DAYA GUNA APLIKASI CASEIN PHOSPHOPEPTIDE-AMORPHOUS CALCIUM PHOSPHATE DENGAN DAN TANPA FLUOR SEBAGAI DESENSITIZING AGENT PADA METODE IN OFFICE BLEACHING

Yulita Kristanti, Prof. drh. Widya Asmara, SU, Ph.D.

2014 | Disertasi | S3 Kedokteran Gigi

Bleaching merupakan perawatan pemutihan gigi yang mengalami diskolorasi. Salah satu efek samping bleaching adalah sensitivitas gigi. Sensitivitas gigi pasca bleaching diatasi dengan desensitizing agent baik yang menggunakan fluor maupun tanpa fluor. Metode aplikasi yang diterapkan selama ini belum cukup dapat mengatasi demineralisasi yang terjadi akibat pemakaian bahan bleaching. Penelitian ini dilakukan dengan tujuan untuk mengetahui pengaruh waktu aplikasi dan kandungan fluor desensitizing agent pada metode in office bleaching terhadap karakteristik permukaan gigi dan kandungan mineral gigi. Empat belas gigi masing-masing dipotong menjadi 4 bagian, 8 potong digunakan untuk pemeriksaan X-Ray Diffraction (XRD) awal, 24 potong pemeriksaan XRD akhir dan 24 potong pemeriksaan kekasaran, sudut kontak, aktivitas glukosiltransferase dan pelekatan S. mutans. Selanjutnya dibagi dalam 4 kelompok perlakuan. Kelompok I: gigi diaplikasi bahan bleaching diikuti aplikasi desensitizing agent tanpa fluor (DA). Kelompok II : Gigi diaplikasi DA, dibleaching, diaplikasi DA. Kelompok III gigi dibleaching diikuti aplikasi desensitizing agent yang mengandung fluor (DAF), Kelompok IV gigi diaplikasi DAF, dibleaching kemudian diaplikasi DAF. Sebelum dan sesudah perlakuan dilakukan pemeriksaan sudut kontak, kekasaran dan kandungan mineral gigi. Selain itu juga dilakukan pengamatan aktivitas glukosiltransferase (GTF) menggunakan pelekatan S. mutans ATCC 25175 dan visualisasi pengamatan kekasaran menggunakan Scanning Electron Microscope (SEM). Hasil penelitian menggunakan uji Mann Whitney menunjukkan penurunan mineral paling sedikit terjadi pada kelompok IV (4.500) . Pemeriksaan kekasaran menunjukkan yang paling halus adalah kelompok IV(1,188±0,196). Hasil penelitian sudut kontak menunjukkan kelompok dengan selisih sudut paling besar yaitu kelompok IV (31,71 ± 3,71). Jumlah koloni S. mutans paling sedikit ditunjukkan oleh kelompok IV (37 ± 2,098), sedangkan aktivitas glukosiltransferase paling rendah ditunjukkan oleh kelompok IV (1,67±0,658). Kesimpulan penelitian ini kelompok IV yang menggunakan desensitizing agent mengandung F sebelum dan sesudah perlakuan in office bleaching menunjukkan hasil yang paling baik. Kelompok ini menunjukkan kehilangan mineral paling sedikit, kekasaran paling halus, paling hidrofil, pelekatan bakteri paling sedikit dan aktivitas glukosiltransferase paling rendah yang berarti risiko karies paling rendah. Kata Kunci : Desensitizing agent, in office bleaching, karakteristik permukaan, kandungan mineral, pelekatan S.mutans dan aktivitas GTF

Bleaching is a whitening process following tooth discoloration. One of the side effect of tooth bleaching is tooth sensitivity. To overcome tooth sensitivity, desensitizing agent with or without fluor usually administered after tooth bleaching was performed. The method used nowadays can not overcome demineralization that happened as a side effect of bleaching agent. The aim of this study was to know the influence of an application method and fluoride containing desensitizing agent on surface characteristics and mineral loss of in office bleaching treated enamel. Fourteen teeth were divided into 4 parts. Before treatment the mineral content of the 6 specimens were examined using using X-Ray Diffraction (XRD), while the other 24 specimens were examined after treatment, 24 specimens for roughness, contact angle, glucosyltransferase activity and the adhesion of S.mutans. The 24 specimens were then divided into 4 groups, group I and III were treated with desensitizing agent (DA) after in office bleaching, while group II and IV were treated with DA before and after bleaching. The desensitizing agent used in group III and IV was the one that contains fluor, while others not. Twenty four of the speciemens were examined for mineral loss, surface roughness, contact angle before and after bleaching, followed by measuring glucosyltransferase activity, the adhesions of S. mutans and Scanning Electron Microscope (SEM). Using Mann Whitney Test, the result of this research showed that the lowest mineral loss value can be seen in group D (4.500) . The Surface roughness examination showed the smoothest group was seen in group D (1.188±0,196). The biggest difference of contact angle value was detected in group IV (31.71 ± 3,71).. The mean value at the accumulation of S. mutans colony was the lowest for group IV (37 ± 2,098), while the mean value at the glucosyltransferase activity can be seen in group IV (1,67±0,658). In conclusion, group IV in which the application of fluoride containing desensitizing agent was administered before and after bleaching showed the best result. Group IV was the most effective in reducing mineral loss, the smoothest, the most hydrophyl. Group IV showed reducing the accumulation of S. mutans colony and glucosyltransferase activity. Keywords : Desensitizing agent, in office bleaching, surface characteristics, mineral loss, S. mutans adhesi

Kata Kunci : Desensitizing agent, in office bleaching, karakteristik permukaan, kandungan mineral, pelekatan S.mutans dan aktivitas GTF