Tesis

Pengaruh Terapi Periodontal terhadap Kadar E-selectin pada Pasien Artritis Reumatoid = Effect of Periodontal Treatment on E-selectin Level in Rheumatoid Arthritis Patients.

Latar Belakang: Kejadian kardiovaskular adalah penyebab kematian utama pada artritis reumatoid (AR). Periodontitis diketahui berperan dalam patogenesis disfungsi endotel pada AR dan periodontitis juga berhubungan dengan risiko aterosklerosis. Aterosklerosis dimulai dari disfungsi endotel. E-selectin merupakan penanda disfungsi endotel yang spesifik dihasilkkan oleh endotel. Sampai saat ini belum ada penelitian yang meneliti efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Tujuan: Tujuan penelitian ini adalah mengetahui efek terapi periodontal terhadap kadar E-selectin pada pasien AR. Metode: Penelitian ini merupakan uji klinis randomisasi pada penderita AR yang berobat di Poliklinik Reumatologi RSCM periode Maret-Mei 2017. Pengambilan sampel dilakukan secara konsekutif. Randomisasi dilakukan dengan randomisasi blok. Subyek dibagi menjadi kelompok terapi periodontal dan kontrol. Dilakukan Uji t untuk melihat perbedaan penurunan E-selectin awal dan akhir studi antara kelompok intervensi dengan kontrol. Hasil: Periodontitis ditemukan pada 31 subyek (64,5%). Tidak didapatkan penurunan E-selectin awal dan akhir studi yang signifikan secara statistik antara kelompok intervensi dengan kontrol (p=0,303). Simpulan: Tidak didapatkan pengaruh terapi periodontal terhadap kadar Eselectin pada pasien AR.
Kata kunci: Periodontitis, terapi periodontal, artritis rheumatoid, disfungsi endotel, E-selectin.


Background: Cardiovascular events is the main cause of mortality in rheumatoid arthritis (RA). Periodontitis is known to be involved in the pathogenesis of endothelial dysfunction in RA and also associated with increased risk of atherosclerosis. Atherosclerosis process is started as endothelial dysfunction. Eselectin is a marker of endothelial dysfunction and was being expressed specifically in endothelial cells. To date, there is no study on the effect of periodontal treatment on endothelial dysfunction in RA patients. Objective: The objective of this study was to determine the effect of periodontal treatment on E-selectin level in RA patients. Methods: This was a randomized clinical trial in RA patients visiting Rheumatology Clinic RSCM between March-May 2017. Samples were collected using consecutive sampling method. Randomization was done using block randomization. Subjects were divided into nonsurgical periodontal treatment group and control group. T-test was used to measure the difference of delta Eselectin before-after study between periodontal treatment group and control. Results: Periodontitis was found in 31 subjects (64,5%). There was no statistically significant difference of delta E-selectin before-after treatment between periodontal treatment group and control. Conclusion: Periodontal treatment has no effect on E-selectin level in RA patients.
Keywords: Periodontitis, periodontal treatment, rheumatoid arthritis,, endothelial dysfunction, E-selectin