PERBANDINGAN REGENERASI PAPILA INTERDENTAL PASCAINJEKSI PLATELET-RICH FIBRIN DAN ASAM HIALURONAT PADA TIKUS MODEL OPEN GINGIVAL EMBRASURE

Rezmelia Sari, Prof. drg. Suryono, S.H., M.M., Ph.D; Dr. dr. Usi Sukorini M.Kes., Sp.P.K(K); Prof. drg. Heni Susilowati, M.Kes., Ph.D., PBO

2025 | Disertasi | S3 Kedokteran Gigi

Latar belakang. Asam hialuronat (AH) dan platelet-rich fibrin (PRF) terbukti mampu meregenerasi papila interdental. Membran Leucocyte PRF (L-PRF) diaplikasikan secara bedah namun hasil samping pembuatan membran L-PRF yaitu eksudat L-PRF, Concentrated PRF (C-PRF) maupun kombinasi eksudat L-PRF dan C-PRF belum dimanfaatkan untuk regenerasi papila interdental. Penelitian ini bertujuan untuk membandingkan regenerasi papila interdental pascainjeksi eksudat L-PRF, C-PRF,  kombinasi eksudat L-PRF dan C-PRF, dengan AH. Metode penelitian. Platelet-rich fibrin berasal dari 10 ml darah manusia yang disentrifugasi dengan mesin fixed angle kecepatan 2700 selama 12 menit. Lapisan PRF dipisahkan, dilanjutkan hitung jumlah trombosit dan leukosit. Dua puluh µL eksudat L-PRF (n=3), C-PRF (n=3), kombinasi eksudat L-PRF dan C-PRF (n=3), AH (n=3), dan phosphate-buffered saline (PBS) (n=3) diinjeksikan pada papila interdental Sprague-Dawley model open gingival embrasure (OGE). Lebar OGE, spring-papilla distance (SPD), fibroblas, kolagen, pembuluh darah, epitel, dan proliferating cell nuclear antigen (PCNA) diamati secara double blinded oleh 2 independent observer dengan indeks reliabilitas >80%. Lebar OGE dan SPD pada hari ke-14 tidak terdistribusi  normal sehingga dilakukan uji Kruskal-Wallis. Parameter lain terdistribusi normal dan dianalisis dengan analisis varians (ANAVA) satu arah  diikuti oleh Tukey's HSD. Hasil penelitian. Semua jenis PRF memiliki jumlah fibroblas yang lebih tinggi daripada AH (p<0>0,05). Kesimpulan. Injeksi hasil samping pembuatan membran L-PRF meningkatkan proliferasi fibroblas dan ekspresi PCNA pada lapisan superfisial epitel lebih tinggi dibandingkan AH. Hanya Concentrated PRF yang menstimulasi vaskularisasi dan memiliki retepeg lebih tinggi dibandingkan AH. Kepadatan kolagen, ketebalan epitel, ekspresi total PCNA pada epitel, dan tinggi papila interdental pascainjeksi PRF sama dengan AH. Injeksi L-PRF, C-PRF, kombinasi L-PRF dan C-PRF berpotensi sebagai alternatif AH pada perawatan rekonstruksi papila interdental secara non bedah.

 

Introduction. Hyaluronic acid (HA) and platelet-rich fibrin (PRF) regenerate interdental papillae. While leucocyte-rich PRF (L-PRF) is applied surgically, other by-products like L-PRF exudate and concentrated PRF (C-PRF) have not been thoroughly studied. This study compares the regeneration effects of L-PRF exudate, C-PRF, their combination, and HA. Method. PRF was obtained by centrifuging 10 ml of human blood at 2700 RPM for 12 minutes, and 20 µL samples were injected into the interdental papillae of an open gingival embrasure (OGE) model in Sprague-Dawley rats. The groups included  L-PRF exudate (n=3), C-PRF (n=3), combined L-PRF exudate and C-PRF (n=3), autologous hemostatic agent (HA) (n=3), and phosphate-buffered saline (PBS) (n=3). OGE width, spring-papilla distance (SPD), fibroblast counts, collagen density, blood vessels, epithelium, and PCNA expression were assessed by two independent observers with a reliability index of>80%. The OGE width and SPD on day 14 were analyzed using the Kruskal-Walli's test, while other parameters were assessed with one-way ANOVA and Tukey's HSD test (p-value<0>Result. All PRF had a higher number of fibroblasts than HA (p<0>0.05). Conclusion. The injection of L-PRF membrane byproduct increased fibroblast proliferation and PCNA expression in the superficial layer of the epithelium, which was higher than AH. Only Concentrated PRF stimulated vascularization and had a higher retepeg than AH. Collagen density, epithelial thickness, total PCNA expression in the epithelium, and height of interdental papillae after PRF injection were similar to AH. Injection of L-PRF, C-PRF, and a combination of L-PRF and C-PRF can be an alternative to AH in the non-surgical reconstructive treatment of interdental papillae. Injection of L-PRF, C-PRF, and a combination of L-PRF and C-PRF can be an alternative to HA in treating the non-surgical reconstruction of interdental papillae.

 

Kata Kunci : asam hialuronat, gingiva, platelet-rich fibrin, proliferating cell nuclear antigen, regenerasi