Abstract
Background: Tissue engineering technology has been used globally and proven to accelerate wound healing. This study aimed to analyse the effect of adding hydroxyapatite (HA) as a scaffold to platelet-rich fibrin (PRF) as a growth factor in accelerating the wound healing process as seen from the expression of matrix metalloproteinase-13 (MMP-13). Methods: This research is an animal experiment conducted on 18 rabbits ( Oryctolagus cuniculus). Rabbits were randomly divided into the following three groups of treatment: (G1) the application of PRF group, (G2) the application of PRF+HA group and (C) the control group without any application. Furthermore, each treatment group was split randomly into three groups of observation time. Periodontal tissue biopsy was performed to analyse the histopathological features that were examined on the basis of the level of MMP-13 immunoexpression. Results: MMP-13 immunoexpression in the PRF+HA group showed better histoscore results, indicating a substantial reduction in MMP-13 values compared with other groups. The healing process was shown to increase with increasing observation time (p<0.05), and the PRF+HA group outperformed the PRF and control groups. On day 3, MMP-13 exhibited a dark brown colour of Immunohistochemistry (IHC), which indicated an increase in the expression value of MMP-13 in the early stages of healing, namely, inflammation. On day 14, light brown IHC was seen, especially in group 2, as a reference that the remodeling process had begun. Conclusions: This study indicates that the application of HA can accelerate the socket healing process by decreasing the level of immunoexpression of MMP-13. HA is an alloplastic material that has inherent bioactive properties that support osteoconduction, which functions as a scaffold in the form of a fibrin matrix that can bind MMPs so that it can accelerate the wound healing process.
Highlights
Tooth extraction is one of the most common treatment procedures in dentistry
On Day 14, it was observed that matrix metalloproteinase-13 (MMP-13) had a lower histoscore, especially in group 2
This preclinical study confirmed the hypothesis that the application of HA in post-extraction socket healing can accelerate the healing process and decrease the level of matrix metalloproteinases (MMPs)-13 immunoexpression based on the stages of wound healing, namely the stages of inflammation, proliferation, and progression
Summary
Tooth extraction is one of the most common treatment procedures in dentistry This procedure may cause resorption of the alveolar bone, gingival recession around the extraction area and periodontal abnormality and may result in an aesthetic problem because of post-extraction anatomical and physiological changes.[1,2] The wound healing process is influenced by various molecules, inflammation mediators, integrins, growth factors and matrix metalloproteinases (MMPs). This study aimed to analyse the effect of adding hydroxyapatite (HA) as a scaffold to platelet-rich fibrin (PRF) as a growth factor in accelerating the wound healing process as seen from the expression of matrix metalloproteinase-13 (MMP-13). The healing process was shown to increase with increasing observation time (p
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