EFEKTIVITAS PENGGUNAAN APLIKASI PASTA GIGI YANG DIFORMULASI ZINC DAN SUPLEMEN ORAL ZINC SETELAH SCALLING DAN ROOT PLANNING TERHADAP KADAR TISSUE INHIBITOR OF MATRIX METALLOPROTEINASE-1 SALIVA PADA GINGIVITIS

fildzah nurul fajrin, haria fitri, nila kasuma, netti suharti

Abstract


Pendahuluan: Terapi pertama gingivitis adalah scaling and root planning (SRP). Terapi ini berfungsi untuk menghilangkan plak dan kalkulus penyebab inflamasi gingiva, namun SRP memiliki keterbatasan yaitu tidak dapat mengeliminasi seluruh bakteri patogen periodontal pada area yang sulit diakses saat instrumentasi. Oleh karena itu dibutuhkan terapi tambahan seperti pemberian imunomodulator untuk meningkatkan keberhasilan SRP. Zinc telah dikenal sebagai imunomodulator. Unsur ini merupakan katalisator dari enzim yang berperan dalam proses degradasi kolagen dan penyembuhan gingivitis yaitu Tissue Inhibitor Matrix Metalloproteinase-1 (TIMP-1). Sebagai terapi penyembuhan gingivitis, zinc digunakan dalam bentuk suplemen (sistemik) dan sebagai bahan tambahan dalam pasta gigi (topikal). Penulis bertujuan untuk membandingkan efektifitas aplikasi zinc yang berbeda terhadap konsentrasi TIMP-1 pada saliva pasien gingivitis setelah scalling and root planning. Metode: Subjek penelitian adalah siswa siswa MAN 2 Padang yang menderita gingivitis sedang dan parah berdasarkan pemeriksaan Gingival Index dan bleeding on probing. Subjek terdiri dari 3 kelompok yaitu kelompok dengan aplikasi pasta gigi zinc citrate 2% setelah SRP (grup 1), kelompok SRP tanpa tambahan perlakuan (grup 2), dan kelompok suplementasi zinc sulfat 20 mg (grup 3) setelah SRP. Masing-masing kelompok terdiri dari 11 orang. Scalling and root planning dilakukan pada subjek yang terjaring. Pasta gigi dan suplemen zinc diberikan pada grup 1 dan 3 selama 14 hari. Setelah perlakuan, saliva subjek penelitian dikumpulkan dengan unstimulated method. Kadar TIMP-1 saliva dianalisis dengan metode ELISA di Laboratorium Biomedik FK UNAND. Analisa statistik dilakukan dengan software SPSS 17 dengan uji ANOVA dan Bonferroni.  Hasil: Terdapat perbedaan yang bermakna antar kelompok perlakuan (p<0.05). Kelompok yang paling menunjukkan peningkatan TIMP-1 yang signifikan adalah grup 1 (p< 0.05). Terdapat perbedaan signifikan antara grup 1 dengan grup 2. Tidak terdapat perbedaan yang bermakna antara grup 2 dengan grup 3, dan grup 1 dengan grup 3 (p>0.05). Simpulan: Penggunaan zinc secara topikal lebih efektif meningkatkan penyembuhan gingivitis setelah SRP dari pada penggunaan zinc secara sistemik.

 

Introduction: The first therapy of gingivitis is scaling and root planning (SRP). This therapy functions to remove plaque and calculus that cause gingival inflammation, but SRP has limitations that cannot eliminate all periodontal pathogenic bacteria in areas that are difficult to access when instrumentation. Therefore, additional therapy is needed such as immunomodulatory administration to increase the success of SRP. Zinc has been known as an immunomodulator. This element is a catalyst of enzymes that play a role in the process of collagen degradation and healing of gingivitis, namely Tissue Inhibitor Matrix Metalloproteinase-1 (TIMP-1). As a healing therapy for gingivitis, zinc is used as a supplement (systemic) and as an additive in toothpaste (topical). The authors aimed to compare the effectiveness of different zinc applications to TIMP-1 concentrations in the saliva of gingivitis patients after scaling and root planning. Methods: The research subjects were students of MAN 2 Padang who suffered from moderate and severe gingivitis based on gingival index and bleeding on probing examination. Subjects consisted of 3 groups, namely the group with the application of 2% zinc citrate toothpaste after SRP (group 1), SRP group without additional treatment (group 2), and zinc sulphate supplementation group 20 mg (group 3) after SRP. Each group consists of 11 people. Scaling and root planning were done on netted subjects. Toothpaste and zinc supplements were given in groups 1 and 3 for 14 days. After the treatment, the saliva of the research subjects was collected by an unstimulated method. TIMP-1 saliva content was analysed by the ELISA method in the Biomedical Laboratory of the UNAND FK. Statistical analysis was performed with SPSS 17 software with ANOVA and Bonferroni tests. Results: There were significant differences between treatment groups (p <0.05). The group that most showed a significant increase in TIMP-1 was group 1 (p <0.05). There were significant differences between group 1 and group 2. There were no significant differences between group 2 and group 3, and group 1 with group 3 (p> 0.05). Conclusion: Topical use of zinc is more effective at improving the healing of gingivitis after SRP than systemic use of zinc.


Keywords


gingivitis, zinc, TIMP-1, Scaling and root planning

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DOI: https://doi.org/10.33854/jbd.v6i2.266

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