EFEKTIVITAS PEMBERIAN KOMBINASI COENZYME Q10 TOPIKAL DAN PERORAL PASCA KURETASE PADA PERAWATAN PERIODONTITIS KRONIS (Kajian pada Bleeding on Probing, Probing Depth, dan Relative Attachment Loss)

ELIZABETH POEDJIONO, Dr. drg. Dahlia Herawati, S.U., SpPerio(K) ; drg. Sri Pramestri Lastianny, M.S., SpPerio(K)

2018 | Tesis-Spesialis | PERIODONSIA

Periodontitis merupakan penyakit immuno-inflamatori akibat interaksi dari serangan bakteri dan respon inflamasi host. Reactive Oxygen Species (ROS) adalah suatu zat pengoksidasi yang sangat reaktif, jika terjadi inflamasi kronis maka produksi ROS akan berlebihan dan menyebabkan destruksi jaringan periodontal. Selain perawatan periodontal berupa kuretase, perlu ditambahkan antioksidan Coenzyme Q10 (CoQ10) yang dapat menetralisir ROS. CoQ10 topikal saja tidak cukup karena efeknya yang cepat hilang setelah pemberian, oleh karena itu ditambahkan CoQ10 oral yang dapat meningkatkan konsentrasi CoQ10 pada gingiva. Penelitian ini bertujuan mengetahui efektivitas pemberian kombinasi CoQ10 topikal dan peroral pasca kuretase pada perawatan periodontitis kronis dengan parameter bleeding on probing, probing depth dan relative attachment loss. Sampel 45 poket periodontal 4-6 mm, dibagi tiga kelompok; kuretase dan CoQ10 topikal, kuretase dan CoQ10 peroral, dan kuretase dan CoQ10 topikal serta CoQ10 peroral. Setiap poket diukur bleeding on probing (BOP), probing depth (PD), dan relative attachment loss (RAL). Pengambilan data BOP hari ke-0,14, dan 21, untuk PD dan RAL hari ke-0, 30, dan 90. Data BOP dianalisis dengan uji non parametrik, Friedman Test dan Kruskal-Wallis Test. Kemudian data reduksi PD dan RAL dianalisis dengan uji non parametrik Kruskal-Wallis dan Mann-Whitney. Hasil penelitian menunjukkan pada BOP tidak terdapat perbedaan (p > 0,05). Pada PD dan RAL terdapat perbedaan (p < 0,05), sehingga disimpulkan bahwa kombinasi CoQ10 topikal dan peroral pasca kuretase mengurangi probing depth dan relative attachment loss dibandingkan pemberian CoQ10 topikal atau konsumsi peroral CoQ10 saja pasca kuretase pada perawatan periodontitis kronis, sedangkan bleeding on probing tidak ada perbedaan.

Periodontitis is an immuno-inflammatory disease caused by interaction of bacterial attacks and host's inflammatory response. Reactive Oxygen Species (ROS) is a highly reactive oxidizing agent, the production of ROS will be excessive if there is an inflammation and there will be destruction of periodontal tissue. Besides periodontal treatment, antioxidants need to be considered. Coenzyme Q10 (CoQ10) is an antioxidant that can neutralize ROS. Topical CoQ10 alone is not enough because the effect is quickly lost shortly after application, therefore oral CoQ10 is added. The aim of this study was to determine the effectiveness of topical and oral Coenzyme Q10 combinations after curettage in the treatment of chronic periodontitis with bleeding on probing, probing depth and relative attachment loss parameters. Sample of 45 periodontal pockets 4-6 mm, divided into three groups; curettage and topical CoQ10, curettage and oral CoQ10, and curettage and topical CoQ10 and CoQ10 oral. BOP data were measured on day 0, 14, and 21 after treatment. PD and RAL data were measured on day 0, 30 and 90 after treatment. BOP data were analyzed by Friedman Test and Kruskal-Wallis Test. Then the PD and RAL reduction data were analyzed by the Kruskal-Wallis test and Mann-Whitney. The results showed that there was no difference in the BOP (p> 0.05). In PD and RAL there were (p <0.05), so it can be concluded that the combination of topical and oral Coenzyme Q10 post curettage reduced probing depth and relative attachment loss compared to topical Coenzyme Q10 or oral Coenzyme Q10 only post curettage in the treatment of chronic periodontitis, while assessed from bleeding on probing there is no difference.

Kata Kunci : Periodontitis kronis, kuretase, Coenzyme Q10 oral, Coenzyme Q10 topikal, CoQ10