Regenerasi Nervus Mentalis akibat Cedera Penjepitan setelah Aplikasi Kombinasi Platelet Rich Plasma yang Diaktivasi Spons Kolagen dan Cytidine 5'-Diphosphocholine

Abstract

Background. Regeneration of peripheral nerves after injury could be stimulated by adding growth factors from Platelet Rich Plasma (PRP) which activated with collagen sponge. Cytidine 5’-diphosphocholine (citicolin) is a neuroprotective agent which
have antioxidant properties so that could overcome the PRP weakness that still contained neutrophils which could produce free radicals. The aim of this study is to determine the benefits of PRP were activated with collagen sponge combined with the provision of cytidine 5’-diphosphocholine towards the regeneration of mental nerve after crush injury. Methods. Thirty-six Wistar rats were divided into Sham operation and group with mental nerve injury (n=6). The injury group consisted of saline group, local application PRP which activated with collagen sponge, citicoline intraperitoneally 50 mg/100 gr weight, local application collagen sponge, and
local application of PRP combined with citicoline intraperitoneally 50 mg/100 gr weight. Histological examination of nerve regeneration performed 4 weeks after mental nerve crush injury with histomorfometri parameters were the number of nerve fibers, nerve fiber diameter, axon diameter, and myelin thickness. The result data were analized by multivariate anova followed by post hoc test HSD.
Result. Application combination of platelet rich plasma which activated with collagen sponge and cytidine 5-diphosphocolin (citicolin) significantly different than the salin group in increasing the number of nerve fibers and thick myelin (p<0,05) and same with Sham group (p> 0.05) in the measurement of the amount of fibers, nerve fiber diameter, the diameter of the axon and myelin thickness.  The mean number of fibers, fiber diameter, the diameter of the axon and myelin thickness in the PRP group-citicolin higher than  the PRP group, citicolin group, collagen sponge group and salin group. Conclusion. Application of a combination of platelet rich
plasma activated collagen sponge and cytidine 5-diphosphocolin could improve nerve regeneration after injury.