluated on days 3 and 14. Results: This study showed there was a significant decrease in the average BoP on day 3 (p=0.022) and 14 (p=0.009) and a reduction in the average pocket depth only on day 14 (p=0.007). Significant decrease in the average number of bacterial colonies on days 3 and 14 (p=0.000). On day 14, there was an increase in the average number of fibroblast cells (p=0.017) and collagen density (p=0.023). The mean increase in FGF-2 expression was significant on day 3 (p=0.024) and 14 (p=0.017). Conclusion: The application of chitosan-based tetracycline gel, FD-PRP, and their combination plays a role in periodontal healing because it can reduce pocket depth, the number of pathogenic bacteria, increase fibroblast cell proliferation and collagen density through increasing FGF-2 expression.