Perbedaan efektivitas antara bahan cangkok tulang Freeze-Dried Bone Allografi dan Hydroxylapatite Alloplast pada perawatan penderita Rapidly Progressive Periodontitis

HAPSARI, Yulitri, drg. Dahlia Herawati, SU.,Sp.Perio

2004 | Tesis | PPDGS I Periodonsia

Rapidly Progressive Periodontitis (RPP) adalah suatu penyakit yang tampak pada pasien usia 20 – 35 tahun, dengan karakteristik terjadi resorpsi tulang yang luas dalam jangka waktu yang pendek, mempunyai gambaran radiografis yang menunjukkan adanya kerusakan tulang horizontal dan vertikal yang parah pada banyak gigi, terjadi inflamasi gingiva yang mudah berdarah dan terbentuknya poket periodontal yang dalam, adanya gambaran abnormal dari monosit, neutrofil dan fungsi sel B. Tujuan penelitian ini adalah untuk mengetahui perbedaan efektivitas antara bahan cangkok tulang Freeze-Dried Bone Allograft (FDBA) dan Hydroxylapatite Alloplast (HA) pada perawatan penderita RPP. Penelitian dilakukan pada 51 sampel dari 6 orang pasien yang terbagi dalam dua kelompok, yaitu FDBA dan HA. Data probing kedalaman poket, tingkat perlekatan klinis, tinggi tulang alveolar sebelum dan 3 bulan sesudah perawatan dianalisis dengan Anava 1 jalur mixed 1 faktor, perdarahan probing dan kegoyahan gigi sebelum dan 3 bulan sesudah perawatan dianalisis dengan Uji Kai-Kwadrat. Hasil penelitian setelah 3 bulan perawatan menunjukkan kemampuan HA dan FDBA dalam penambahan tinggi tulang alveolar HA 4,564 ± 1,147, FDBA 4,493 ± 1,297, penurunan poket periodontal HA 3,871 ± 0,596, FDBA 3,591 ± 0,484, peningkatan perlekatan klinis HA 3,096 ± 0,670, FDBA 3,108 ± 0,471. Penurunan perdarahan probing dan kegoyahan gigi menunjukkan nilai p<0,05 setelah 3 bulan perawatan. Kesimpulan penelitian ini adalah (1) Ada kecenderungan FDBA lebih efektif daripada HA pada penurunan kedalaman poket, penambahan ketinggian tulang alveolar, peningkatan perlekatan klinis, penurunan perdarahan probing dan penurunan kegoyahan gigi, namun secara statistik tidak bermakna (p>0,05); (2) terdapat perbedaan bermakna (p,0,05) pada penurunan kedalaman poket periodontal, penambahan tinggi tulang alveolar, peningkatan perlekatan klinis, pengurangan perdarahan probing dan tingkat kegoyahan gigi antara sebelum dan 3 bulan setelah perawatan; (3) Aplikasi bahan cangkok tulang FDBA dan HA efektif pada perawatan penderita RPP

Rapidly progressive periodontitis (RPP) is a disease that was seen in age 20 – 35 years old, with characterized a wide bone resorption in short period. Patients with RPP have horizontal and vertical bone defects as a radiographically, gingival inflammation that bleeding easily and have deep periodontal pocket and indicated features neutrophil, monocyte and cell B function that abnormal. The purpose of the study was to investigate comparison between Freeze-Dried Bone Allograft (FDBA) and Hydroxylapatite Alloplast (HA) in the treament of RPP patients. The study consisted of 51 samples from six patients which were divided into two groups; first group was treated with FDBA and the second group was treated with HA as a materials graft after periodontal surgery. Clinical parameters probing pocket depth, clinical attachment level, bone height, bleeding on probing and tooth mobility were taken at baseline and three months after treatment. The data obtained for pocket depth, clinical attachment level and alveolar bone fill differences were statistically analyzed using Anava mixed, bleeding on probing and tooth mobility differences were statistically analyzed by Chi Square test. The results of the study indicates that HA and FDBA have the ability showed the effects of promoting alveolar bone height HA 4,564 ± 1,147, FDBA 4,493 ± 1,297, reducing probing depth HA 3,871 ± 0,596, FDBA 3,591 ± 0,484, improving clinical attachment level HA 3,096 ± 0,670, FDBA 3,108 ± 0,471 after three months treatment. Decrased of bleeding on probing and tooth mobility after three months treatment showed statistically significant (p<0,05). Conclusion: (1) there were FDBA more effective than HA at promoting alveolar bone fill, reducing pocket depth, gain of clinical attachment level, decreased bleeding on probing and tooth mobility, but statistically no significant (p>0,05), after three months treatment; (2) there were statistically significant differences (p<0,05) of reducing pocket depth, gain attachment level, increased alveolar bone fill, reducing bleeding on probing and reducing tooth mobility between before treatment and three months after treatment; (3) the application of FDBA and HA as a material graft was effective in the treatment of RPP patients.

Kata Kunci : Rapidly Progressive Periodontitis,Bahan Cangkok Tulang,FDBA dan HA