Pengaruh Implantasi Subkutan Logam Kobalt Kromium sebagai Bahan Alternatif Mini Screw Orthodontics terhadap Reaksi Jaringan Kelinci Albino

https://doi.org/10.22146/majkedgiind.9018

Ananto Ali Alhasyimi(1*), Siti Sunarintyas(2), Marsetyawan HNE Soesatyo(3)

(1) Program Studi Master Ilmu Kedokteran Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Bagian Biomaterial, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Bagian Histologi dan Biologi Sel, Fakultas Kedokteran, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Mini screw orthodontics merupakan alat yang digunakan dalam perawatan ortodonsia untuk kasus yang membutuhkan absolute anchorage. Mini screw yang tersedia terbuat dari logam nikel titanium atau stainless steel yang pada beberapa pasien menyebabkan reaksi pada jaringan. Uji implantasi adalah uji yang dilakukan untuk menentukan biokompatibilitas medical device yang berkontak langsung dengan jaringan hidup. Respon jaringan terhadap jejas pasca implantasi
mempengaruhi derajat pembentukan jaringan granulasi, reaksi benda asing, dan fibrosis. Penelitian ini bertujuan untuk mengetahui efek lokal implantasi kobalt kromium sebagai alternatif bahan mini screw orthodontics terhadap jaringan subkutan kelinci albino. Subjek penelitian berupa 20 ekor kelinci jantan albino yang digunakan untuk 2 kelompok
(perlakuan dan kontrol negatif). Kobalt kromium dibuat lempengan diameter 10 mm dan ketebalan 1 mm. Pada kelompok perlakuan, material diimplankan pada jaringan subkutan dorsum kelinci dengan insisi sampai terbentuk poket subkutan, dasar poket tidak lebih dari 10 mm dari garis awal insisi dan dilakukan suturing. Kelompok kontrol hanya dilakukan
incisi kemudian disuturing. Secara makroskopis 24 jam pasca implantasi, daerah implan diamati terjadinya edema, hematoma, enkapsulasi dan tanda-tanda inflamasi. Evaluasi secara mikroskopis pada hari ke 14 pasca implantasi, diamati perubahan histopatologis infiltrasi sel-sel inflamasi, kemudian rerata hasil diuji dengan uji independent sample
t-test untuk mengetahui apakah ada perbedaan jumlah sel-sel inflamasi pada kelompok perlakuan dan kontrol. Hasil pengamatan makroskopis, kelompok perlakuan maupun kontrol hanya terlihat tanda inflamasi ringan berupa eritema. Rerata dan Simpangan baku jumlah PMN, limfosit, sel plasma, makrofag, giant cell, neovaskularisasi, fibrosis kobalt kromium dan kontrol berturut turut yaitu (0,6 ± 0,49; 0,7 ± 0,48); (0,9 ± 0,87; 1,0 ± 0,67); (0,6 ± 0,24; 0,6 ± 0,21); (1,4 ± 0,84; 0,9 ± 0,74); (0,5 ± 0,27; 0); (0,6 ± 0,33; 0,7 ± 0,48); (0,5 ± 0,27; 0,1 ± 0,02). Hasil t-test menunjukkan perbedaan yang tidak signifikan (p>0,05) pada 6 parameter inflamasi sedangkan parameter giant cell menunjukkan perbedaan yang signifikan (p<0,05). Kesimpulan penelitian ini adalah implantasi subkutan logam kobalt kromium menyebabkan reaksi jaringan berupa infiltrasi giant cell selama 14 hari pasca implantasi sebagai respon tehadap benda asing.

 

Effect Of Subcutaneous Implantation Of Cobalt Chromium As An Alternative Material For Mini Screw Orthodontics Against Albino Rabbit’s Tissue. Mini screw orthodontics is an instrument which is used in orthodontic treatment for some cases that require absolute anchorage. Available mini screws are made of nickel titanium or stainless steel alloy which in some patients may cause a reaction to the tissues. Implantation test is a test performed to determine the biocompatibility of medical devices that are directly contacted to the living tissue. Tissue response to injury after implantation affects the degree of formation of granulation tissue, foreign body reaction, and fibrosis. The aim of this study is to determine the local effect of implantation of cobalt chromium as an alternative material for mini screw orthodontic against the subcutaneous tissue of albino rabbits. The subjects of study were 20 male albino rabbits divided into two groups (treatment and negative control groups). Cobalt chromium was made in the form of discs with 10 mm in diameter and 1 mm in thickness. In the treatment group, the material was implanted in the subcutaneous tissue of the dorsum of the rabbits with an incision to form a subcutaneous pocket. The pocket base was not more than 10 mm from the initial line of incision then suturing was performed. The control group only had incision then sutured to maintain aseptic conditions. Macroscopically 24 hours after implantation, the implant area was observed related to the occurrence of oedema, haematoma, encapsulation and signs of inflammation. The evaluation on day 14 post-implantation shows the histopathologic changes observed by the infiltration of inflammatory cells types. The average of the results was analyzed using independent sample t-test. The results of the macroscopic observation shows that the treatment and control group were only seen of mild inflammatory signs included erythema. The mean and standard deviation of the amount of PMN, lymphocyte, plasma cells, macrophage, giant cell, neovascularisation, and fibrosis from cobalt chromium and control groups were (0.6 ± 0.49; 0.7 ± 0.48); (0.9 ± 0.87; 1.0 ± 0.67); (0.6 ± 0.24; 0.6 ± 0.21); (1.4 ± 0.84; 0.9 ± 0.74); (0.5 ± 0.27; 0); (0.6 ± 0.33; 0.7 ± 0.48); (0.5 ± 0.27; 0.1 ± 0.02). The results of t-test show a significant difference in giant cell (p<0.05), while the six others did not (p>0.05). The conclusion of this study is that the cobalt chromium alloy can affect the subcutaneous tissue by inducing giant cell infiltration on day 14 post-implantation as the result of foreign body reactions.


Keywords


mini screw orthodontics; implantasi; kobalt kromium; reaksi jaringan; mini screw orthodontics; implantation; cobalt chromium; tissue response

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DOI: https://doi.org/10.22146/majkedgiind.9018

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