EFEKTIVITAS PASTA GIGI YANG MENGANDUNG PYROPHOSPHATE DAN PAPAIN TERHADAP PENURUNAN KALSIUM DALAM PEMBENTUKAN KALKULUS : Pada Pasien Yang Menggunakan Ortodonti Cekat

Latar Belakang: Kebersihan mulut mempunyai peran penting di bidang kesehatan gigi, karena kebersihan mulut yang buruk dapat mengakibatkan timbulnya berbagai penyakit baik lokal maupun sistemik. Pemakai alat ortodonti cekat lebih sulit untuk memelihara kebersihan mulut selama perawatan. sehingga mempermudah melekatnya debris karena adanya braket menempel pada gigi, sehingga menyulitkan pasien untuk melakukan pembersihan dengan baik sehingga cenderung terjadinya penumpukan plak pada gigi geligi dan lama-kelaman jika tidak dibersihkan plak ini akan terkalsifikasi dan terbentuklah kalkulus. Penggunaan pasta gigi yang mengandung pyrophosphate dan papain mampu bekerja dengan menstabilkan kadar kalsium dalam saliva dan menghambat pertumbuhan kristal yang membantu pembentukan kalkulus serta sebagai antimikroba. Metode: Sampel dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kelompok kontrol. Pada kelompok perlakuan diberi pasta gigi yang mengandung pyrophosphate dan papain sedangkan kelompok kontrol diberi pasta gigi plasebo. Pada kedua kelompok dilakukan koleksi saliva pada hari ke 1,3,dan 5. Pada hari pertama setelah koleksi saliva dilakukan pengukuran pH saliva kemudian dilakukan scalling gigi, pada hari ketiga setelah koleksi saliva, dilakukan pengukuran pH saliva dan sampel diberikan pasta gigi secara acak. Pada hari ke 5 dilakukan koleksi saliva dan dilakukan pengukuran pH saliva, kemudian saliva dari sampel dilakukan analisa dengan pembacaan kadar kalsium menggunakan SSA (Spektrofotometer Serapan Atom) dan pengukuran pH saliva dengan pH meter Hasil: Hasil kelompok kontrol yang diberi pasta gigi plasebo memiliki rata-rata sebesar 1.58 pada hari ke-1, 1.70 pada hari ke-3, 1.21 pada hari ke-5. Sedangkan pada kelompok perlakuan yang diberi pasta gigi yang mengandung pyrophosphate dan papain memiliki rata-rata sebesar 1.65 pada hari ke-1, 1.78 pada hari ke-3, 1.12 pada hari ke-5. Kelompok perlakuan tersebut mengalami penurunan yang lebih banyak dibandingkan dengan kelompok kontrol. Uji Paired T-test diperoleh nilai signifikan p<0,05 dan uji Independent T-test didapatkan perbedaan yang tidak signifikan antara kelompok kontrol dan perlakuan. Kesimpulan: Penggunaan pasta gigi yang mengandung pyrophosphate dan papain efektif dalam menurunkan kadar kalsium dalam pembentukan kalkulus pada pasien yang menggunakan ortodonti cekat. Kata Kunci: Kalkulus, Kadar kalsium, pyrophosphate dan papain, ortodonti cekat, pH saliv

Effectiveness of Toothpaste containing Pyrophosphate and Papain to Inhibit Calculus Formation in patient using Fixed Orthodontic Appliance

Patients using fixed orthodontic appliance are more susceptible to calculus formation than patient without orthodontic treatment. Pyrophosphate and papain toothpaste can be used to reduce dental plaque and calculus accumulation. The aim of this study was to analyze the differences in the calcium level and phosphate level in saliva, also saliva pH in patient’s after treated with toothpaste containing pyrophosphate and papain. This study was true experimental study with pre-test and post-test controls group design with random sampling. Sample size was (n=20). Sample was 17-22 years old male or female patient using fixed orthodontic appliance. Sample divided into two groups: control group treated with placebo toothpaste and treatment group treated with toothpaste containing pyrophosphate and papain with blind method. Patients were instructed to brush their tooth twice a day daily. 3 ml unstimulated saliva was collected on the Day 1, 3, and 5. Spectrophotometer Atom Absorbance (SAA) was used to measure calcium level and phosphate level in saliva, while saliva pH measurement using pH meters. Treatment group showed lowest mean (SD) calcium level [1.12(0.29]. Calcium level in treatment group between groups (p0.05). Treatment group showed lowest phosphate level in Day 5. Phosphate level in treatment group between groups (p<0.05) was significantly different. Toothpastes containing pyrophosphate and papain decreased calcium levels, phosphate levels effectively and maintaining normal salivary pH to inhibit calculus formation in patients using fixed orthodontic appliance

Molecular docking of polyether ether ketone and nano-hydroxyapatite as biomaterial candidates for orthodontic mini-implant fabrication.

Context: Modified polyether ether ketone (PEEK) by adding nano-hydroxyapatite (HA) material on its fixture for mini-implant fabrication may increase resistance force through osseointegration. Aims: To analyze the binding molecular docking of PEEK incorporated with HA as a biomaterial candidate for orthodontic mini-implant fabrication through a bioinformatic approach, an in silico study. Methods: 3D ligand structure consisting of HA, PEEK and target proteins consisting of osteopontin, osteocalcin, osteonectin, bone morphogenetic protein 4 (BMP4), bone morphogenetic protein 2 (BMP2), bone morphogenetic protein 7 (BMP7), alkaline phosphatase (ALP), runt-related transcription factor 2 (RUNX2), Insulin growth factor-1 (IGF-1), osterix, tartrate-resistant acid phosphatase (TRAP), collagen alpha-1 (COL1A1) obtained from RCSB-PDB. It was analyzed the binding affinity of a single HA, PEEK, and HA + PEEK complex to twelve target proteins related to osseointegration. The types of chemical interactions produced by the ligands in the target protein domain consisted of Van der Waals, hydrogen, hydrophobic, pi, and alkyl. Results: The blind docking simulation succeeded in identifying the most negative binding affinity; it was found in the HA + PEEK molecular complex compared to HA and PEEK in the single condition. The type of chemical interaction formed consisted of hydrogen, van der Waals, pi, and alkyl. HA+PEEK showed the most negative binding affinity with ALP and IGF-1, as much as -8.7 binding affinity. Conclusions: The molecular docking of PEEK with HA exhibited a prominent binding affinity with osteogenic markers like ALP and IGF-1 in silico, allowing it to have a higher potential than nano-HA or PEEK as a single biomaterial for osseointegration as the fabrication of mini-implants that may support orthodontic treatment

Epigallocatechin-3-gallate Green Tea (Camelia Sinensis) Phytomedicine for Orthodontic Tooth Relapse Prevention: Narrative Review

Epigallocatechin-3-gallate (EGCG) is an active compound that is abundant in green tea (Camellia sinensis). EGCG has potential as an antioxidant, anti-inflammatory, anti-osteoclastogenesis as well as pro-angiogenic and pro-osteoblastogenesis. Orthodontic tooth relapse (OTR) may occur due to suboptimal alveolar bone remodeling and excessive inflammation during orthodontic tooth movement (OTM) which causes inhibition of periodontal tissue regeneration. EGCG is thought to increase the regeneration of periodontal tissue after OTM so as to prevent relapse. This narrative literature review aimed to describe the potential of the active compound EGCG in green tea phytomedicine as a candidate biomaterial to prevent OTR. EGCG has strong antioxidant potential by being able to reduce High Mobility Group Box 1 (HMGB-1) and Heat Shock Protein-70 (HSP-70) during inflammation. EGCG in green tea can inhibit pro-inflammatory cytokines such as Tumor Necrosis Factor-α (TNF-α) through its antioxidant properties. Osteoclastogenesis can be suppressed by administering EGCG because of the effect of decreasing TNF-α and signaling inhibition of Receptor activator of nuclear factor κ-β (RANK) and Receptor activator of nuclear factor κ-β ligand (RANKL) so that osteoblastogenesis can increase. The increase in osteoblastogenesis after EGCG administration was due to osteoinductive effects such as Bone Morphogenic Protein-2 (BMP-2) activating runt-related transcription factor-2 (RUNX2) and osterix, resulting in osteoblast maturation. Mature osteoblasts secreted bone related proteinfor alveolar bone regeneration such as osteocalcin, osteonectin and osteopontin which can prevent relapse after OTM. EGCG, which is the active compound in green tea (C. sinenis) may potential to be used as phytotherapy for orthodontic tooth relapse