One of the local factors causing tooth loss is tooth extraction. A normal tooth extraction process will always be followed by the resorption and regeneration of the alveolar bone. Alveolar bone is one part of the oral cavity with an important role in the use of dentures. Dentures require holding factor in the form of alveolar bone with good density, for removable dentures, fixed dentures or implant dentures. Alveolar bone resorption is known to last for 1 year after tooth extraction and will continue the following year. During the first year after tooth loss, there was a 25% decrease in bone width 1 and 40% reduction in bone width during the first one to three years after tooth extraction.
The extraction of natural tooth usually causes trauma extraction trauma which triggers inflammation, leading to the growth of osteoclasts and alveolar bone resorption. Preservation of the original tooth extraction socket is needed in patients to reduce the occurrence of alveolar bone resorption, also an effort to maintain the alveolar bone so it has good density, both vertically and horizontally.
In the field of Medicine and Dentistry, the use of graft to repair bone defects and augmentation has often been done. Bovine Bone Graft (BBG) is an allograft made by Dr. Soetomo’s tissue network has been used often. Propolis contains many resins and bioactives, such as bioflavonoids, artepilin, apigenin, Caffeic Acid Phenethil Ester (CAPE) which have efficacy as a remedy for inflammation, anti-oxidants, antibacterial, antiviral and immunomodulatory as well as stimulating tissue healing.
Heat shock protein 70 (HSP70) is a stress protein that can occur in all types of cells. Under normal circumstances HSP acts as a companion molecule. Under normal conditions HSP maintains cell homeostasis and is expressed when cells experience stress due to injury. Intracellular HSP70 acts as an anti-inflammatory and increases cell proliferation thereby supporting its role in wound healing, while Osteocalcine is the largest part of osteoblasts as a sign of bone regeneration and reduces resorption of alveolar bone after tooth extraction.
What is the condition of the alveolar bone when propolis extract and bovine bone graft are filled in the tooth extraction socket seen on day 3 and 7? This research was carried out treatment on day 3 and 7, by comparing the charging socket filled with, Polyethylene glycol (PEG) as a control, propolis extract, + PEG, Bovine Bone Graft (BBG) + PEG and a combination of Propolis + BBG + PEG.
The aim of this immunohistochemistry research is to preserve tooth extraction sockets by combining natural propolis extract and Bovine Bone Graft material to fill in tooth extraction sockets to increase HSP 70 and Osteocalsin which are the largest part of osteoblasts as a sign of bone regeneration and reduce the resorption of alveolar bone after tooth extraction.
The results of this study showed that group with a combination of propolis and BBG extracts on day 3 and 7 showed the highest number of HSP70 expression, osteocalsin expression, and osteoblast cells and showed the lowest number of osteoclast cells. In this study it was proven that the combination of propolis and BBG extract could increase intracellular HSP70 expression. This can occur because propolis extract contains polyphenol compounds which have anti-oxidant, cytoprotective and anti-inflammatory effects. Polyfenol is able to capture free radicals produced by oxidative stress.
HSP70 also has the ability and activity in cell repair systems, so it is also called cellular stress response. Increased HSP70 will protect proteins, including protecting the expression of cells themselves. This will improve cell function including cells of the immune system. Furthermore, HSP70 activity in wound healing is mediated by macrophages by increasing the regulation of phagocytic function and inducing macrophages in the release of cytokines and growth factors.
The combination of natural propolis extract and BBG to maintain tooth extraction sockets can reduce inflammation, increase HSP 70 and decrease osteoclasts, and accelerate osseointegration, thereby accelerating the growth of osteocalcin expression, which is the largest element of osteoblast cells. The conclusion of this study, a group with a combination of propolis and BBG extracts on day 3 and 7 increased HSP70 expression, osteocalcin expression, and highest osteoblast cells, which showed alveolar bone regeneration and lowest osteoclast counts, thereby reducing alveolar bone resorption.
Author: Utari Kresnoadi
Penelitian ini dapat dilihat pada DOI https://doi.org/10.105/s-0040-1701921
ISSN1305-7456 @2020 Dental Investigation Society
Utari Kresnoadi, Retno Pudji Rahayu, Maretaningtias DA, Soesanto : (2020) The Potential of Natural Propolis Extract combined Bovine Bone Graft in Increasing Heat Shock Protein 70 and Osteocalcin on Socket Preservation,, Europian Journal of Dentistry,2020 ,14(1):31-37