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Efek Perbedaan Sistem Adhesif Terhadap Pembentukan Apatit Pada Pulpal Wall Restoresi Komposit Bioaktif

MARIA ENDANG SUMANTI, drg. Margareta Rinastiti, M.Kes, Sp.KG(K), PhD; drg. Andina Widyastuti, Sp.KG(K)

2023 | Tesis-Spesialis | S2 Ilmu Konservasi Gigi

Komposit bioaktif adalah suatu material restorasi dengan reaksi double- setting yang mempunyai sifat bioaktif yaitu mampu membentuk lapisan apatit. Kandungan bioactive glass pada komposit bioaktif memerlukan kontak dengan air untuk membentuk lapisan apatit. Lapisan apatit yang terbentuk pada permukaan restorasi komposit bioaktif mampu mencegah terjadi kebocoran mikro, karies sekunder, dan kegagalan restorasi. Aplikasi sistem adhesif yang berbeda menghasilkan perbedaan permeabilitas cairan pada permukaan pelekatan. Tujuan penelitian ini adalah untuk mengetahui perbedaan pembentukan apatit pada permukaan dinding pulpa restorasi komposit bioaktif tanpa adhesif, dengan sistem adhesif etch-and-rinse, universal adhesive, serta sistem adhesif self-etch

Penelitian menggunakan 24 gigi premolar yang dipreparasi sesuai outline form kavitas kelas V dengan dimensi 3 mm mesiodistal, 2 mm oklusogingival, dan kedalaman 1,5 mm. Dua puluh empat sampel dibagi menjadi 4 kelompok yaitu: kelompok A (tanpa adhesif), kelompok B (sistem adhesif etch-and-rinse), kelompok C (sistem universal adhesive), kelompok D (sistem adhesif self-etch) kemudian direstorasi dengan komposit bioaktif (Activa Bioactive Restorative). Sampel dipotong horizontal pada servikal gigi dan vertikal arah bukal lingual pada tengah gigi. Sampel direndam ke dalam larutan PBS selama 14 hari dan disimpan dalam inkubator 37oC. Lapisan apatit yang terbentuk diamati dengan SEM-EDX dengan mengukur jumlah ion Ca dan P. Data jumlah ion Ca dianalisis dengan ANAVA satu jalur. Data jumlah ion P dan data nilai Ca/P dianalisis dengan uji Kruskal Wallis derajat signifikansi 95%. Uji post hoc dilakukan dengan Mann- Whitney U

Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan jumlah ion Ca (p>0,05) namun terdapat perbedaan jumlah ion P pada kelompok tanpa adhesif (p<0>etch-and-rinse, universal adhesive, maupun self-etch


Bioactive composite is restorative material with a double-setting reaction that has bioactive characteristic, namely being able to form apatite layer. Bioactive glass in bioactive composite requires contact with fluid to form an apatite layer. The apatite layer was able to prevent microleakage, secondary caries, and restoration failure. The use of different adhesive systems may result in different fluid permeability at the bonding surface. The purpose of this study was to determine the differences in apatite formation on the pulpal wall of bioactive composite restoration without adhesive, with etch-and-rinse adhesive, universal adhesive, and self-etch adhesive. 

This study used 24 premolar teeth. Samples were prepared according to the outline form of class V cavity with dimensions: 3 mm mesiodistal, 2 mm oclusogingival, and 1,5 mm depth. Twenty-four samples were divided into 4 groups based on the adhesive system: group A (without adhesive), group B (etch-and-rinse adhesive), group C (universal adhesive), and group D (self-etch adhesive). Then each cavity was restored with bioactive composite (Activa Bioactive Restorative). Samples were sectioned horizontally at cervical line and vertically in buccal-lingual direction at the center of the tooth. The sectioned teeth were immersed in PBS solution for 14 days in an incubator at 37oC. Apatite layer was observed with SEM- EDX by measuring the amount of Ca and P ions. The amounts of Ca ions were analyzed using one-way ANOVA. The amounts of P ions and the values Ca/P were analyzed using Kruskall-Wallis with significant level of 95%. Post hoc test was performed with Mann Whitney U. 

The results showed that there were no differences in mean values of Ca ions (p>0,05) but there were differences in P ions (p<0>


Kata Kunci : apatite, bioactive composite, restoration, adhesive

  1. SPESIALIS-2023-468539-abstract.pdf  
  2. SPESIALIS-2023-468539-bibliography.pdf  
  3. SPESIALIS-2023-468539-tableofcontent.pdf  
  4. SPESIALIS-2023-468539-title.pdf