PERBEDAAN EFEKTIVITAS IRIGASI HIDROGEN PEROKSIDA 1,5% DENGANKLORHEKSIDIN 0,2% SETELAH SCALING ROOTPLANINGPADA PERIODONTITIS DIABETIKA (Kajian Terhadap Perubahan Kadar HbA1c, Papilla Bleeding Index, Pocket Depth,dan Gingival Index)

ISNIYA NOSARTIKA, Dr. drg. Ahmad Syaify, SpPerio(K); drg. Soetomo Nawawi, DPHDent, SpPerio(K)

2017 | Tesis-Spesialis | SP PERIODONSIA

Diabetes mellitus(DM) kontrol glikemik buruk menimbulkan komplikasi di rongga mulut yaitu periodontitis. Pasien DM diberikan perawatan periodontal berupa scaling root planing (SRP). PasienDM diperlukan tambahan kemoterapetik setelah SRP karena selain faktor lokal, terdapat perubahan respon inflamasi pada pasien DM. Klorheksidin(CHX) dan hidrogen peroksida (H2O2) mampu mengurangi skor plak dan digunakan sebagai bahan irigasi setelah SRP. Tujuan penelitian ini adalah untuk melihat perbedaan efektifitas irigasi H2O2 1,5% dan klorheksidin 0,2% setelah SRP padapenurunan HbA1c, pocket depth (PD), papilla bleeding index (PBI), gingival index (GI), pasien periodontitis diabetika. Penelitian ini menggunakan sampel 54 poket periodontal dibagi menjadi 3 kelompok. Masing-masing kelompok terdiri dari 18 sampel,kelompok pertama perawatan SRP,kelompok kedua perawatan SRP+H2O2dan kelompok ketiga perawatanSRP+CHX. Masing-masing kelompok diukur PD, PBI, GIpada baseline (bulan ke-0), bulan ke-1, dan bulan ke-3. Masing-masing kelompok diukur kadar HbA1c pada baselinedan bulan ke-3 setelah terapi. Selanjutnya data PBI, PD, kadar HbA1c dianalisa secara statistik menggunakan uji Kruskall-Wallis, untuk data GIdianalisa menggunakan ANOVAmixed design. Hasil penelitian menunjukkan penurunan PD dan PBI terbesar pada SRP+H2O2pada baseline-bulan ke-1. Penurunan GI terbesar pada SRP+H2O2 pada bulan ke-3 setelah terapi.PenurunanKadar HbA1c setelah terapi tidak bermakna pada semua kelompok.Kesimpulan: Irigasi H2O21,5% setelah SRP lebih efektif menurunkan PBI dan GI dibandingkan dengan irigasi klorheksidin 0,2%. Irigasi H2O21,5% dan klorheksidin 0,2% sama efektifnya dalam menurunkan PD periodontitis diabetika.

Poor glycemic control in Diabetes Mellitus patients can cause complications in oral cavity such as periodontitis. Scaling Root Planning (SRP) is the periodontal treatment provided to diabetic patients. Additional chemotherapeutic substance is needed after SRP because in addition to local factors, there are changes in the inflammatory response in patients with diabetic. Irrigation of hydrogen peroxide (H2O2) 1,5% and Chlorhexidine 0,2% after SRP was suggested to remove supra and subgingiva bacteria and reduce periodontal inflamation. The aim of this study was to evaluate the difference of effectiveness between irrigation using H2O2 1.5% and chlorhexidine 0.2% after SRP to lowering HbA1c level, pocket depth (PD), papillary bleeding index (PBI), gingival index (GI), on diabetic periodontitis patients. There were 54 periodontal pocket samples used in this study and divided into 3 groups. Each group consisted of 18 samples. The first group received SRP only. The second group received SRP+H2O2 and the third group received SRP+CHX. Each group was measured PD, PBI, GI at baseline (month 0), 1st and 3rd month. HbA1c level was measured at baseline and 3rd month after therapy for each group. HbA1c level, PBI, PD data analyzed statistically using Kruskall-wallis, and the GI data analyzed satatistically using mixed design ANOVA. The results showed GI at 3rd months after therapy reduced significantly in SRP+H2O2 groups. Pocket depth and PBI decreased significantly after a month therapy in SRP+H2O2 groups. HbA1c level decreased 3rd month after, but not significant. Conclusion: Irrigation H2O2 1.5% after SRP more effectively reduced PBI and GI than chlorhexidine 0.2% irrigation. Irrigation H2O2 1.5% and chlorhexidine 0.2% after SRP equally effective in reducing the PD on diabetic periodontitis.

Kata Kunci : : Periodontitis diabetika, chlorhexidine, hidrogen peroksida, HbA1c, pocket depth, papilla bleeding index, gingival index