Fektivitas Kombinasi Platelet-Rich Plasma dan Metronidazole Gel Berbasis Kitosan terhadap Penyembuhan Pasca Bedah Periodontal Studi In Vivo

Abstract

Introduction: Periodontitis is inflammatory disease at tooth-supporting tissue that cause loss of attachment and bone loss progressively. The purpose of periodontitis treatment is to eliminate inflammation, to prevent development of the disease and to regenerate the loss periodontal tissue. Application of platelet-rich plasma and local antibiotic, such as metronidazole can give beneficial effect to promote healing. Aim: The aim of this research is to prove effectivity of freeze-dried platelet-rich plasma (FD-PRP) and chitosan-based metronidazole gel combination application to promote periodontal wound healing. Methods: This research is experimental laboratory research with pre and post-test only control group design to analyzed microbiology (Porphyromonas gingivalis colonies), clinical (BOP and probing depth), histologic (fibroblast cell count and collagen density) and immunohistochemistry (PDGF-BB expression) parameter of periodontitis-induced Wistar rats. The rats are divided into 5 groups, such as negative and positive control group, open flap debridement (OFD) + FD-PRP, OFD + metronidazole (M) and OFD + metronidazole (M) + FD-PRP. The rats are euthanized and we observed all parameters at 3rd and 14th day. Results: We found positive control and OFD + M + FD-PRP groups to have a better result in reduction of Porhpyromonas gingivalis colonies at 3rd (p=0.000) and 14th (p=0.000) day. In clinical aspect, we found all treatment groups have better results from reduction of probing depth at 14th day (p=0.007) and bleeding on probing at 3rd (p=0.022) and 14th (p=0.009) day. In histologic aspect, we found OFD + FD-PRP and OFD + M + FD-PRP groups have better result at 14th day for reduction of fibroblast cells count (p=0.020) and escalation of collagen density (p=0.001). However, we didn’t find any significant difference at 3rd and 14th day of any groups in immunohistochemistry aspect. Conclussion: Open flap debridement with freeze-dried platelet-rich plasma and chitosan-based metronidazole gel combination application is proven to promote periodontal wound healing in microbiology, clinical and histologic aspect.