EFFECTIVENESS OF CHITOSAN-BASED 0.5% TETRACYCLINE GEL AND FREEZE-DRIED PLATELET-RICH PLASMA ON POST-PERIODONTAL SURGERY HEALING: CLINICAL AND IMMUNOHISTOCHEMICAL EVALUATION

Authors

  • RIO SIMANJUNTAK Resident of Periodontology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia
  • PITU WULANDARI Department of Periodontology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia
  • DENNY SATRIA Department of Pharmaceutical Biology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia https://orcid.org/0000-0003-4724-3256
  • KWARTARINI MURDIASTUTI Department of Periodontology, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
  • ARMIA SYAHPUTRA Department of Periodontology, Faculty of Dentistry, Universitas Sumatera Utara, Medan, Indonesia

DOI:

https://doi.org/10.22159/ijap.2024.v16s2.13

Keywords:

Chitosan, PRP, Periodontitis, Tetracycline, Wound healing

Abstract

Objective: Periodontal treatment widely uses tetracycline as a local antibiotic because it has broad-spectrum antibacterial and anticollagenase properties. Chitosan-based 0.5% tetracycline gel, there was an increase in the performance of tetracycline because chitosan released the drug locally, was slower, controlled, lasted longer, had better stability and lower toxicity. Periodontal treatment is currently trending using Platelet-Rich Plasma (PRP) because of its properties, which release many growth factors. To facilitate clinical administration, PRP was developed by the freeze-drying process to become allogeneic Freeze Dried PRP (FD-PRP) obtained from the blood bank. Combination can help accelerate the healing of periodontal surgical wounds. To evaluate the effectiveness of administration of chitosan-based 0.5% tetracycline gel and FD-PRP.

Methods: Laboratory experimental study with posttest-only control group design on 30 Wistars-induced periodontitis. The sample was divided into 5 groups: negative and positive control group and 3 periodontal surgical intervention groups accompanied by drug administration. The examination of clinical parameters such as Bleeding on Probing (BoP) and Pocket Depth (PD) as well as immunohistochemical parameters such as fibroblast growth factor-2 (FGF-2) were evaluated on days 3 and 14.

Results: This study showed a significant decrease in BoP on day 3 (p=0.022) and 14 (p=0.009), decrease in PD on day 14 (p=0.007) and a significant increase in FGF-2 on day 3 (p=0.024) and decrease on day 14 (p=0.017).

Conclusion: Administration of chitosan-based 0.5% tetracycline gel and FD-PRP were effective in periodontal surgical wound healing because it reduced BoP and PD and increased fibroblast cell proliferation through increasing FGF-2 expression.

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References

Newman MG, Takei HH, Klokkevold PR, Carranza FA. Clinical periodontology. 13th ed. Amsterdam: Elsevier; 2019: 55-79, 90-111, 507-10.

Charalambidou G, Kofidou E, Papaioannou N, Karampatakis V, Komnenou A. The effect of intrastromal PRP and oral doxycycline in corneal wound healing after alkali burn. J Hellenic Vet Med Soc. 2018;69(4):1213-25. doi: 10.12681/jhvms.16119.

Dahlen G, Basic A, Bylund J. Importance of virulence factors for the persistence of oral bacteria in the inflamed gingival crevice and in the pathogenesis of periodontal disease. J Clin Med. 2019;8(9):1339-58. doi: 10.3390/jcm8091339, PMID 31470579.

Sanz M, Tonetti M. Periodontitis new classification of periodontal and peri-implant diseases. Perio Clin. 2019;1(15):18-24.

Bathla S, Bathla M. Periodontics revisited. New Delhi: Jaypee Brothers; 2011. p. 129-36, 187-90.

Gonzalez AC, Costa TF, Andrade ZA, Medrado AR. Wound healing-a literature review. An Bras Dermatol. 2016;91(5):614-20. doi: 10.1590/abd1806-4841.20164741, PMID 27828635.

Alven S, Aderibigbe BA. Chitosan and cellulose-based hydrogels for wound management. Int J Mol Sci. 2020;21(24):1-30. doi: 10.3390/ijms21249656, PMID 33352826.

Alves R, Grimalt R. A review of platelet-rich plasma: history, biology, mechanism of action, and classification. Skin Appendage Disord. 2018;4(1):18-24. doi: 10.1159/000477353, PMID 29457008.

Andia I, Perez Valle A, Del Amo C, Maffulli N. Freeze-drying of platelet-rich plasma: the quest for standardization. Int J Mol Sci. 2020;21(18):1-18. doi: 10.3390/ijms21186904, PMID 32962283.

Price Evans A. Introducing volume 14 of regenerative medicine. Regen Med. 2019;14(1):1-5. doi: 10.2217/rme-2018-0167, PMID 30570390.

Shiga Y, Kubota G, Orita S, Inage K, Kamoda H, Yamashita M. Freeze-dried human platelet-rich plasma retains activation and growth factor expression after an eight-week preservation period. Asian Spine J. 2017;11(3):329-36. doi: 10.4184/asj.2017.11.3.329, PMID 28670400.

Oentaryo G, Istiati I, Soesilawati P. Acceleration of fibroblast number and FGF-2 expression using channa striata extract induction during wound healing process: in vivo studies in wistar rats. Dent J (Majalah Kedokteran Gigi). 2016;49(3):125-32. doi: 10.20473/j.djmkg.v49.i3.p125-32.

Chicharro Alcantara D, Rubio Zaragoza M, Damia Gimenez E, Carrillo Poveda JM, Cuervo Serrato B, Pelaez Gorrea P. Platelet-rich plasma: new insights for cutaneous wound healing management. J Funct Biomater. 2018;9(1):1-20. doi: 10.3390/jfb9010010, PMID 29346333.

Yun YR, Won JE, Jeon E, Lee S, Kang W, Jo H. Fibroblast growth factors: biology, function, and application for tissue regeneration. J Tissue Eng. 2010;2010:218142. doi: 10.4061/2010/218142, PMID 21350642.

Shetty A, Bhandary R, Thomas B. Highlights on role of antibiotics in periodontics. Int J Dentistry Res. 2016;1(1):24-7. doi: 10.31254/dentistry.2016.1105.

Susanto C, Ervina I, Agusnar H. In vitro evaluation of antimicrobial effectiveness chitosan-based tetracycline gel on some pathogenic periodontal bacteria. Int J Appl Dent Sci. 2017;3(2):71-6.

Andrew A, Ervina I, Agusnar H. In vitro chitosan hydrogel-based tetracycline cytotoxicity test on fibroblast viability. Adv Health Sci Res. 2018;4:266-72. doi: 10.2991/idsm-17.2018.36.

Oz HS, Puleo DA. Animal models for periodontal disease. J Biomed Biotechnol. 2011;2011:754857. doi: 10.1155/2011/754857, PMID 21331345.

Guvva S, Patil MB, Mehta DS. Rat as laboratory animal model in periodontology. Int J Oral Health Sci. 2017;7(2):68-75. doi: 10.4103/ijohs.ijohs_47_17.

Struillou X, Boutigny H, Soueidan A, Layrolle P. Experimental animal models in periodontology: a review. Open Dent J. 2010;4:37-47. doi: 10.2174/1874210601004010037, PMID 20556202.

Ionel A, Lucaciu O, Moga M, Buhatel D, Ilea A, Tabaran F. Periodontal disease induced in wistar rats–experimental study. HVM Bioflux. 2015;7(2):90-5.

Maryani I, Rochmah YS, Parmana AD. Analisa gel kombinasi platelet rich plasma dan chitosan terhadap peningkatan jumlah osteoblas sebagai bone regeneration pada luka pasca ekstraksi gigi tikus wistar. ODONTO: Dental Journal. 2018;5(2):89-96. doi: 10.30659/odj.5.2.89-96.

Yang LC, Hu SW, Yan M, Yang JJ, Tsou SH, Lin YY. Antimicrobial activity of platelet-rich plasma and other plasma preparations against periodontal pathogens. J Periodontol. 2015;86(2):310-8. doi: 10.1902/jop.2014.140373, PMID 25345340.

Kinane DF, Stathopoulou PG, Papapanou PN. Periodontal diseases. Nat Rev Dis Primers. 2017;3:17038. doi: 10.1038/nrdp.2017.38, PMID 28805207.

Veith AP, Henderson K, Spencer A, Sligar AD, Baker AB. Therapeutic strategies for enhancing angiogenesis in wound healing. Adv Drug Deliv Rev. 2019 Jun;146:97-125. doi: 10.1016/j.addr.2018.09.010, PMID 30267742.

Ding ZY, Tan Y, Peng Q, Zuo J, Li N. Novel applications of platelet concentrates in tissue regeneration (review). Exp Ther Med. 2021;21(3):226. doi: 10.3892/etm.2021.9657, PMID 33603835.

Ervina I, Wilson AWD, Amalia M, Syahputra A, Nasution AH. The role of scaling-root planing with a subgingival application of tetracycline 0,7 % based chitosan hydrogel in periodontitis rats’ model (Evaluation of clinical parameters and fibroblast cell counts on periodontal ligaments). Nat Volatiles Essent Oils. 2021;8(4):2315-24.

Mohammadi R, Mehrtash M, Mehrtash M, Hassani N, Hassanpour A. Effect of platelet-rich plasma combined with chitosan biodegradable film on full-thickness wound healing in rat model. Bull Emerg Trauma. 2016;4(1):29-37. PMID 27162924.

Dukka H, Saleh MH, Ravida A, Greenwell H, Wang HL. Is bleeding on probing a reliable clinical indicator of peri-implant diseases? J Periodontol. 2021;92(12):1669-74. doi: 10.1002/JPER.20-0890, PMID 33829501.

Matesanz Perez P, Garcia Gargallo M, Figuero E, Bascones Martinez A, Sanz M, Herrera D. A systematic review on the effects of local antimicrobials as adjuncts to subgingival debridement, compared with subgingival debridement alone, in the treatment of chronic periodontitis. J Clin Periodontol. 2013;40(3):227-41. doi: 10.1111/jcpe.12026, PMID 23320860.

Sutamaya AG, Hendiani I, Susanto A. Clinical evaluation of adjunctive topical therapy of tetracycline HCl 25 mg in the surgical periodontal flap. PJoD. 2016;28(2):121-5.

Kida D, Zakrzewska A, Zborowski J, Szulc M, Karolewicz B. Polymer-based carriers in dental local healing-review and future challenges. Materials (Basel). 2021;14(14):3948. doi: 10.3390/ma14143948, PMID 34300865.

He J, Da L, Pan Y, Tan X, Li Z, Luo F. Association between quantitative analyses of periodontal pathogens and the depth of periodontal pockets. Biotechnol Biotechnol Equip. 2020;34(1):515-21. doi: 10.1080/13102818.2020.1764387.

Nayak S, Goel MM, Makker A, Bhatia V, Chandra S, Kumar S. Fibroblast growth factor (FGF-2) and its receptors FGFR-2 and FGFR-3 may be putative biomarkers of malignant transformation of potentially malignant oral lesions into oral squamous cell carcinoma. Plos One. 2015;10(10):e0138801. doi: 10.1371/journal.pone.0138801, PMID 26465941.

Maeda H, Tomokiyo A, Wada N, Koori K, Kawachi G, Akamine A. Regeneration of the periodontium for the preservation of the damaged tooth. Histol Histopathol. 2014;29(10):1249-62. doi: 10.14670/HH-29.1249, PMID 24777740.

Alvarez AL, Espinar FO, Mendez JB. The application of microencapsulation techniques in the treatment of endodontic and periodontal diseases. Pharmaceutics. 2011;3(3):538-71. doi: 10.3390/pharmaceutics3030538, PMID 24310596.

Kononen E, Gursoy M, Gursoy UK. Periodontitis: a multifaceted disease of tooth-supporting tissues. J Clin Med. 2019;8(8):1-12. doi: 10.3390/jcm8081135, PMID 31370168.

Garzon H, Suarez LJ, Munoz S, Cardona J, Fontalvo M, Alfonso Rodriguez CA. Biomaterials used for periodontal disease treatment: focusing on immunomodulatory properties. Int J Biomater. 2022;2022:7693793. doi: 10.1155/2022/7693793, PMID 35528847.

Fraser D, Caton J, Benoit DS. Periodontal wound healing and regeneration: insights for engineering new therapeutic approaches. Front Dent Med. 2022;3:1-24. doi: 10.3389/fdmed.2022.815810.

Smith PC, Martínez C, Martínez J, McCulloch CA. Role of fibroblast populations in periodontal wound healing and tissue remodeling. Front Physiol. 2019;10(270):270. doi: 10.3389/fphys.2019.00270, PMID 31068825.

Nagayasu Tanaka T, Anzai J, Takaki S, Shiraishi N, Terashima A, Asano T. Action mechanism of fibroblast growth factor-2 (FGF-2) in the promotion of periodontal regeneration in beagle gogs. Plos One. 2015;10(6):1-19. doi: 10.1371/journal.pone.0131870.

Zhang Y, Wang ZL, Deng ZP, Wang ZL, Song F, Zhu LL. Emerging delivery strategies of platelet-rich plasma with hydrogels for wound healing. Adv Polym Technol. 2022;2022:1-11. doi: 10.1155/2022/5446291.

Published

27-05-2024

How to Cite

SIMANJUNTAK, R., WULANDARI, P., SATRIA, D., MURDIASTUTI, K., & SYAHPUTRA, A. (2024). EFFECTIVENESS OF CHITOSAN-BASED 0.5% TETRACYCLINE GEL AND FREEZE-DRIED PLATELET-RICH PLASMA ON POST-PERIODONTAL SURGERY HEALING: CLINICAL AND IMMUNOHISTOCHEMICAL EVALUATION. International Journal of Applied Pharmaceutics, 16(2), 68–73. https://doi.org/10.22159/ijap.2024.v16s2.13

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