Effects of Cocoa Pod Husk Extract (Theobroma Cacao L.) on Alveolar Bone in Experimental Periodontitis Rats

Abstract

Periodontitis is a destructive inflammatory disease of the periodontal tissues with a high prevalence in the world. Phorphyromonas gingivalis as one of the main bacteria causing periodontitis produces virulence factors that trigger immune cells to produce proinflammatory cytokines that can reduce the number of osteoblasts, thereby triggering alveolar bone resorption. Osteoblast cell differentiation is mediated by a number of growth factors such as cytokines and bone morphogenic proteins (BMPs). SRP mechanical therapy is sometimes not optimal and Metronidazole as an effective antibiotic against periodontitis has been reported to have several adverse effects. Utilization of cocoa pod waste (Theobroma cacao L) with its polyphenol content has antibacterial, antioxidant and anti-inflammatory effects. This study aims to determine the effect of ethanol extract gel from cocoa pod husk extract (Theobroma cacao L.) on the number of osteoblasts and osteoclasts, as well as the expression of BMP-2 in the alveolar bone of periodontitis-model rats. This laboratory experimental study used 24 rats which were divided into negative control group (CMC-Na gel), positive control group (metronidazole gel), and treatment group (100 mg/mL cocoa pod husk extract gel). 24 Wistar rats were divided into 3 groups which were observed on days 7 and 14. The number of osteoblasts and osteoclasts of alveolar bone were observed by hematoxillin eosin staining and BMP-2 expression by immunohistochemistry staining. One-way ANOVA test showed that there was a significant difference (p < 0.05) between groups. The LSD test average of BMP-2 expression in the treatment group on the day 7 and day 14 was higher than the negative control group (p < 0.05). The conclusion of the study was that giving 100 mg/mL of cacao pod husk extract gel (Theobroma cacao L.) increased the number of osteoblasts and increased the expression of BMP-2 in the alveolar bone of periodontitis rats. HIGHLIGHTS Cocoa pod husk extract gel (Theobroma cacao) 100 mg/mL increased the ratio of osteoblasts to osteoclasts and increased BMP-2 expression in the alveolar bone of periodontitis rats The histological staining with IHC was analyzed using Quantitative Pathology 0.3.2 software The cocoa pod husk (Theobroma Cacao L.) extract gel effectively triggers and increased BMP-2 which stimulates bone formation in periodontitis rat models GRAPHICAL ABSTRACT