Saran - KESIMPULAN DAN SARAN - METODE PENELITIAN

BAB III. METODE PENELITIAN

BAB 6 KESIMPULAN DAN SARAN

6.2 Saran

Memerlukan penelitian yang lebih lanjut dengan jumlah sampel yang lebih banyak dan lebih luas karena dalam penelitian ini sampel sangat terbatas sehingga data yang didapatkan tidak terdistribusi normal.

Masih diperlukan banyak penelitian mengenai perubahan yang terjadi pada tahap awal pergerakan gigi sehingga dapat dapat diambil kesimpulan dan

dikembangkan mekanoterapi yang baik sehingga perawatan ortodonti dapat menjadi lebih efektif dan efisien tanpa merusak jaringan ortodonti.

Penggunaan elastik separator dari Orto Organizer tipe Blue Regular 300-355 bentuk ring sebaiknya tidak lebih dari 3 hari supaya tidak terjadi resorpsi yang tidak diinginkan. Terbuka kesempatan untuk meneliti lebih lanjut apa yang terjadi di jaringan periodontal bila separator dipakai lebih dari durasi tersebut.

DAFTAR PUSTAKA

1. Bhalaji SI, Orthodontics The Art Science 4^th, Ed. 7-22

2. Profitt WR. Fields WH, 2000. Contemporary Orthodontics. Mosby Inc, St. Louis, Missouri US, 4rd. 332-357.

3. Uitto VJ. Gingival Crevice Fuild. Blackwell Munksgaard. Denmark, Periodontology. 2000, 3003;31:9-42.

4. Dudic A, et.al. Composition Changes in Gingival Crevicular Fluid During Orthodontic Tooth Movement : Comparison Between Tension and compression Sides. Eur J Oral Sci 2006;114:418-22.

5. Deinzer R, et. al. After Effects of Stress on Crevicular Interleukin-1β. J Clin Perodontol 2000;27:74-77.

6. Yamamoto, et.al. Mechanical stress induces expression of cytokines in human periodontal ligament cells. University of Medicine Graduate School, Kyoto, Japan, 2006:171-5.

7. Engebretson SP, et.al. GCF IL-1β profiles in periodontal disease. J Clin Periodontal 2002;29:48-53.

8. Nishiyama Y, Yamaguchi M, Kojima T, et.al. Levels og RANKL and OPG in gingival crevicular fluid during orthodontic tooth movement and effect of compression force on releases from periodontal ligament cells in vitro. Orthod Craniofacial Res 9, 2006;63-70.

9. Bhalaji SI, Orthodontics, The Art and Science. Arya Publishing House, New Delhi, 1998:374.

10. Krishnan V. Orthodontic pain : from causes to management-a review. Eur J of Orthod, 2007:29(2):170-9.

11. Marris CK. Effects of preoperative ibuprofen, anxiety and gender on post separator placement pain. University of Flourida, 2004:1-19.

12. Bondenmark L, Fredkriksson K, Iiros S. Separation effects and perception of pain and discomfort from two types of orthodontic separators. World J Orthod 2004;5:172-176.

13. Tanaka KK, Kurokawa A, Mitsuhasi M. Fujita S, Goseki T, Yamaguchi M, dkk, Expression of Heat Shock Protein 70 in the Periodontal Ligament During Orthodontic Tooth Movement, Int. J. Oral. Med. Sci.2010:9(2):115-121.

14. Mitsuharhi M, Yamaguchi M, Jokima T, Nakajiwa R, Kasal K, Effects of HSP70 on the Compression Force-Induced TNF-α and RANKL expression in human Periodontal. Inflamm. Res. 2011:60:187-194.

15. Shigehara S, Matsuzaka K and Inoue T. Morphohistological Change and

Expressin of HSP70, Osteopontin and Osteocalcin mRNAs in Rat Dental Pulp Cells with Orthodontic Tooth Movement. Bull Toyko dort coll. 2006,

47(3);117-124.

16. Profitt WR, Fields HW. Contemporary Orthodontics. Mosby Inc, St. Louis, Missouri US, 3^rd ed, 2000:296-304.

17. Nanda R. Biomechanical and Esthetic Strategies in Clinical Orthodontics. Elsevier Saunders, St. Lois, Missuori, 2005:17-7.

18. Masella RS, Chung PL. Thinking Beyond the Wire: Emerging Biologic Relationships in Orthodontics and Periodontology. Semin Orthod 2008:14:290-304.

19. Kokich VG. Kokich VO. Interrelationship or Orthodontics with Periodontics and Restorative Dentistry. 2005:348.

20. Trowbridge HO, Emling RC. Inflammation, A Review of the Process. Quintessence Publishing Co, Inc., Moscow, 1993:80-2

21. Schlesinger M.J. Heat Shock Proteins. J. Chem Biol. 1990;265:12111-12111. 22. Schlesinger M.J. Heat Shock Proteins : The Search for Function. J Cell Biol. Vol

103, Agust 1986 :321-325.

23. Yamaguchi M. Kazuaka. Inflammation in Periodontal Tissues in Response to Mechanical Force, Japan, 2005:388-94.

24. Nakano K, Saito S, Nabeyama A, Oishi S, Sato M, Yokoi Y, et. al. HSP70 Expression in the Mouse Dental Pulp After Immediate Teeth Separation. Journal of Hard Tissue Biology 22(1) (2013).7-12.

25. Bhalaji SI, Orthodontics The Art Science 4^th, Ed. 197-210.

26. Graber T.M. Current Orthodontic Concepts and Techniques. 1969 by W.B. Saunders Company. Librarby of Congress catalog card number 69-12882.

27. Nakano K, Muraoka R, Tomida M, Matsuura S, Okafuji N, Siar CH, etl. al. Expression of HSP in Dental Root Pulp Cell due to Experimental Orthodontic Mechanical Stress. Journal of Hard Tissue Biology 1831) (2009).127-130.

28. Bhalaji SI, Orthodontics The Art Science 4^thEd Mechanics of Tooth Movement. 212-218.

29. Nanda R. Biomechanics and Esthetic Strategies in Clinical Orthodontics: Principles of Biomechanics.

30. Malagan M, P. Biswa, Muddaiah S, Reddy R, Shetty BK, Preetham J, et. al. Comparison Between efficacy of Four Different Types of Orthodontic Separator. Journal of Clinical and Diagnostic Research, 2014. Aug, Vol.8(8): ZC41-ZCA4. 31. Davidovitch M, Papamnicolaou S, Vardimon AD, Brosh T. Duration of

Elastomeric separation and effect on interproximal contact point characteristics. American Association of Orthodontic doi:10.1016/j.ajodo.2006.02.036.

32. Sandhu GPS, Kanase A, Naite CR, Pupnejol P, Sudan S. Separation Effect and Perception of Pain and Discomfort form Three Types of Orthodontic Separator. J Ind Orthod Soc 2012; 47(1):6-9.

33. Krishnan V. Orthodontic pain : from causes to management-a review. European Journal of Orthodontics 29 (2007) 170-179.

34. Alfaqeeh SA, Anil S. Gingival Crevicular Fluid Flow rate and Alkaline Phosphatase Level as Potential Marker of Active Tooth Movement. OHDM-Vol.13-No.2-June, 2014.

35. Ngan P, Wilson S,Shanfild J, Amini H. The effect of ibuprofen on the level of discomfort in patients undergoing orthodontic treatment. Am J Orthod Dentofac Orthop 1994;106:88-95.

36. Hoffman WE. A study of four types of orthodontic separator. Am J Orthod 1972;62:67-73.

37. Yuwono T. Biologi Molekuler. Erlangg. Universitas Gajah Mada. Jakarta. 2008:1-5

38. Widjaja F. Santoso LA. Waspadji S. Peran Head Shock Protein terhadap resistensi insulin. Tinjauan pustaka. Majalah Kedokteran Indonesia 2009; Vol. 59,Nomor 3:121-128.

Lampiran 1

Gambar 1. Rata-rata kadar HSP 70 (ng/mL) setelah beberapa waktu pengamatan

a

b

Correlations

Jarak HSP 70 0 Jam

Jarak Pearson Correlation 1 -,050

Sig. (2-tailed) ,751

N 42 42

Bootstrap^c Bias 0 ,006

Std. Error 0 ,146

95% Confidence Interval Lower 1 -,317

Upper 1 ,257

HSP 70 0 Jam Pearson Correlation -,050 1

Sig. (2-tailed) ,751

N 42 42

Bootstrap^c Bias ,006 0

Std. Error ,146 0

95% Confidence Interval Lower -,317 1

Upper ,257 1

c. Unless otherwise noted, bootstrap results are based on 1000 bootstrap samples

Hasil; Hubungan antara jarak pergerakan gigi dengan kadar HSP70 nya tidak berhubungan kuat dan tidak signifikan.

Tests of Normality

Jam

Kolmogorov-Smirnov^a Shapiro-Wilk

Statistic Df Sig. Statistic Df Sig.

HSP 70 0 jam ,236 14 ,033 ,790 14 ,004

12 jam ,226 14 ,050 ,761 14 ,002

24 jam ,374 14 ,000 ,710 14 ,000

a. Lilliefors Significance Correction

Test of Homogeneity of Variance

Levene Statistic df1 df2 Sig.

HSP 70 Based on Mean 1,131 2 39 ,333

Based on Median ,752 2 39 ,478

Based on Median and with

adjusted df ^,752 ² ^34,601 ^,479

Based on trimmed mean ,942 2 39 ,399

Data tidak berdistribusi normal tetapi homogen. Setelah ditransformasi data-data tersebut, ternyata tetap distribusi tidak normal maka dilanjutkan dengan uji non parametrik “friedmen tast” (uji lebih dari 2 perlakuan dan dependen).

Friedman Test Ranks Mean Rank HSO 70 0 jam 2,00 HSP 70 12 jam 2,04 HSP 70 24 jam 1,96 Test Statistics^a N 14 Chi-Square ,036 Df 2 Asymp. Sig. ,982 a. Friedman Test

Kesimpulan: Jumlah HSP 70 di sekitar mulut setelah beberapa jam tindakan maka tidak terdapat perbedaan yang nyata (p=0,982 atau p>0,05).

Lampiran 2

Tests of Normality^a

Jam

Kolmogorov-Smirnov^b Shapiro-Wilk

Statistic df Sig. Statistic df Sig.

Jarak 12 jam ,226 14 ,051 ,810 14 ,007

24 jam ,237 14 ,031 ,834 14 ,013

a. Jarak is constant when Jam = 0 jam in one or more split files. It has been omitted. b. Lilliefors Significance Correction

Test of Homogeneity of Variance^a

Levene Statistic df1 df2 Sig.

Jarak Based on Mean ,024 1 26 ,877

Based on Median ,042 1 26 ,839

Based on Median and with

adjusted df ^,042 ¹ ^25,311 ^,839

Based on trimmed mean ,023 1 26 ,882

a. Jarak is constant when Jam = 0 jam in one or more split files. It has been omitted.

Friedman Test Ranks Mean Rank Jarak 0 jam 1,14 Jarak 12 jam 1,93 Jarak 24 jam 2,93 Test Statistics^a N 14 Chi-Square 25,120 df 2 Asymp. Sig. ,000 a. Friedman Test

Kesimpulan: Jarak gigi setelah beberapa jam tindakan maka terdapat perbedaan yang nyata (p=0,000 atau p<0,05). Test Statistics^a Jarak 12 jam - Jarak 0 jam Jarak 24 jam - Jarak 0 jam Jarak 24 jam - Jarak 12 jam Z -2,879^b -3,322^b -3,071^b

Asymp. Sig. (2-tailed) ,004 ,001 ,002

a. Wilcoxon Signed Ranks Test b. Based on negative ranks.

Hasil: ada perbedaan yang nyata antara jarak pada 0 vs 12 jam, 0 vs 24 jam, dan jarak 12 vs 24 jam.

Lampiran 3

Judul Tesis : Perbandingan Ekspresi Heat Shock Protein-70 (HSP-70) di Dalam Cairan Sulkus Gingiva Pada Pergerakan Gigi Secara Ortodonti

Nama Mahasiswa : Yusmaini Maizir Nomor Induk Mahasiswa : 117160001

Program Studi : Pendidikan Dokter Gigi Spesialis Ortodonti

Menyetujui Pembimbing :

Pembimbing Utama Pembimbing Anggota

Prof. Nazruddin, drg., C.Ort., Ph.D, Sp.Ort Nurhayati Harahap, drg., Sp.Ort (K) NIP : 1952062219800310001 NIP. 19481230197802 2 002

Sekretaris Program PPDGS-1 Ortodonti

Muslim Yusuf, drg. Sp. Ort (K) NIP. 195808281988031002

Dalam dokumen PERUBAHAN KADAR HEAT SHOCK PROTEIN-70 (HSP-70) DI DALAM CAIRAN SULKUS GINGIVA PADA PERGERAKAN GIGI SECARA ORTODONTI (Halaman 59-71)