VITAMIN E PREVENTS OXIDATIVE STRESS AND INFLAMMATION CONDITIONS IN PERIODONTITIS WISTAR RATS

Periodontitis terutama disebabkan bakteri patogen periodontal yang dapat memicu pembentukan radikal bebas yang berlebihan, menyebabkan stres oksidatif sehingga terjadi kerusakan jaringan. Hal ini mempunyai pengaruh bermakna terhadap peningkatan produksi Reactive Oxygen Species (ROS) dalam tubuh dan kerusakan sel pada jaringan alveolar gigi. Penelitian ini bertujuan untuk mengetahui pengaruh vitamin E dalam mengatasi stres oksidatif pada tikus putih strain Wistar yang mengalami periodontitis. Penelitian ini merupakan penelitian eksperimental dengan post test only control group design. Tiga puluh ekor tikus dikelompokan menjadi 5 kelompok yaitu kontrol negatif (tanpa perlakuan), kontrol positif (diberi silk ligature 14 hari) dan perlakuan 1, 2, dan 3 (diberi silk ligature selama 14 hari, dilanjutkan dengan pemberian vitamin E dengan dosis 20, 40, dan 60 IU selama 10 hari). Pada hari terakhir penelitian dilakukan pengambilan darah untuk pemeriksaan kadar Malondialdehyde (MDA) dan penilaian inflamasi gingiva melalui skor indeks gingiva. Hasil penelitian menunjukkan bahwa rerata kadar MDA pada kelompok kontrol positif yang diberikan silk ligature saja mempunyai kadar MDA tertinggi dibandingkan dengan kelompok kontrol negatif dan semua kelompok perlakuan. Pemberian vitamin E mampu menurunkan kadar MDA serum secara bermakna pada semua kelompok perlakuan (p < 0,05). Vitamin E juga mampu menurunkan skor indeks gingiva dibandingkan dengan kelompok kontrol positif pada semua kelompok. Simpulan: Pemberian vitamin E mampu mengatasi stres oksidatif dan inflamasi pada periodontitis yang ditandai dengan penurunan kadar MDA dan skor indeks gingiva.


INTRODUCTION
Periodontal disease is an infectious disease caused by the accumulation of bacteria that can cause inflammation around the teeth supporting tissues, including the gingiva, periodontal ligament, and alveolar bone (Genco and Williams, 2010). If periodontal disease has been going on for a long time and is severe, it can cause pain, discomfort, masticatory disorders, and ultimately tooth loss. Periodontal disease affects humans almost all over the world and reaches 50% of the adult population. Studies have shown that periodontal disease affects the health of the world's population, which is the most significant cause of tooth loss (Glascoe L et al., 2015). Predisposing factors for periodontal disease are stress, nutritional deficiency, systemic disease, alcohol and tobacco consumption, genetics, and plaque accumulation (Quamilla, 2016). The diagnosis of periodontitis is conventionally carried out by measuring periodontal tissue damage, such as examination of clinical attachment level and probing depth (Hong et al., 2019). One of the causes of the increasing prevalence of dental and oral problems in Indonesia is the lack of public awareness in maintaining dental and oral health.
Studies of the etiology of the prevention and treatment of periodontal disease show that this disease can be prevented by maintaining good oral hygiene (Santoso, 2019).
Oxidative stress has been linked as a major contributor to more than 100 disorders and more recently in periodontists (Ayala et al., 2014). The body's antioxidant defense system plays an important role in fighting chronic disease. Inflammation (local or systemic) has been directly associated with periodontal disease (Liu et al., 2014). Excessive oxidative stress conditions in the body are highly reactive and damaging to cell structures in the form of carbohydrates, nucleic acids, lipids, and proteins. In addition, free radicals also change cell function and even cause cell death (Liu et al., 2014). If the endogenous antioxidant system is insufficient, the body needs antioxidants from outside (exogenous) such as vitamins A, C, E, and flavonoid compounds (Kurutas, 2016). Vitamins A, C, and E are compounds that contain antioxidants because they have antibacterial, antiviral, and cell apoptosis-inducing or antitumor activities (Birben et al., 2012). Vitamin E is fat-soluble and consists of two isomers: tocopherols and tocotrienols (Mohd Zaffarin et al., 2020). Vitamin E as an exogenous antioxidant can break radical chain reactions (Stolzenberg-Solomon et al., 2009)

Periodontitis Induction
The rats were anesthetized using ether, then induced periodontitis by binding a silk ligature to the rat's lower central incisor. The excess wire was tucked at the mesial margin for 14 days, as previously reported (Ionel et al., 2015).

Assessment of inflammation with Gingival
Index Score   Periodontitis is an inflammatory disease that affects the supporting structures of the teeth leading to loss of alveolar bone and teeth (Könönen et al., 2019).
The main causative factor is the microorganism that colonizes the subgingival dental plaque, which induces an inflammatory host response. However, the inflammatory infection and the surrounding healthy tissue eventually lead to the destruction of the periodontium. Chronic inflammation in the tissues surrounding the teeth caused by an imbalance between the oral biofilm and the periodontal host response will lead to the loss of the supporting tissues of the teeth (Singh et al., 2017). The use of vitamin E as an adjunct to nonsurgical periodontal treatment has been shown to affect periodontal parameters positively (Behfarnia et al., 2021).

CONCLUSION
Administration of vitamin E can overcome oxidative stress and inflammation in periodontitis conditions.

ACKNOWLEDGEMENT
The author thanks Syafriman and Yusniati for their technical assistance.