PENGARUH PENGGUNAAN IBUPROFEN TERHADAP PROSES PENYEMBUHAN TULANG ALVEOLAR PASCA PENCABUTAN GIGI TIKUS (Rattus norvegicus) JANTAN GALUR WISTAR

FANNI KUSUMA DJATI, Dr. dr. Eti Nurwening Sholikhah, M.Kes; dr. Irianiwati, Sp.PA (K)

2015 | Tesis | S2 Ilmu Kedokteran Dasar dan Biomedis

Pencabutan gigi merupakan tindakan bedah minor yang sering dilakukan dan menimbulkan nyeri dan luka pada jaringan lunak maupun tulang alveolar. Proses penyembuhan tulang alveolar pasca pencabutan gigi merupakan hal penting, terutama jika akan dilakukan perawatan lanjutan seperti pemasangan protesa atau perawatan ortodontik. Ibuprofen merupakan gold standart obat antiinflamasi nonsteroid untuk mengatasi rasa sakit pasca pencabutan gigi. Beberapa penelitian menunjukkan bahwa ibuprofen memperlambat penyembuhan tulang. Penelitian ini bertujuan mengetahui secara histologis pengaruh ibuprofen terhadap proses penyembuhan tulang alveolar tikus (Rattus norvegicus) putih jantan galur Wistar pasca pencabutan gigi, dengan menghitung jumlah sel inflamasi, osteoblas, fraksi volume kolagen dan trabekula. Sebanyak 48 ekor tikus jantan galur Wistar umur 10 minggu berat 200-250g dibagi menjadi 2 kelompok besar, yaitu kelompok kontrol dan perlakuan. Setiap kelompok besar dibagi menjadi 4 kelompok berdasarkan waktu proses penyembuhan (hari ke-7, 14, 21, dan 63). Semua hewan coba diaklimatisasikan selama 7 hari, kemudian dilakukan pencabutan gigi incisivus central rahang bawah kanan. Kelompok perlakuan diberikan suspensi ibuprofen, sedangkan kelompok kontrol diberikan akuades sesuai dosis peroral tiap 12 jam selama 5 hari. Hewan coba dikorbankan sesuai kelompoknya,dilakukan pengambilan jaringan tulang rahang bawah, dibuat sediaan histologi dan pemeriksaan histopatologi untukjumlah sel inflamasi, osteoblas, fraksi volume kolagen dan trabekulapada sepertiga apikal, tengah, dan sepertiga servikal. Uji ANOVA dilakukan bila distribusi datanya homogen atau uji Kruskall-Wallis bila datanya tidak homogen, lalu dilakukan uji Post-hoc. Hasil penelitian menunjukkan jumlah sel inflamasi dan osteoblas kelompok ibuprofen lebih rendah dibandingkan dengan kelompok kontrol (masing-masing nilai p<0,005). Rerata fraksi volume kolagen kelompok ibuprofen lebih tinggi dibandingkan dengan kelompok kontrol pada hari ke-14, 21, dan 63 (p<0,05), rerata fraksi volume trabekula kelompok ibuprofen lebih rendah dibandingkan kelompok kontrol pada hari ke-14, 21, dan 63 (p<0,05). Sebagai kesimpulan pemberian ibuprofen dapat menghambat penyembuhan tulang alveolar pasca pencabutan gigi tikus (Rattus norvegicus) putih jantan galur Wistar.

Tooth extraction is a common procedure in denstistry and often resulting pain and destruction of alveolar bone and surrounding soft-tissues. Alveolar bone healing process is important, especially if will be conducted follow-up treatment such as prosthesis or ortodontic treatment. Ibuprofen is the gold standard of NSAID for treatment of acute dental pain after tooth extraction. Several studies have suggested that ibuprofen have inhibitory effect in bone healing. This study aims to analyze the effect of ibuprofen histogically on on alveolar bone healing process in male wistar white rat (Rattus norvegicus) after tooth extraction, by counting the number of inflammatory cells, osteoblast, volume fraction of collagen and trabecular bone. A total of 48 male Wistar rats with 10 weeks-old (about 200-250g body weight) were divided into two groups:control (distilled water) and treatment (ibuprofen). Each group were divided into 4 groups with 6 animals from each group were sacrificed at 7, 14, 21, and 63 days after tooth extraction. Animals were acclimatized for 7 days.These animals had their right lower incisor extracted. After extraction, treated rats received oral doses of 1 mL ibuprofen suspension and control rats received 1mL distilled water by gavage each 12 hours for 5 days.Animals were sacrificed, the mandibles were resected, made histology preparation and histopathology examination for the number of inflammatory cells, osteoblast, volume fraction of collagen and trabecular bone in the apical, middle, and cervical thirds of each alveolus. Data were analized statistically by ANOVA when the distribution of data homogenous or Kruskall-Wallis test when the data were not homogenous, then the post hoc test done. The results showed that the number of inflammatory cells and osteoblast from ibuprofen group was less than control group (p <0,05). The mean of volume fraction of collagen on ibuprofen group was greater than control group at 14th, 21st, and 63rd day after tooth extraction (p<0,05), and volume fraction of trabecular bone on ibuprofen group was less than control group at 14th, 21st, and 63rd day after tooth extraction (p<0,05). This results suggest that the use of ibuprofen can inhibit alveolar bone healing process after tooth extraction in male wistar rat (Rattus norvegicus).

Kata Kunci : Ibuprofen, penyembuhan tulang alveolar, pencabutan gigi, sel inflamasi, osteoblas, fraksi volume kolagen, fraksi volume trabekula