Based on the research results of Health’s Basic Research Department (RISKESDAS) Ministry of Health in 2018, there was 57.6 percent of Indonesia’s population experience oral health problems affecting their quality of life. Meanwhile, the prevalence of caries in the population aged between 12 and over 65 years ranged from 65.5 percent to 95 percent.
Oral health problems such as dental caries must be dealt with immediately and appropriately to prevent caries from being so severe that the affected teeth must be extracted. Moreover, in Indonesia, tooth extraction has become the most common form of treatment applied to severe dental caries that has the potential to cause alveolar bone damage.
The percentage of procedures involving tooth extraction in Indonesia is around 79.6 percent. The normal healing sequence of bone extraction is resorption, usually involving hard and soft tissue defects in the alveolar bone region.
Loss of periodontal tissue structure in the affected area after tooth extraction is a problem and can affect the aesthetic and function of dental prosthetics for rehabilitation of the masticatory system. Post-extraction dental socket preservation, which involves the use of bone graft as a biomaterial scaffold, is needed because of the alveolar bone’s resorption pattern.
Regenerative dentistry involving the application of tissue engineering techniques is starting to emerge and is increasingly popular. The tissue engineering combines biocompatible scaffolding, growth factors, and stem cells which are then grafted into the affected area to increase remodeling or regeneration of damaged tissue.
Bone regeneration can be achieved optimally with the application of mesenchymal stem cells (MSCs). One promising source of MSC in the orofacial section is deciduous dental pulp (SHED) stem cells which demonstrate the potential osteogenic differentiation ability that supports regeneration of bone defects. However, biocompatible scaffolding is needed to optimally support and facilitate MSC proliferation.
The apatite carbonate scaffold (CAS) biomaterial is relatively popular and is often used in Indonesia to stimulate bone regeneration as a way to overcome excessive bone resorption. GAMA-CHA®, the product used in this study, is a scaffold made and formulated in Indonesia consisting of apatite carbonate and gelatin.
SHED can attach and multiply optimally because of CAS (GAMACHA®) rather than hydroxyapatite. Meanwhile, there have been no studies analyzing the ability of SHED combined with CAS (GAMA-CHA®) to improve alveolar bone over resorption in experimental animals. The hypothesis of this study is that CAS transplantation combined with SHED increases alveolar bone remodeling through expression of bone morphogenic proteins 2 and 7 (BMP-2 and BMP-7) and decreases matrix metalloproteinase-8 (MMP-8) expression in experimental animals. Therefore, the aim of this study was to investigate the expression of BMP-2, BMP-7 and MMP-8 after CAS transplantation combined with SHED in experimental animals.
The results of this study showed that expression of BMP-2 and BMP-7 was higher in CAS + SHED than in the CAS group. MMP-8 levels were lower in the CAS + SHED group than in the CAS group. There was an increase in BMP-2 and BMP-7 expression in the CAS + SHED group compared with the CAS group (p
Based on the results of the study, it can be concluded that CAS combined with SHED can increase BMP-2 and BMP-7 expression, but also decreases MMP-8 expression during alveolar bone remodeling in wistar rats ( R. norvegicus ). (*)
Author: Prof. Dr. Chiquita Prahasanti, drg., Sp.Perio(K)