Pengaruh platelet rich fibrin terhadap percepatan proliferasi osteoblas pasca insersi implan gigi jenis endoseous

EVAN CHANDRA, drg Murti Indrastuti M.Kes Sp.Pros(K) ; Dr. Drg. Suparyono Saleh Sp.Pros(K)

2018 | Tesis-Spesialis | PROSTODONSIA

Proses oseointegrasi pasca pemasangan implan gigi dimulai dengan diferensiasi dan proliferasi osteoblas yang merupakan aspek penting pada proses pembentukan tulang. Platelet rich fibrin (PRF) merupakan platelet yang kaya akan fibrin dan growth factor, digunakan untuk mempercepat proses regenerasi tulang. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh platelet rich fibrin terhadap percepatan proliferasi osteoblas pasca insersi implan gigi jenis endosseous. Penelitian ini menggunakan 12 ekor tikus Wistar jantan dengan berat 250 sampai 300 gr, usia 8 sampai 15 minggu yang dibagi 2 kelompok yaitu kelompok kontrol dan kelompok perlakuan berupa hari dan pemberian PRF. Pembuatan PRF dilakukan dengan mengambil darah tikus Wistar sebanyak 3ml dan disentrifugasi selama 12 menit dengan kecepatan 2700 rpm. Platelet rich fibrin diaplikasikan pada implant bed, selanjutnya dilakukan pemasangan implan gigi dengan ukuran panjang 3mm dan diameter 1,8 mm pada daerah epicondylus lateralis femoris dextra. Pada kelompok kontrol implan gigi langsung diinsersikan setelah persiapan implant bed tanpa pemberian PRF. Pengamatan subjek penelitian diakukan pada hari ke-14 dan 28, seluruh subjek penelitian dikorbankan sesuai dengan kelompok hari perlakuannya. Pada subjek penelitian dilakukan pengambilan tulang epicondylus lateralis femoris dextra dan difiksasi dengan larutan buffered formalin 10%. Selanjutnya dibuat preparat histologi dengan pewarnaan hematoxylin eosin. Pengamatan preparat sampel pada mikroskop cahaya untuk penghitungan jumlah osteoblas. Data yang diperoleh dianalisa dengan uji ANAVA dua jalur dilanjutkan uji post hoc LSD. Berdasarkan uji ANAVA dua jalur terlihat perbedaan bermakna antara kelompok kontrol dengan kelompok perlakuan (p<0,05), serta terdapat perbedaan bermakna antara hari pengamatan ke-14 dan 28 (p<0,05). Pemberian PRF meningkatkan proliferasi osteoblas pada 14 hari pertama dan menurun setelahnya. Berdasarkan uji post hoc LSD terdapat perbedaan proliferasi osteoblas antar semua kelompok perlakuan dan hari pengamatan (p<0,05). Kesimpulan dari penelitian ini adalah platelet rich fibrin dapat meningkatkan percepatan proliferasi osteoblas pasca insersi implan gigi jenis endosseous.

Dental implant osseontegration process begins with osteoblast differentiation and proliferation which is an important aspect for bone regereration process. Platelet rich fibrin (PRF) is platelet that contain large amount of fibrin and growth factor, usually used for accelerate bone regeneration. The aim of this study was to determine the effect of platelet rich fibrin on the acceleration of osteoblast proliferation after endosseous dental implant insertion. Twelve male Wistar rats with weight 250 to 300gr and age 8 to 15 weeks as animal model were divided into 2 groups, control group and treatment group which is days and PRF treatment. Three ml of Wistar rat blood was obtain and centrifuged for 12 minutes at a speed of 2700 rpm to made PRF. Platelet rich fibrin was applied to implant bed, after that dental implan was inserted at lateral epicondyle of the right femur in the 3 mm depth and 1.8mm diameter dimension. In control groups, dental implants were immediately inserted after implant bed preparation without PRF administration. Observation time of the Wistar rats were carried out on day 14 and 28 for each groups. The time of sacrificing was conducted acording to group design. The part of epicondylus lateralis femoris dextra bone was taken and fixed with 10% buffered formalin solution. Then histological samples were made with hematoxylin eosin staining. Sample observation was done under light microscope to calculate the number of osteoblast. The data were analyze using two ways ANOVA test, followed by LSD post hoc test. Based on the two ways ANOVA, there were significant differences betwen control groups and treatment groups (p<0.05), and there were significant difference between 14 and 28 observation day (p<0.05). Application of PRF incerased osteoblast proliferation the first 14 days and decreased thereafter. Based on, LSD post hoc test there were differences of osteoblast proliferation between treatment and control group (p<0.05). It is concludes that platelet rich fibrin increase the acceleration of osteoblast proliferation after endosseous dental implant insertion

Kata Kunci : platelet rich fibrin, dental implant, osteoblast, growth factor, osseointegration