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Pengaruh Gel Probiotik Lactobacillus Reuteri terhadap Makrofag, Fibroblas dan Limfosit pada Terapi Gingivitis (Studi in-Vivo) Firmantini, Herrina; Riberu, Agustina Oartansia Tita; Dude, Muhammad Aksal; Hayon, Sabina Dwiratnasary
Bhakta Dental Journal Vol 1 No 2 (2023): Desember
Publisher : Fakultas Kedokteran Gigi IIK Bhakti Wiyata, Kediri.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56710/bhaktadent.v1i2.33

Abstract

Abstrak Latar belakang : Gingivitis merupakan suatu penyakit yang menyerang jaringan periodontal yang bisa disebabkan oleh penumpukan plak dan bakteri sehingga menimbulkan reaksi inflamasi pada gingiva. Makrofag merupakan sel imun dan inflamasi yang berfungsi dalam pertahanan tubuh terhadap infeksi patogen penyakit periodontal. Sel inflamasi yang muncul pada peradangan kronis adalah limfosit dan juga poliferasi fibroblas biasanya muncul pada jaringan gingiva setelah diberikan terapi periodontal. Pemberian gel probiotik Lactobacillus reuteri pada hewan coba yang mengalami inflamasi menyebabkan sel makrofag terpolarisasi dari makrofag M1 menjadi makrofag M2, yang menghambat terjadinya inflamasi dan mengontrol keseimbangan pertahanan tubuh, yang berdampak pada efek penghambatan produksi sitokin proinflamasi yaitu TNF- α dan interleukin. Begitu juga limfosit dan fibroblas. Obyektif: Tujuan dari pelaksanaan penelitian eksperimental ini adalah untuk mengetahui apakah pada pemberian gel probiotik Lactobacillus reuteri dapat mempengaruhi hitung jumlah sel makrofag, limfosit dan Fibroblas pada tikus wistar untuk pengobatan gingivitis atau radang pada gingiva. Metode: Penelitian ini merupakan penelitian jenis eksperimental laboratoris dengan rancangan yang digunakan pada penelitian adalah post-test-only control group design. Dilakukan pada sejumlah tikus wistar berjenis kelamin jantan sebanyak 32 ekor tikus yang berumur sekitar 2-3 bulan dengan berat badan seberat 150-200 gram, dalam penelitian ini dibagi menjadi dua kelompok penelitian yaitu tikus wistar kelompok penelitian pertama diberi perlakuan akuades steril tanpa gel probiotik, dan kelompok penelitian kedua diberi perlakuan gel probiotik Lactobacillus reuteri. Pemberian gel probiotik dilakukan saat terjadi tanda-tanda inflamasi pada gingiva tikus akibat induksi LPS E. coli. Kemudian pada hari ke-11 dilakukan proses dekaputasi jaringan setelah perlakuan. Selanjutnya bagian labial gingiva anterior mandibula dibuat preparat histologis untuk pewarnaan hematoxylineosin dan pemeriksaan mikroskopis untuk menghitung jumlah sel makrofag. Data yang telah diperoleh kemudian dilakukan analisis dengan menggunakan uji statistik Independent sample t-test. Hasil: Perolehan dari uji statistika Independent sample t-test dalam penelitian ini dengan p-value < 0,05 menunjukkan perbedaan yang signifikan pada perlakuan antar kelompok penelitian. Kesimpulan Abstrak : Pemberian gel probiotik Lactobacillus reuteri dapat mempengaruhi jumlah makrofag, limfosit dan fibroblas tikus wistar dalam pengobatan gingivitis. Kata kunci: Makrofag, Limfosit, Fibroblas, Gingivitis, Lactobacillus reuteri Abstract Background: Gingivitis is a common disease that occur in periodontal and caused by plaque accumulation, resulting in an inflammatory reaction of the gingiva. Macrophages are immune and inflammatory cells that function in the body's defense against microbial infection with periodontal disease pathogens. Inflammatory cells will be appear in chronic inflammations are lymphocytes and also proliferation of fibroblast usually appear in the gingival tissue after periodontal theraphy is given. Giving probiotic gel Lactobacillus reuteri to experimental animals that experience inflammation causes macrophage cells to polarize from M1 macrophages towards M2 macrophages, which inhibit inflammation and control immune balance, which affects the inhibitory effect of pro-inflammatory cytokine production, namely TNF-α and Interleukins. So do lymphocites and fibroblast. Objective: This study aims to determine whether administering Lactobacillus reuteri probiotic gel can affect the number of macrophages, Lymphocites and Fibroblasts in Wistar rats to treat gingivitis. Methods: This research is an experimental laboratory with a post-test-only control group design. This experimental research was conducted on 32 male Wistar rats aged 2-3 months with a weight of 150-200 grams in laboratory. These rats is divided into two groups: Wistar rats in the first group were given distilled water without probiotic gel, and the second group was treated with Lactobacillus reuteri probiotic gel. Administration of probiotic gel was carried out when signs of inflammation occurred in the rat gingiva due to LPS E. coli induction. Then on the 11th day, decaputation was carried out after treatment. Furthermore, the labial portion of the mandibular anterior gingiva was made histological preparations for staining hematoxylin-eosin and microscopic examination to count the number of macrophage cells. Data were analyzed using the Independent sample t-test. Results : The results of statistical analysis, shows significant differences between research groups with a p-value is <0, 05 by the Independent sample t-test. Conclusion: Administration probiotic gel Lactobacillus reuteri can affecting the numbers of macrophages, lymphocites and fibroblast of wistar rats in the treatment of gingivitis. Keywords: Macrophages, Lymphocites, Fibroblast, Gingivitis, Lactobacillus reuteri
Gingivectomy And Gingivoplasty Combined With Low Dose Doxycicline For Treatment Of Inflammed Fibromatous Epulis In Anterior Gingival Of Maxilla ( Case Report ) Firmantini, Herrina
Bhakta Dental Journal Vol 2 No 02 (2024): Desember
Publisher : Fakultas Kedokteran Gigi IIK Bhakti Wiyata, Kediri.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56710/bhaktadent.v2i02.45

Abstract

Background: The Periodontopathogen bacteria is the main etiology of periodontal disease such an fibromatous epulis. Epulis is such a gingival hyperplasia (tumor-like) that came from connective tissue of periodontal. It can caused by Periodontopathogen bacteria and aggravated by a local irritation that occur in long period. The inflammation process made the epulis getting bigger and painfull sometimes. Patient feels unconfidence with this lump mean while the epulis getting bigger. On the other hand, there is some halitosis and uncomfort feeling during chewing and speaking regarding to the epulis. Epulis that grows on the anterior maxilla area can be inconvenient because it became an aesthetics problem and also disrupts the function of the mastication system. Therefore, it has to be completely removed by surgery and some host immunomodulation to eliminate the inflammation and collagenases activity. Case Report: A 44-year-old male patient presented with a chief complaint of a lump on the gum of the anterior teeth on his upper jaw that made him unconfident to smile, difficulties in chewing and speaking. The lump consistency is dense and chewy, bleeds easily, had been there for 3 years. Panoramic reveal a slight bone resorption at the right maxillary second incisor. Case Management : Gingivectomy and gingivoplasty procedures has been done to correct the condition of epulis which is excision and gingival contouring for aesthetic need and Followed with host immunomodulation therapy by using 20 mg low dose doxycicline twice a day for 14 days. Discussion : The condition of epulis can be corrected by gingivectomy and gingivoplasty procedure also by removing the main cause of the epulis (sub-gingival calculus). The aesthetic result can be obtained by gingival contouring after the excision. Host modulation theraphy been given to the patient by using low dose doxycycline for eliminating collagenases activity and breaking the inflammation process in gingiva in order to stop the epulis relapsed. This 20 mg dose of Doxy prevented the elevation of the pro-inflammatory enzyme COX-2 and its downstream product PGE2, which is a potent inflammatory mediator. Conclusion : periodontal surgery treatment need to be followed by certain therapy such as host modulation therapy for gaining successful treatment of periodontal diseases. Keywords : Epulis Fibromatous, inflammation, low dose doxycycline