PERBEDAAN HASIL PERAWATAN ANTARA PENAMBAHAN PHOTODYNAMIC THERAPY PASCA KURETASE DAN OPEN FLAP DEBRIDEMENT PADA PERIODONTITIS KRONIS

M FAIZAR RAHMAN, drg. Kwartarini Murdiastuti, SpPerio(K), Ph.D; Dr. drg. Ahmad Syaify, SpPerio(K)

2020 | Tesis-Spesialis | PERIODONSIA

Perawatan periodontitis kronis bertujuan untuk menghilangkan bakteri patogen periodontal. Kuretase adalah tindakan untuk menghilangkan jaringan yang rusak, sementum nekrotik, serta jaringan yang mengiritasi gingiva. Penambahan photodynamic therapy (PDT) dapat meningkatkan eliminasi bakteri patogen pada area yang tidak terjangkau kuretase. Open flap debridement (OFD) merupakan perawatan bedah untuk mendapatkan akses debridement langsung ke permukaan akar gigi. Penelitian ini bertujuan untuk mengetahui perbedaan hasil perawatan antara penambahan PDT pasca kuretase dibanding dengan OFD pada periodontitis kronis dengan parameter pocket depth (PD), relative attachment loss (RAL), papillary bleeding index(PBI), dan jumlah koloni bakteri. Sampel penelitian ini diambil dari 32 titik poket periodontal yang dibagi menjadi dua kelompok perlakuan. Cara penelitian dimulai dengan pengambilan bakteri pada poket menggunakan paper point, dilanjutkan pengukuran PD, RAL, PBI. Perawatan OFD dilakukan pada kelompok pertama, dan dilakukan kuretase dengan tambahan PDT pada kelompok kedua. Hasil PD, RAL, PBI diukur pada hari ke-0, ke- 30, dan ke-90, sedangkan koloni bakteri dihitung pada hari ke-0, dan ke-90. Hasil penelitian menunjukkan terdapat penurunan PD,RAL,PBI, dan koloni bakteri pada kedua kelompok, tetapi terdapat perbedaan signifikan pada PD di hari ke 0-30, dan RAL di hari ke 0-90.Kesimpulan penelitian ini adalah terdapat perbedaan signifikan pada PD di hari ke 0-30, dan RAL di hari ke 0-90, tetapi tidak terdapat perbedaan penurunan PBI dan jumlah koloni bakteri. Kata kunci: kuretase, photodynamic therapy, open flap debridement, periodontitis kronis

Chronic periodontitis therapy is aimed to remove periodontal pathogen. Curretage was a procedure to remove damaged tissue, necrotic sementum, and infected tissue that caused gingival inflammation. Photodynamic therapy (PDT) was additional therapy in order to eradicate pathogen bacteria in areas that cannot be reached by curretage. Open flap debriedement (OFD) was a surgical method to get direct debridement acces to root surface. This study was designed to compare the differences of the therapy result between curretage with additional PDT and OFD in treating chronic periodontitis, which was seen from the clinical parameters of Pocket Depth (PD), Relative Attachment Loss (RAL), Papillary Bleeding Index (PBI), and the amount of bacterial colonies. The study samples were taken from 32 periodontal pocket points which were divided into two treatment groups. The procedure was started by taking bacteria in pocket using paper point, then measured PD, RAL and PBI. After baseline records, OFD was done in group I, and curretage with additional PDT was done in group II. Result of PD, RAL, PBI, were observe at baseline, 30 days, and 90 days, while the amount of bacteria was calculated at baseline and 90 days. This study showed there were reduction of PD, RAL, PBI, and amount of bacteria on both groups, but there were significance difference in PD at baseline to 30 days, and RAL at baseline to 90 days. This study conluded, there were significance difference in PD at baseline to 30 days, and RAL at baseline to 90 days, but there were not difference on reduction of PBI and amount of bacteria. Keywords: curettage, photodynamic therapy, open flap debridement, chronic periodontitis

Kata Kunci : kuretase, photodynamic therapy, open flap debridement, periodontitis kronis