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Yessy Ariesanti
Penggunaan komposit membran (polivinilalkohol-kolagen-hidroksiapatit) pada regenerasi tulang mandibula hewan coba tikus Sprague-Dawley = Use of membrane composite (polivinilalcohol-colagen-hydroxyapatite) in mandibular bone regeneration of animal testing Sprague-Dawley rats
"[ABSTRAK
Latar Belakang: Kebutuhan bahan pengganti tulang pada bidang bedah mulut dan maksilofasial semakin meningkat. Metode guided bone regeneration (GBR) yaitu suatu metode penambahan volume tulang dengan memungkinkan terjadinya pertumbuhan jaringan tulang yang selektif dalam suatu ruang, dimana pertumbuhan sel-sel tulang tersebut dijaga oleh suatu bahan (membran). Berkembangnya bahan biokomposit yang diketahui secara fakta bahwa pada penggunaan satu bahan saja tidak dapat digunakan untuk memenuhi seluruh kebutuhan pada penggunaan bahan implan pada biomedikal. Pada penelitian ini dibuat suatu komposit membran yang terdiri dari perpaduan bahan polivinilalkohol (PVA) + kolagen + hidroksiapatit. Kompositmembran (PVA-Kolagen-HA) diaplikasikan pada defek mandibular tikus Sprague-Dawley. Tujuan: Mengkaji penggunaan komposit membran (PVA-Kolagen- Hidroksiapatit) dalam regenerasi defek tulang mandibula pada hewan coba tikus perlakuan dibandingkan dengan hewan coba tikus kontrol dengan menilai sel osteoblas, sel radang dan angiogenesis.Metode Penelitian: 40 ekor tikus jantan jenis Sprague-Dawley usia 8-10 minggu dengan berat badan rata-rata 225 ± 25 gram. Tikus dibagi atas kelompok kontrol dan kelompok perlakuan dengan masing-masing berjumlah 20 ekor tikus. Dilakukan pembuatan defek pada angulus mandibular kiri tikus. Pada tikus kontrol tidak diaplikasi dengan komposit membran sedangkan pada kelompok perlakuan diaplikasi dengan komposit membran (PVA-Kolagen-HA). Kelompok kontrol dan kelompok perlakuan dengan komposit membran diamati sel osteoblas, sel radang dan angiogenesis melalui preparat histopatologi pada interval waktu hari ke-3, hari ke-7, hari ke-10, hari ke-14 dan hari ke-21. Hasil: Terdapat perbedaan bermakna (p<0,01) terhadap jumlah sel osteoblas, jumlah sel radang dan angiogenesis antara kelompok kontrol dan kelompok perlakuan dengan komposit membran (PVA-Kolagen-Hidroksiapatit). Terdapat perbedaan bermakna (p<0,01) antara jumlah sel osteoblas, jumlah sel radang dan angiogenesis terhadap interval waktu (3 hari, 7 hari, 10 hari, 14 hari dan 21 hari). Kesimpulan: Penggunaan komposit membran (PVA-Kolagen-Hidroksiapatit) mempercepat regenerasi tulang mandibular pada hewan coba tikus Sprague?Dawley.
ABSTRACT
Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. Guided bone regeneration method (GBR) is one of bone adding volume method by making the bone tissue regeneration to occur selectively in a room where the growth of bone cells are protected by a particular substance (membrane). It has been known that the developing biocomposite substance is cannot be achieved from only a single substance to recover all the requirements needed in the use of biomedic implant. In this study, a composite membrane consist of combination of polivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Composite membrane applied on the mandibular defect of Sprague-Dawley rats.
Objective: To evaluate the use of compocite membrane (PVA-Collagen-Hydroxyapatite) for regeneration of mandibular defect in animal testing (rats) comparing with group control of animal testing by observing the osteoblas, membrane (PVA-Collagen-HA) applied only in rats of testing group. The appearance of osteoblasts, inflammation cells, and angiogenesis were evaluated histopathologically on interval of 3rd, 7th, 10th, 14th and 21st day after application of composite membrane. Result: There are significant differences (p<0,01) in the number of osteoblast cells, inflammation cells and angiogenesis between the control group and the group applied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval of determined days (day 3, day 7, day 10, day 14 and day 21st). Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats.;Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.
Guided bone regeneration method (GBR) is one of bone adding volume method by
making the bone tissue regeneration to occur selectively in a room where the
growth of bone cells are protected by a particular substance (membrane). It has
been known that the developing biocomposite substance is cannot be achieved from
only a single substance to recover all the requirements needed in the use of
biomedic implant. In this study, a composite membrane consist of combination of
polivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Composite
membrane applied on the mandibular defect of Sprague-Dawley rats.
Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)
for regeneration of mandibular defect in animal testing (rats)
comparing with group control of animal testing by observing the osteoblas,
inflammation cells and angiogenesis.
Method: 40 male Sprague-Dawley rats aged 8-10 months with weight of
approximately 225 ± 25 grams were divided into two groups. First twenty rats were
treated as control group and another twenty rats for testing group. Defecation on
left angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)
applied
only
in
rats
of
testing
group.
The
appearance
of
osteoblasts,
inflammation
cells,
and
angiogenesis
were
evaluated
histopathologically
on
interval
of
3rd,
7th,
10th,
14th
and
21st
day
after
application
of
composite
membrane.
This
study
was
done
under
certification
from
the
research
ethical
committee.
Result:
There
are
significant
differences
(p<0,01)
in
the
number
of
osteoblast
cells,
inflammation
cells and angiogenesis between the control group and the group
applied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval of
determined days (day 3, day 7, day 10, day 14 and day 21st).
Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. ;Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.
Guided bone regeneration method (GBR) is one of bone adding volume method by
making the bone tissue regeneration to occur selectively in a room where the
growth of bone cells are protected by a particular substance (membrane). It has
been known that the developing biocomposite substance is cannot be achieved from
only a single substance to recover all the requirements needed in the use of
biomedic implant. In this study, a composite membrane consist of combination of
polivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Composite
membrane applied on the mandibular defect of Sprague-Dawley rats.
Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)
for regeneration of mandibular defect in animal testing (rats)
comparing with group control of animal testing by observing the osteoblas,
inflammation cells and angiogenesis.
Method: 40 male Sprague-Dawley rats aged 8-10 months with weight of
approximately 225 ± 25 grams were divided into two groups. First twenty rats were
treated as control group and another twenty rats for testing group. Defecation on
left angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)
applied
only
in
rats
of
testing
group.
The
appearance
of
osteoblasts,
inflammation
cells,
and
angiogenesis
were
evaluated
histopathologically
on
interval
of
3rd,
7th,
10th,
14th
and
21st
day
after
application
of
composite
membrane.
This
study
was
done
under
certification
from
the
research
ethical
committee.
Result:
There
are
significant
differences
(p<0,01)
in
the
number
of
osteoblast
cells,
inflammation
cells and angiogenesis between the control group and the group
applied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval of
determined days (day 3, day 7, day 10, day 14 and day 21st).
Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. , Background: The need of alternative bone substance in oral and maxillofacial surgery has increased. There are many ways can be done to add bone volume.
Guided bone regeneration method (GBR) is one of bone adding volume method by
making the bone tissue regeneration to occur selectively in a room where the
growth of bone cells are protected by a particular substance (membrane). It has
been known that the developing biocomposite substance is cannot be achieved from
only a single substance to recover all the requirements needed in the use of
biomedic implant. In this study, a composite membrane consist of combination of
polivinilalcohol material (PVA) + collagen + hydroxyapatite was made. Composite
membrane applied on the mandibular defect of Sprague-Dawley rats.
Objective: To evaluate the use of compocite membrane (PVA-CollagenHydroxyapatite)
for regeneration of mandibular defect in animal testing (rats)
comparing with group control of animal testing by observing the osteoblas,
inflammation cells and angiogenesis.
Method: 40 male Sprague-Dawley rats aged 8-10 months with weight of
approximately 225 ± 25 grams were divided into two groups. First twenty rats were
treated as control group and another twenty rats for testing group. Defecation on
left angulus mandibula was done for all groups and composite membrane (PVACollagen-HA)
applied
only
in
rats
of
testing
group.
The
appearance
of
osteoblasts,
inflammation
cells,
and
angiogenesis
were
evaluated
histopathologically
on
interval
of
3rd,
7th,
10th,
14th
and
21st
day
after
application
of
composite
membrane.
This
study
was
done
under
certification
from
the
research
ethical
committee.
Result:
There
are
significant
differences
(p<0,01)
in
the
number
of
osteoblast
cells,
inflammation
cells and angiogenesis between the control group and the group
applied with composite membrane (PVA-Collagen-Hydroxyapatite) on interval of
determined days (day 3, day 7, day 10, day 14 and day 21st).
Conclusion: Use of composite membrane (PVA-Collagen-Hydroxy) accelerates the mandibular bone regeneration of animal testing Sprague-Dawley rats. ]"
Fakultas Kedokteran Gigi Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Ista Damayanti
Laju Biodegradasi Screw Magnesium ECAP (Studi Percobaan Pada Hewan Kelinci) = Degradation Rate of Magnesium ECAP Screw (In Vivo Study in Rabbits)
"Latar Belakang : Bahan Magnesium mempunyai potensi sebagai bahan biodegradasi untuk aplikasi di bidang bedah mulut dan maksilofasial karena mempunyai sifat dapat terdegradasi. Dengan sifat biodegradasinya, Magnesium mempunyai keuntungan dibandingkan bahan biodegradable lain yang sudah ada seperti polimer, keramik dan gelas bioaktif dimana kekuatannya cukup dan nilai modulus Young mendekati tulang. Namun, degradasi magnesium yang cepat akibat korosi di dalam tubuh makhluk hidup dapat membatasi aplikasi klinisnya, misalnya aplikasi di bidang bedah mulut dan maksilofasial, karena tingkat degradasi yang terlalu tinggi menyebabkan kerusakan fungsi yang dini. Equal Channel Angle Pressing (ECAP) adalah prosedur pembentuk bahan yang digunakan untuk mengeluarkan material dengan menggunakan saluran yang dirancang secara khusus tanpa menyebabkan perubahan geometri yang substansial dan dapat membuat bahan berbutir dengan ukuran yang mengecil dengan menerapkan teknik Severe Plastic Deformation.
Tujuan : Pada penelitian ini kami menggunakan bahan Magnesium yang telah diproses dengan teknik Equal Channel Angular Pressing (ECAP) untuk produk screw. Kami mengembangkan model in vivo pada kelinci untuk menilai degradasi bahan Magnesium ECAP untuk aplikasi klinis di bidang bedah mulut dan maksilofasial.
Metode : Empat sekrup ditanamkan ke tulang paha kanan masing-masing dari 10 kelinci. Kelompok ini dibagi dalam periode pengamatan 4, 12 dan 20 minggu. Densitas degradasi bahan dan keadaan biologis disekitar screw dianalisa menggunakan pemeriksaan Micro-Computed Tomography (Mikro-CT) dan pewarnaan histologis setelah necropsy kelinci.
Hasil: Kami mengamati kehilangan volume pada semua screw, dengan timbulnya produk korosi. Nilai laju degradasi untuk screw ditemukan sebesar (0,49 ± 0,14 mm a-1). Kami juga menemukan perbedaan perilaku korosi antar bagian sekrup. Secara khusus, data kami menunjukkan bahwa korosi terjadi pada kepala dan batang screw.
Kesimpulan : Hasil penelitian baru pada kelinci ini menunjukkan bahwa sekrup Magnesium ECAP ini dapat dipertimbangkan sebagai bahan alternatif dibandingkan dengan bahan implan konvensional.
Background : Magnesium alloys have shown potential as biodegradable metallic materials for oral and maxillofacial surgery applications due to their degradability. Biodegradable magnesium are advantageous over existing biodegradable materials such as polymers, ceramics and bioactive glasses where sufficient strength and Young’s modulus close to that of the bone are required. However, fast degradation of magnesium due to corrosion in the human bio-environment may limit its clinical applications, for example, oral and maxillofacial surgery applications, because a too high degradation rate leads to premature deterioration of biofunctionality. Equal channel angular pressing (ECAP) is a viable forming procedure to extrude material by use of specially designed channel dies without a substantial change in geometry and to make an ultrafine grained material by imposing severe plastic deformation.
Objectives : In this study we use Mg alloys processed by Equal Channel Angular Pressing (ECAP) for screw fabrication products. We developed an in vivo model in rabbits to assess Mg ECAP alloys degradation for oral and maxillofacial surgery applications.
Methods : Four screws were implanted to the right femur of each of 10 rabbits. This group was divided into observation periods of 4, 12 and 20 weeks. Alloy degradation and biological effect were determined by Micro-computed Tomography (Micro-CT) and histological staining after sacrifice the rabbits.
Results : We observed a net volume loss for all devices, with considerable corrosion product formation. A greater corrosion rate for the screws (0.49 ± 0.14 mm a-1). We also found differences in corrosion behavior between screw regions. Specifically, our data suggest that corrosion was enhanced for screw shafts compared to heads
Conclusion : The results of this novel study in rabbits indicates that this screw Magnesium ECAP should be considered as an alternative to conventional implant materials."
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2017
PR-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Lisa Handayani
Respon jaringan tulang setelah implantasi miniplate dan screw magnesium ecap dengan pulasan imunohistokimia pengamatan khusus respon terhadap collagen-1, osteocalcin, alpha smooth muscle actin, cd68 = Bone tissue response post ecap processed magnesium miniplate and screw implantation by immunohistochemical staining specific response observation towards collagen-1, osteocalcin, alpha smooth muscle actin, cd68
"Latar Belakang: Magnesium ECAP mempunyai sifat mekanis yang baik danpengaruh osteoanabolik, namun magnesium memiliki sifat korosif.Imunohistokimia mengidentifikasi respon proses korosi dengan melihat jejakjaringan sekitar.
Metode: Tulang femur dipasang miniplate dan screwdikelompokkan 1-3-5 bulan. Tulang kontrol diambil pada sisi berlawanan. Hasil Imunohistokimia dinilai dengan skoring. Data diuji nonparametrik dengan tingkatkepercayaan 99.
Hasil: Perbedaan bermakna kelompok perlakuan dengankelompok kontrol p=0,000 . Peningkatan pembentukan trabekula dan responosteogenesis. Peningkatan revaskularisasi dan reaksi kluster diferensiasi terhadapgas poket hingga bulan ke-3.
Kesimpulan: Respon jaringan sekitar tertoleransi dengan terjadinya peningkatan osteogenesis, tidak ditemukannya jaringannekrosis, dan penurunan nilai gas poket.
Background : ECAP processed magnesium has an excellent mechanicalproperties and osteoanabolic effect. However metal materials are known to havecorrosive nature, and magnesium was no exception. Immunohistochemistry is ableto identify corrosion process response in living organism by looking into its tracesin surrounding tissus.
Methods : The femur bone samples were implanted byECAP processed magnesium miniplate and screw for 1, 3, and 5 months. Theopposing femur was left alone as control samples. Afterwards,immunohistochemical staining results were scored and tested using nonparametrictests with confidence interval of 99.
Results : Significant differences werefound between treatment groups and control groups p=0.000. The increase oftrabeculae formation and osteogenesis responses also revascularisation anddifferentiation clusters to gas voids are observed well into the 3 month samples.
Conclusion : Surrounding tissue responses are tolerated as shown by the increaseof osteogenesis, untraceable necrotic tissues, and the decrease in gas voids score."
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2018
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Aria Adhitya Suyatno
Efektivitas kombinasi platelet-rich plasma dan human amniotic membran terhadap adhesi paratenon dan kekuatan tendon pada penanganan total ruptur tendon achilles akut pada kelinci putih New Zealand = The Effectiveness of platelet-rich plasma combined with human amniotic membrane on paratenon adhesion and tensile strength in the treatment of acute achilles tendon rupture in New Zealand white rabbit
"Pendahuluan: Kejadian ruptur tendon Achilles meningkat dalam beberapa dekade terakhir dengan insiden tertinggi didapatkan pada kelompok usia 30-39 tahun. Penanganan terkini untuk ruptur tendon Achilles adalah pembedahan dengan penjahitan primer, serta dapat juga secara konservatif pada kondisi-kondisi tertentu. Karena komplikasi adhesi dan gliding tendon sering terjadi pasca tindakan pembedahan, para peneliti berusaha menemukan bahan yang secara efektif mampu memperbaiki proses penyembuhan tendon. Platelet-rich plasma (PRP) dan membran amnion merupakan bahan yang dinyatakan memiliki potensi dalam memperbaiki proses penyembuhan tendon, mencegah adhesi dan gliding tendon. Namun, penelitian mengenai efek kombinasi keduanya masih belum pernah dilakukan.
Metode: Model ruptur tendon Achilles dilakukan pada 24 ekor kelinci putih New Zealand yang terbagi dalam 4 kelompok perlakuan, yaitu kelompok kontrol, kelompok dengan pemberian membran amnion, kelompok dengan pemberian PRP dan kelompok dengan pemberian kombinasi membran amnion dan PRP. Evaluasi dilakukan pada 6 minggu setelah tindakan pembedahan berdasarkan penilaian terhadap pemeriksaan gliding tendon dengan USG, Tang score gambaran makroskopis adhesi tendon, grading adhesi secara makroskopis, Tang score gambaran histopatologis adhesi, grading adhesi secara histopatologis, serta Tensile strength tendon dengan uji tarik. Data yang didapatkan diuji secara statistik dengan jenis data dan jumlah kelompoknya.
Hasil: Kelompok perlakuan membran amnion serta kelompok kombinasi membran amnion dan PRP memiliki perbedaan bermakna terhadap dalam hal gliding tendon secara USG, Tang score makroskopis dan histopatologis serta grading adhesi makroskopis dan histopatologis. Kelompok perlakuan PRP dan kombinasi membran amnion dan PRP menunjukkan perbedaan bermakna terhadap kelompok kontrol dalam hal nilai tensile strength test.
Background: The incidence of Achilles tendon rupture has increased in the last few decades with the highest incidence found in the 30-39 years of age group. The current treatment for Achilles tendon rupture is surgery with primary suturing, and can also be conservative under certain conditions. Because adhesion complications and gliding tendons often occur after surgery, the researchers tried to find a material that is able to effectively improve the tendon healing process. Platelet-rich plasma (PRP) and amniotic membrane are substances that have the potential to improve tendon healing processes, prevent adhesion and gliding tendons. However, research on the effects of the combination of both has never been done.
Methods: The Achilles tendon rupture model was carried out in 24 New Zealand white rabbits, which were divided into 4 treatment groups, namely the control group, the group with the administration of amniotic membrane, the group with the administration of PRP and the group with the combination of amniotic membrane and PRP. The evaluation was carried out at 6 weeks after surgery based on an assessment of gliding tendon examination with ultrasound, Tang score macroscopic image of tendon adhesion, macroscopic adhesion grading, Tang score histopathological adhesion, histopathological adhesion grading, and Tensile strength tendon with the tensile test. The data obtained were tested statistically with the type of data and the number of groups.
Results: Amniotic membrane treatment group and combined amniotic membrane and PRP treatment group had significant differences in terms of gliding tendon by ultrasound, macroscopic and histopathological Tang scores and macroscopic and histopathological adhesion grading. The PRP treatment group and combined amniotic membrane and PRP treatment group showed significant differences compared to the control group in terms of tensile strength test values.
Conclusion: The administration of amniotic membrane can reduce the formed paratenon adhesion, however, it does not have statistical significance in influencing tendon strength. Giving Platelet-rich Plasma (PRP) does not affect the formation of paratenon adhesion statistically, but it affects the increase in tendon strength. The combination of amniotic membrane and PRP has a significant effect in reducing paratenon adhesion and increasing tendon strength."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2019
T58541
UI - Tesis Membership  Universitas Indonesia Library
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Andra Hendriarto
Efektivitas injeksi intra artikular sekretom sel punca jaringan adiposa terhadap regenerasi tulang rawan pada osteoartritis sendi lutut : penelitian pada domba = Efficacy of intra-articular injection of adipose-derived mesenchymal stem cells secretome on cartilage regeneration on knee osteoartritis : a study in sheep model
"ABSTRAK
Pendahuluan: Sebagai salah satu penyebab nyeri dan disabilitas, saat ini tidak terdapat terapi efektif yang dapat mencegah osteoartritis lutut. Saat ini, sel punca mesenkimal (SPM) telah mendapatkan banyak perhatian karena kapasitas regeneratifnya. Meskipun demikian, penggunaan SPM berkaitan dengan beberapa kekurangan seperti dibutuhkan jumlah investasi uang yang besar, sulitnya penanganan dan manufaktur sel, dan prosedur pengambilan yang invasif. Bukti saat ini menunjukkan bahwa SPM memperbaiki osteoartritis lutut melalui aksi parakrin faktor pertumbuhan dan sitokin yang disekresikan oleh SPM; factor yang disekresi ini disebut sekretom. Secara klinis, sekretom yang didapatkan dari SPM dapat menjadi alternatif yang lebih baik daripada terapi berbasis SPM, karena sekretom memiliki komplikasi lebih sedikit, penanganan, manufaktur, dan transportasi sel yang lebih mudah. Saat ini, tidak ada penelitian terpublikasi mengenai penggunaan sekretom SPM asal jaringan adiposa pada model domba. Penelitian ini bertujuan untuk mengetahui efek sekretom yang didapatkan dari SPM jaringan adiposa pada model domba dengan osteoartritis.
Metode: Induksi osteoartritis lutut dilakukan dengan menisektomi lateral total. Domba- domba (n=15) dibagi menjadi tiga kelompok; setiap kelompok terdiri dari lima domba. Kelompok pertama mendapatkan sekretom SPM jaringan adiposa, kelompok kedua mendapatkan asam hyaluronat (AH), dan kelompok ketiga mendapatkan sekretom dan asam hyaluronat. Masing-masing terapi diberikan mulai saat 4 minggu pascaoperasi. Empat minggu setelah injeksi, seluruh domba dikorbankan. Lutut dari ketiga kelompok dibandingkan secara makroskopik dan mikroskopik menggunakan skor OARSI.
Hasil: Dalam 4 minggu pasca injeksi, ditemukan fibrosis pada kelompok sekretom ditambah dengan AH yang tidak ditemukan pada kelompok lainnya. Skor osteofit pada kelompok yang diberikan sekretom lebih rendah dibandingkan kelompok-kelompok lainnya (p=0,031). Parameter-parameter lainnya, baik makroskopik maupun histologis, tidak memiliki perbedaan signifikan antar grup.
Diskusi: Hasil yang didapatkan disebabkan oleh penggunaan sekretom dari sel punca mesenkimal yang tidak diinisiasi sehingga tidak memiliki potensi anti-inflamasi maksimal. Selain itu, injeksi sekretom setelah masa inflamasi mengurangi potensi anti- inflamasi yang dimiliki oleh sekretom. Penggunaan sekretom xenogenik meningkatkan potensi inflamasi dan fibrosis karena memiliki MHC kelas I dan II.
Kesimpulan: Tidak ditemukan perbedaan signifikan pada parameter-parameter lainnya, baik makroskopik mikroskopik, pada 4 minggu pasca injeksi. Dibutuhkan penelitian lebih lanjut untuk membandingkan sel punca mesenkimal dengan sekretom, dengan mengikutsertakan penilaian fungsional.
ABSTRACT
Introduction: Despite being a common source of pain and disability, currently therapies that could retard the progression of knee osteoartritis (KOA) are lacking. Nowadays, mesenchymal stem cells (MSCs) have garnered many interests due to their regenerative capacity. However, the use of such cells is associated with several drawbacks including high capital investment, complex cell handling and manufacturing, and invasive collection procedure. Moreover, existing evidence demonstrated that these cells ameliorate KOA via paracrine actions of growth factors and cytokines secreted from them, which is referred as secretome. Clinically, the secretome derived from MSC may represent a better alternative compared with the MSC-based treatments as the former is associated with less complications, easier cell handling, manufacturing, and transportation. To date, there are no published studies regarding the use of adipose- derived mesenchymal stem cells (AD-MSCs) secretome in sheep models. The objective of this study is to investigate the effect of secretome derived from AD-MSCs in a sheep model of KOA.
Methods: Induction of KOA was performed surgically through anterior cruciate ligament transection and lateral meniscectomy. The sheep (n=15) were divided into three groups; each group consisted of five sheep. The first group received secretome derived from AD- MSCs, the second group was administered with hyaluronic acid (HA), and the third group received both secretome and HA. Each of the therapy was given weekly four weeks postoperatively. Four weeks post-injection, the sheep were sacrificed. Knees of the three groups were compared macroscopically and histologically.
Results: At 4 weeks post-injection, we found intraarticular fibrosis on secretome combined with HA, which were not found on two other groups.Tthe osteophyte score in the secretome-treated group was lower compared to the other groups (p=0.031). Other parameters, both macroscopic and histological ones did not differ significantly between groups.
Discussion: The results showed that using non-activated secretome from stem cells do not confer therapeutic advantage. The injection of secretome past the inflammation phase also attenuates the potency of secretome. The use of xenogeneic secretome which possess MHC Class I and II also enhances the pro-inflammatory capabilities of secretome and contributes to fibrosis formation .
Conclusions: Macroscopic and microscopic scores did not significantly differ between the groups after 4 weeks of injection. Further studies are needed to directly compare secretome with MSCs, including functional parameters."
Depok: Fakultas Kedokteran Universitas Indonesia, 2019
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Andi Praja Wira Yudha Luthfi
Efektivitas injeksi intra artikular sekretom sel punca mesenkimal tali pusat terhadap perbaikan defek kartilago: penelitian pada domba = Efficacy of intra-articular injection of human umbilical cord-derived mesenchymal stem cells secretome on cartilage regeneration in knee cartilage defect: an experimental study in a sheep model
"ABSTRAK
Pendahuluan: Defek tulang rawan memiliki kemampuan penyembuhan yang terbatas. Beberapa studi dengan hasil jangka panjang dalam upaya tatalaksana lesi ini terbukti belum memuaskan. Sel punca mesenkimal (SPM) banyak mendapatkan perhatian kemampuan dalam proses regenerasi sel. Namun, dibutuhkan investasi yang besar, sulitnya penanganan dan manufaktur sel, dan tindakan invasif untuk
mendapatkannya. Sekretom yang diperoleh dari SPM dapat menjadi alternatif yang baik, karena sekretom memiliki komplikasi lebih sedikit, penanganan, manufaktur, dan transportasi sel yang lebih mudah. Saat ini, tidak ada penelitian terpublikasi mengenai penggunaan sekretom SPM asal jaringan tali pusat pada model domba. Penelitian ini bertujuan untuk mengetahui efek sekretom yang didapatkan dari SPM jaringan tali pusat pada model domba dengan defek tulang rawan.
Metode: Defek tulang rawan dilakukan dengan tindakan operatif dengan membuat defek sebesar 5x5mm2 pada lutut kanan. Domba-domba (n=15) dibagi menjadi tiga kelompok; setiap kelompok terdiri dari lima domba. Kelompok pertama mendapatkan tindakan injeksi sekretom SPM tali pusat, dan kelompok ketiga mendapatkan tindakan kombinasi antara mikrofraktur dan injeksi sekretom SPM tali pusat. Enam bulan setelah tindakan, seluruh domba dikorbankan. Lutut dari
ketiga kelompok dibandingkan secara makroskopik dengan sistem skor Goebel dan mikroskopik menggunakan sistem skor Pineda.
Hasil: Pada hasil makroskopis, kelompok yang mendapatkan terapi kombinasi antara mikrofraktur dan injeksi sekretom SPM tali pusat lebih rendah secara signifikan bila dibandingkan dengan kelompok yang mendapatkan tindakan mikrofraktur saja (p=0,006). Tidak ada perbaikan bermakna pada kelompok yang mendapatkan sekretom saja terhadap kedua kelompok lainnya. Dan pada hasil mikroskopis, tidak ada perbaikan bermakna pada ketiga kelompok perlakuan.
Kesimpulan: Penggunaan terapi kombinasi antara mikrofraktur dan injeksi intraartikular sekretom SPM tali pusat memberikan potensi yang dapat menjadi alternatif terapi pada defek tulang rawan sendi lutut. Dibutuhkan penelitian lebih lanjut untuk membandingkan sel punca mesenkimal dengan sekretom, dengan mengikutsertakan penilaian fungsional.
ABSTRACT
Introduction: Cartilages with defect have limited healing capacity. Previous longterm studies to evaluate the treatment for cartilage defects have not yielded satisfactory results. Mesenchymal stem cells (MSC) have attracted attention regarding its capacity to regenerate cells. However, massive investment, difficulties in cell manufacturing and handling, and invasiveness of the procedure often gets in the way. The secretome attained from MSC may serve as an alternative as it is
correlated with lower complications; handling, manufacturing, and transport are also considered easier. Until now, there are no published article regarding the use of umbilical cord derived MSC secretome in sheep model. This study is conducted to investigate the effect of secretome derived from umbilical cord MSC in sheep models with cartilage defects.
Methods: Cartilage defect is made using operative procedures. 5x5mm2 defects are created on the right knee. 15 sheeps are divided into three groups: each group contains five sheeps. The first group was administered with umbilical cord MSC secretome, and the third group with microfacturing and umbilical cord MSC injection. Six months after the procedure, all sheeps were sacrified. Knees from the three groups are compared macroscopically using the Goebel score and microscopically using the Pineda score.
Results: Macroscopically, the group treated with combination therapy achieved lower compared to the group treated with microfacturing only (p=0,006). There was no significant difference in groups treated with secretome only and the other two groups. Microscopically, there was no significant difference between all groups.
Conclusions: The administration of combination therapy of microfacturing and intraarticular injection of umbilical cord MSC secretome gives potential results and may act as an alternative therapy in knee cartilage defect. However, further study is required to compare MSC and secretome, while also incorporating the functional measures."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
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UI - Tesis Membership  Universitas Indonesia Library
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Ariefianto Yudhi Nugroho
Pengaruh Penambahan Platelet rich plasma pada Autogenous Bone Graft Terhadap Jumlah Osteoblas (Studi Pada Ovis Aries Sebagai Model Manusia) = The Effect of Addition of Platelet Rich Plasma on Autogenous Bone Graft on The Number of Osteoblas. (Study on Ovis Aries As A Human Model)
"Latar Belakang : Teknik bone engineering dalam rekonstruksi mandibula banyak dilakukan di bidang bedah mulut guna keberhasilan proses rehabilitasi. Penambahan dua hal yang memungkinkan untuk membantu proses penyembuhan adalah dengan bone graft dan penambahan growth factors seperti Platelet Rich Plasma (PRP). Penggunaan bone graft pada defek tulang yang besar dapat membantu penyembuhan luka. Autogenous bone graft merupakan jenis graft yang paling sering digunakan, dikarenakan sifatnya yang osteogenik, osteoconductive dan osteoinductive. Vascularized bone graft merupakan terapi pilihan pada defek mandibula dengan panjang lebih dari 6 cm. Namun non vascularized bone graft juga menjadi pilihan karena memiliki beberapa keuntungan seperti kontur yang lebih baik, memiliki volume tulang yang cukup untuk keperluan estetik atau insersi implan. Serta merupakan terapi pilihan pada defek tulang kurang dari 6 cm. Tetapi resiko resorpsi pada non vascularized bone graft lebih besar. Penambahan PRP yang mengandung banyak growth factor dapat membantu proses rehabilitasi penyembuhan jaringan tulang. Salah satunya TGF-β yang membantu peningkatan jumlah osteoblas untuk penyembuhan jaringan tulang. Pada penelitian ini penambahan PRP pada autogenous bone graft non vascularized diharapkan mampu membantu penyembuhan tulang, dengan melakukan pengamatan pada jumlah osteoblas. Tujuan : Mengevaluasi pengaruh penambahan platelet rich plasma pada penyembuhan tulang mandibula dengan autogenous bone graft dilihat dari jumlah osteoblas (studi pada Ovis Aries) Material dan Metode : Penelitian quasi eksperimental in vivo dengan membagi dua kelompok, kelompok dengan pemberian autogenous bone graft dan kelompok dengan pemberian autogenous bone graft dan penambahan PRP. Kemudian dilakukan evaluasi pengaruh pemberian platelet rich plasma pada penyembuhan tulang mandibula dengan autogenous bone graft dilihat dari jumlah osteoblas (studi pada Ovis Aries) Kesimpulan : Terdapat perbedaan bermakna antara jumlah osteoblas kelompok dengan pemberian autogenous bone graft dan kelompok dengan pemberian autogenous bone graft dan penambahan PR
Background: Bone engineering techniques in mandibular reconstruction are mostly performed in the field of oral surgery for the success of the rehabilitation process. Two additional things that make it possible to help the healing process are bone graft and the addition of growth factors such as Platelet rich plasma (PRP). The use of bone grafts in large bone defects can aid in wound healing. Autogenous bone graft is the type of graft that is most often used, because of its osteogenik, osteoconductive and osteoinductive properties. Vascularized bone graft is the treatment of choice in mandibular defects longer than 6 cm. However, non-vascularized bone graft is also an option because it has several advantages such as better contours, having sufficient bone volume for aesthetic purposes or implant insertion. And is the treatment of choice for bone defects less than 6 cm. But the risk of resorption in the non-vascularized bone graft is greater. The addition of PRP which contains a lot of growth factors can help the rehabilitation process of healing bone tissue. One of them is TGF-β which helps increase the number of osteoblass for healing bone tissue. In this study, the addition of PRP to non-vascularized autogenous bone graft is expected to be able to help bone healing, by observing the number of osteoblass. Objective: To evaluate the effect of platelet rich plasma administration on the healing of mandibular bone with autogenous bone graft based on the number of osteoblass (study on Ovis Aries). Material and Methods: This in vivo analytical experimental study was divided into two groups, a group with autogenous bone graft and a group with autogenous bone graft and the addition of PRP. Then an evaluation of the effect of platelet rich plasma on the healing of mandibular bone with autogenous bone graft was evaluated from the number of osteoblass (study in Ovis Aries). Conclusion: There is a significant difference between the number of osteoblass in the group with autogenous bone graft and the group with autogenous bone graft and the addition of PRP."
Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia, 2021
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UI - Tesis Membership  Universitas Indonesia Library
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Andi Praja Wira Yudha Luthfi
Efektivitas Injeksi Intra Artikular Sekretom Sel Punca Mesenkimal Tali Pusat terhadap Perbaikan Defek Kartilago: Penelitian pada Domba = Efficacy of Intra-Articular Injection of Human Umbilical Cord-Derived Mesenchymal Stem Cells Secretome on Cartilage Regeneration in Knee Cartilage Defect: An Experimental Study in A Sheep Model.
"ABSTRAK
Pendahuluan: Defek tulang rawan memiliki kemampuan penyembuhan yang terbatas. Beberapa studi dengan hasil jangka panjang dalam upaya tatalaksana lesi ini terbukti belum memuaskan. Sel punca mesenkimal (SPM) banyak mendapatkan perhatian kemampuan dalam proses regenerasi sel. Namun, dibutuhkan investasi yang besar, sulitnya penanganan dan manufaktur sel, dan tindakan invasif untuk mendapatkannya. Sekretom yang diperoleh dari SPM dapat menjadi alternatif yang baik, karena sekretom memiliki komplikasi lebih sedikit, penanganan, manufaktur, dan transportasi sel yang lebih mudah. Saat ini, tidak ada penelitian terpublikasi mengenai penggunaan sekretom SPM asal jaringan tali pusat pada model domba. Penelitian ini bertujuan untuk mengetahui efek sekretom yang didapatkan dari SPM jaringan tali pusat pada model domba dengan defek tulang rawan.
Metode: Defek tulang rawan dilakukan dengan tindakan operatif dengan membuat defek sebesar 5x5mm2 pada lutut kanan. Domba-domba (n=15) dibagi menjadi tiga kelompok; setiap kelompok terdiri dari lima domba. Kelompok pertama mendapatkan tindakan injeksi sekretom SPM tali pusat, dan kelompok ketiga mendapatkan tindakan kombinasi antara mikrofraktur dan injeksi sekretom SPM tali pusat. Enam bulan setelah tindakan, seluruh domba dikorbankan. Lutut dari ketiga kelompok dibandingkan secara makroskopik dengan sistem skor Goebel dan mikroskopik menggunakan sistem skor Pineda.
Hasil: Pada hasil makroskopis, kelompok yang mendapatkan terapi kombinasi antara mikrofraktur dan injeksi sekretom SPM tali pusat lebih rendah secara signifikan bila dibandingkan dengan kelompok yang mendapatkan tindakan mikrofraktur saja (p=0,006). Tidak ada perbaikan bermakna pada kelompok yang mendapatkan sekretom saja terhadap kedua kelompok lainnya. Dan pada hasil mikroskopis, tidak ada perbaikan bermakna pada ketiga kelompok perlakuan. Kesimpulan: Penggunaan terapi kombinasi antara mikrofraktur dan injeksi intraartikular sekretom SPM tali pusat memberikan potensi yang dapat menjadi alternatif terapi pada defek tulang rawan sendi lutut. Dibutuhkan penelitian lebih lanjut untuk membandingkan sel punca mesenkimal dengan sekretom, dengan mengikutsertakan penilaian fungsional.
ABSTRACT
Introduction: Cartilages with defect have limited healing capacity. Previous long-term studies to evaluate the treatment for cartilage defects have not yielded satisfactory results. Mesenchymal stem cells (MSC) have attracted attention regarding its capacity to regenerate cells. However, massive investment, difficulties in cell manufacturing and handling, and invasiveness of the procedure often gets in the way. The secretome attained from MSC may serve as an alternative as it is correlated with lower complications; handling, manufacturing, and transport are also considered easier. Until now, there are no published article regarding the use of umbilical cord derived MSC secretome in sheep model. This study is conducted to investigate the effect of secretome derived from umbilical cord MSC in sheep models with cartilage defects.
Methods: Cartilage defect is made using operative procedures. 5x5mm2 defects are created on the right knee. 15 sheeps are divided into three groups: each group contains five sheeps. The first group was administered with umbilical cord MSC secretome, and the third group with microfacturing and umbilical cord MSC injection. Six months after the procedure, all sheeps were sacrified. Knees from the three groups are compared macroscopically using the Goebel score and microscopically using the Pineda score.
Results: Macroscopically, the group treated with combination therapy achieved lower compared to the group treated with microfacturing only (p=0,006). There was no significant difference in groups treated with secretome only and the other two groups. Microscopically, there was no significant difference between all groups.
Conclusions: The administration of combination therapy of microfacturing and intraarticular injection of umbilical cord MSC secretome gives potential results and may act as an alternative therapy in knee cartilage defect. However, further study is required to compare MSC and secretome, while also incorporating the functional measures."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2020
T-pdf
UI - Tesis Membership  Universitas Indonesia Library
cover
Petrus Aprianto
Efektivitas Injeksi Intra Artikular Sekretom Dan Sel Punca Mesenkimal Tali Pusat Terhadap Regenerasi Tulang Rawan Pada Osteoartritis Sendi Lutut Penelitian Pada Domba = Effectiveness of Intra-articular Secretome Injection and Cord Mesenchymal Stem Cells Against Osteoarthritis Cartilage Regeneration in Knee Joint Studies in Sheep
"Latar Belakang: Osteoartritis adalah penyakit sendi inflamasi yang paling umum, ditandai dengan penyakit sinovial degeneratif yang menghasilkan gangguan seluler dan ekstraseluler. Saat ini, pilihan perawatan bedah dan non-bedah untuk OA terbatas pada mengurangi gejala atau memperbaiki lesi yang terisolasi, dengan operasi penggantian lutut total diperlukan kemudian. Dewasa ini, timbul suatu kebutuhan terhadap terapi yang tidak hanya sementara, tetapi juga memiliki potensi untuk mengubah arah dan perkembangan penyakit, menurunkan kebutuhan analgetik dan operasi di masa depan. Penelitian lebih lanjut terkait terapi pencegahan progresivitas osteoartritis terfokus pada terapi rekayasa jaringan dengan penggunaan sekretom sel punca mesenkimal (SPM). Hingga saat ini studi-studi yang ada terkait topik tersebut masih cukup terbatas. Studi ini bertujuan untuk melihat efektivitas penggunaan sekretom dan sel punca mesenkimal tali pusat pada manajemen osteoartritis. Metode: Sebanyak 18 domba (Ovies aries) menjalani intraartikular menisektomi total sisi lateral tungkai belakang untuk membuat suatu model hewan osteoartritis. Setelah terkonfirmasi osteoartritis secara radiologis, domba tersebut kemudian dibagi menjadi tiga kelompok: kelompok sekretom, kelompok asam hyaluronat, dan kelompok SPM-sekretom yang disintesis sebelumnya dengan kultur, isolasi, dan ekspansi SPM yang dikultur di laboratorium. Semua domba kemudian disuntikkan secara intraartikular dan dievaluasi dengan pencitraan, pemeriksaan makroskopik, pemeriksaan mikroskopik (analisis histopatologi), dan imunohistokimia aggrecan. Skoring makroskopik dan mikroskopik dilakukan menggunakan intraartikular OARSI, sementara IHK protein aggrecan dihitung menggunakan system IRS agar dapat secara objektif mengevaluasi progresivitas osteoartritis. Analisis statistik kemudian dilakukan dengan analisis One-way ANOVA dan Kruskal-Wallis.
Hasil: Analisis makroskopik dengan menggunakan penilaian OARSI telah menunjukkan skor OARSI yang lebih rendah pada kelompok sekretom (6.833 ± 1.471) dibandingkan dengan dua kelompok lainnya, yang menandakan bahwa tingkat progresivitas osteoartritis paling rendah terjadi pada kelompok tersebut. Ditemukan perbedaan yang bermakna secara intraartikular antara kelompok sekretom dengan kelompok asam hyaluronat (p <0,05), namun tidak ditemukan perbedaan yang bermakna secara intraartikular antara kelompok sekretom dengan SPM-sekretom (p>0,05). Hasil serupa juga ditemukan pada kelompok mikroskopik dengan kelompok sekretom memiliki skor terendah (26.00 ± 4,24).
Kesimpulan: Sekretom menunjukkan efektivitas yang lebih baik dalam menghambat progresivitas osteoarthritis pada hewan model dibandingkan dengan asam hyaluronat, dimana tingkat efektivitas ini tidak berbeda bermakna secara intraartikular dengan SPM-sekretom. Studi lebih lanjut di lapangan untuk menentukan dosis dan frekuensi penyuntikan intraartikular harus dilakukan untuk evaluasi selanjutnya
Background: Osteoarthritis is the most prevalent inflammatory joint disease, characterized by degenerative synovial diseases that produce cellular and extracellular disruptions. Recently, the surgical and non-surgical treatment options for OA have been confined to alleviating symptoms or correcting isolated lesions, with a total knee replacement operation being necessary later. Currently, there is a need for therapy that is not only transitory but also has the potential to alter the disease's course and development, lowering the need for analgesics and surgery in the future. More investigations on such therapy are shifting into the use of mesenchymal stem cell (MSC) secretome, however, limited studies on the topic are found. This study aims to evaluate the use of MSC-secretome on the management of osteoarthritis.
Method: A total of 18 sheep (Ovies aries) underwent menisectomy to make a model osteoarthritis animal, the sheep then were divided into three groups: the secretome group, hyaluronic acid group, and MSC-secretome group, which was synthesized earlier by culture, isolation, and expansion of mesenchymal stem cell line. All the sheep were then injected intraarticularly and evaluated by imaging, macroscopic examination, and microscopic examination (histopathology and immunohistochemistry analysis) and then subjected to OARSI scoring to objectively evaluate the osteoarthritis severity. Statistical analysis were then conducted with One-way ANOVA and Kruskal-Wallis analysis.
Result: The macroscopic and microscopic analysis using OARSI scoring has revealed lower OARSI score on the secretome group (6,833 ± 1,471) as compared to other two group, implying lower grade of osteoarthritis found in the group. There are significant differences between the secretome group with the hyaluronic acid group (p <0.05). Similar result also found in the microscopic group with secretome group having the lowest score (26,00 ± 4,24).
Conclusion: Secretome is more effective on managing osteoarthritis on the model animal as compared to hyaluronic acid and no significant difference of MSC injection statistically. Further studies on the field, to evaluate the doses and frequency of injection."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022
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UI - Tugas Akhir  Universitas Indonesia Library