SKRIPSI - repository.unair.ac.idrepository.unair.ac.id/29185/1/KG. 141-16 Les e - HALAMAN DEPAN... · Seluruh dosen dan staf Departemen Bedah Mulut dan Maksilofasial Fakultas Kedokteran

EFEKTIVITAS EKSTRAK BUAH BELIMBING WULUH

TERHADAP ANGIOGENESIS PENYEMBUHAN LUKA

PENCABUTAN GIGI MARMUT

SKRIPSI

Oleh:

ANGELINA PUTRI LESTARI

021211131019

FAKULTAS KEDOKTERAN GIGI

UNIVERSITAS AIRLANGGA

SURABAYA

2015

ADLN - PERPUSTAKAAN UNIVERSITAS AIRLANGGA

SKRIPSI EFEKTIVITAS EKSTRAK BUAH ... ANGELINA PUTRI LESTARI

i

EFEKTIVITAS EKSTRAK BUAH BELIMBING WULUH

TERHADAP ANGIOGENESIS PENYEMBUHAN LUKA


SKRIPSI

Oleh :

ANGELINA PUTRI LESTARI

021211131019

FAKULTAS KEDOKTERAN GIGI

UNIVERSITAS AIRLANGGA

SURABAYA

2015



iii

PENETAPAN PANITIA PENGUJI SKRIPSI Skripsi ini telah diuji pada tanggal 22Desember 2015

PANITIA PENGUJI SKRIPSI

1. Dr. David B. Kamadjaja, drg., MDS., Sp.BM (ketua penguji)

2. R. Soesanto, drg, M.Kes., Sp.BM(K) (pembimbing utama/anggota)

3. Djodi Asmara, drg., SU., Sp.BM (pembimbing serta/anggota)

4. Herdi Eko Pranjoto, drg., SU., Sp.BM (penguji)

5. Andra Rizqiawan, drg., PhD., Sp.BM (penguji)



iv

UCAPAN TERIMA KASIH

Segala puji bagi Allah SWT, atas rahmat dan karunia-Nya sehingga skripsi

saya yang berjudul “Efektivitas Ekstrak Buah Belimbing Wuluh terhadap

Angiogenesis Penyembuhan Luka Pencabutan Gigi Marmut” dapat selesai,

sebagai salah satu syarat menyelesaikan pendidikan dokter gigi di Fakultas

Kedokteran Gigi Universitas Airlangga.

Perkenankanlah saya mengucapkan terima kasih yang sebesar-besarnya

kepada :

1. Dr. R. Darmawan Setijanto, drg., M.Kes selaku dekan Fakultas Kedokteran

Gigi Universitas Airlangga 2015-2020 yang telah memberi kesempatan untuk

menempuh pendidikan di Fakultas Kedokteran Gigi Universitas Airlangga.

2. Prof. R. M. Coen Pramono D, drg., SU., Sp.BM(K)., selaku dekan Fakultas

Kedokteran Gigi Universitas Airlangga periode 2010-2015 yang telah

memberi kesempatan untuk menempuh pendidikan di Fakultas Kedokteran

Gigi Universitas Airlangga.

3. Herdi Eko Pranjoto, drg., SU., Sp.BM selaku Ketua Departemen Bedah Mulut

dan Maksilofasial yang telah memberikan ijin dalam pembuatan skripsi.

4. R. Soesanto, drg, M.Kes., Sp.BM(K) selaku dosen pembimbing utama yang

selalu memberikan bimbingan, masukan, arahan, serta meluangkan waktu

selama penyusunan skripsi.

5. Djodi Asmara, drg., SU., Sp.BM selaku dosen pembimbing serta yang turut

memberikan masukan, evaluasi, koreksi, serta meluangkan waktu selama

penyusunan skripsi.



v

6. Tim penguji yang telah banyak memberikan kritik dan saran dalam

penyusunan skripsi ini.

7. Seluruh dosen dan staf Departemen Bedah Mulut dan Maksilofasial Fakultas

Kedokteran Gigi Universitas Airlangga.

8. Terima kasih tak terhingga kepada kedua orang tua saya Bapak Restu

Harianto dan Ibu Endah Basuki Prihariani yang tersayang, serta adek-adek

saya Belinda Harianti Putri dan Chikita Hariani Putri yang telah memberikan

doa, semangat, dan dukungan yang tiada henti.

9. Teman-teman seperjuangan yang telah melalui hari-hari pembuatan skripsi

bersama dan memberikan dukungan satu sama lain.

10. Semua pihak yang tidak dapat disebutkan satu persatu yang terkait dan telah

mendukung saya dalam pembuatan skripsi ini.

Penulis menyadari bahwa penyusunan skripsi ini tidak lepas dari

kekurangan. Oleh karena itu, penulis terbuka atas kritik dan saran yang

membangun dan semoga penulisan ini dapat bermanfaat bagi pembaca

Surabaya, Desember 2015

Penulis



vi

ABSTRACT

EFEKTIVITAS EKSTRAK BUAH BELIMBING WULUH TERHADAP ANGIOGENESIS PENYEMBUHAN LUKA


EFFECTIVITY OF Averrhoa bilimbii EXTRACT OF ANGIOGENESIS WOUND HEALING

MARMOT TOOTH EXTRACTION

Background. The prevalence of tooth extraction in dentistry is 54,3%. Tissue damage that occurs after tooth extraction can cause release growth factor of platelet, namely PDGF and VEGF. Both of growth factor, PDGF and VEGF, simultaneous triggering angiogenesis and mediates blood vessel growth. VEGF plays a role in the increased permeability of blood vessels, and PDGF plays a role in facilitating vascular maturation. This research to find alternatif materials that have increased angiogenesis and by utilizing natural ingredients that can later be used as a gel topical for increased wound healing.Averrhoa bilimbii extract contains flavonoids, saponins and tannins. Flavonoids, saponins and tannins have antioxidant and anti-inflammatory effects. Flavonoids also increase growth factor and wound healing post tooth extraction. Purpose. The aim of this study was to determine Averrhoa bilimbii extract against angiogenesis in socket of marmot post tooth extraction. Method. This research is a laboratory experimental with post test only group design, using 32 marmots, which divided into 8 groups, 4 groups was observed angiogenesis on the third day and 4 groups was observed angiogenesis on the fifth day. 1 of 4 groups as a control group was given CMC-Na and three others as an intervention groups was given Averrhoa bilimbii extract with concentration 10%, 20%, and 40%. Observations were made by calculating the lumens of blood vessels and using histopatological samplings. Finally, the data were analysed using One-Way ANOVA. Result. At the concentration 10%, 20%, and 40% of Averrhoa bilimbii extract showed that affects the increased angiogenesis in socket of marmot post tooth extraction on the third day and fifth day. Conclusion. The Averrhoa bilimbii extract can increased angiogenesis effect in socket of marmot post tooth extraction on the third day and fifth day

Keyword : Averrhoa bilimbii extract, Angiogenesis, Tooth extraction.



vii

DAFTAR ISI

Sampul Depan

Sampul Dalam ................................................................................................................. i

Prasyarat Gelar/Persetujuan ......................................................................................... ii

Penetapan Panitia Penguji.............................................................................................. iii

Ucapan Terima Kasih ..................................................................................................... iv

Abstract............................................................................................................................. v

Daftar Isi .......................................................................................................................... vi

Daftar Gambar ................................................................................................................ x

Daftar Tabel .................................................................................................................... xi

Daftar Lampiran ............................................................................................................. xii

BAB 1 PENDAHULUAN .............................................................................................. 1

1.1 Latar Belakang .................................................................................................... 1

1.2 Rumusan Masalah ............................................................................................... 4

1.3 Tujuan Penelitian ............................................................................................... 4

1.3.1 Tujuan Umum ........................................................................................... 4

1.3.2 Tujuan Khusus .......................................................................................... 4

1.4 Manfaat .............................................................................................................. 4

BAB 2 TINJAUAN PUSTAKA ...................................................................................... 6

2.1 Pencabutan Gigi ................................................................................................. 6

2.2 Penyembuhan Luka ............................................................................................ 7

2.2.1 Pengertian Luka ........................................................................................ 7

2.2.2 Fase Penyembuhan Luka .......................................................................... 7

2.2.2.1 Fase Inflamasi .............................................................................. 8

2.2.2.2 Fase Proliferasi ............................................................................ 9

2.2.2.3 Fase Remodeling .......................................................................... 9



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2.3 Penyembuhan Luka Pasca Pencabutan Gigi ....................................................... 9

2.4 Angiogenesis ....................................................................................................... 10

2.4.1 VEGF (Vascular Endothelial Growth Factor) .......................................... 12

2.5 Radikal Bebas .................................................................................................... 14

2.6 Antioksidan ........................................................................................................ 15

2.7 Belimbing Wuluh ............................................................................................... 15

2.7.1 Taksonomi Belimbing Wuluh ................................................................... 15

2.7.2 Karakteristik Tumbuhan Belimbing Wuluh .............................................. 16

2.7.3 Morfologi Tumbuhan Belimbing Wuluh ................................................... 17

2.7.4 Fitokimia Belimbing Wuluh ..................................................................... 18

2.7.4.1 Saponin ........................................................................................ 18

2.7.4.2 Flavonoid ..................................................................................... 19

2.7.4.3 Tanin ............................................................................................ 21

2.7.5 Manfaat Belimbing Wuluh ........................................................................ 23

2.8 CMC Na ............................................................................................................. 23

BAB 3 KERANGKA KONSEP ...................................................................................... 24

3.1 Kerangka Konsep Penelitian ............................................................................... 24

3.2 Hipotesis Penelitian ............................................................................................. 26

BAB 4 METODE PENELITIAN ................................................................................... 27

4.1 Jenis Penelitian .................................................................................................... 27

4.2 Sampel Penelitian ................................................................................................ 29

4.2.1 Jenis Sampel ............................................................................................. 29

4.2.2 Kriteria Sampel ......................................................................................... 29

4.2.3 Besar Sampel ............................................................................................ 29

4.3 Variabel Penelitian .............................................................................................. 30

4.3.1 Variabel Bebas .......................................................................................... 30

4.3.2 Variabel Terikat ........................................................................................ 30



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4.3.3 Variabel Terkontrol ................................................................................... 30

4.4 Definisi Operasional............................................................................................ 31

4.5 Instrument Penelitian .......................................................................................... 31

4.6 Lokasi Penelitian ................................................................................................. 32

4.7 Waktu Penelitian ................................................................................................. 32

4.8 Obyek Penelitian ................................................................................................. 32

4.9 Alat dan Bahan .................................................................................................... 33

4.10 Jalannya Penelitian .............................................................................................. 34

4.10.1 Tahap Persiapan ...................................................................................... 34

4.10.2 Tahap Eksperimen .................................................................................. 37

4.10.3 Tahap Observasi...................................................................................... 39

4.11 Pengolahan dan Analisis Data ............................................................................ 39

4.12 Alur Penelitian .................................................................................................... 41

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ............................................... 42

5.1 Data Penelitian .................................................................................................... 42

5.2 Analisis Data ....................................................................................................... 43

5.3 Data Gambar Preparat HPA ................................................................................ 46

BAB 6 PEMBAHASAN .................................................................................................. 48

BAB 7 KESIMPULAN DAN SARAN ........................................................................... 53

7.1 Kesimpulan ......................................................................................................... 53

7.2 Saran ................................................................................................................... 53

DAFTAR PUSTAKA ...................................................................................................... 54

LAMPIRAN



x

DAFTAR GAMBAR

Gambar 2.1 Fase Penyembuhan Luka .............................................................. 8

Gambar 2.2 Struktur Protein Faktor Angiogenik ............................................. 13

Gambar 2.3 Buah Belimbing Wuluh ................................................................ 17

Gambar 2.4 Struktur Kimia Senyawa Saponin ................................................. 19

Gambar 2.5 Struktur Kimia Senyawa Flavonoid .............................................. 20

Gambar 2.6 Struktur Kimia Senyawa Tanin .................................................... 22

Gambar 4.1 Skema Rancangan Penelitian ....................................................... 27

Gambar 5.1 Angiogenesis ............................................................................... 47



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DAFTAR TABEL

Tabel 2.1 Taksonomi Belimbing Wuluh ........................................................... 16

Tabel 5.1 Jumlah endotel yang teramati ............................................................ 42

Tabel 5.2 Grafik rata-rata endotel yang teramati ............................................... 43

Tabel 5.3 Hasil uji normalitas data ................................................................... 44

Tabel 5.4 Hasil uji homogenitas Variance Levine ............................................. 44

Tabel 5.5 Hasil uji One-Way ANOVA ............................................................... 45

Tabel 5.6 Uji Tukey HSD .................................................................................. 46



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DAFTAR LAMPIRAN

Lampiran 1. Keterangan Laik Etik

Lampiran 2.Analisis Fitokimia Ekstrak Daun Belimbing Wuluh

Lampiran 3.Gambar Alat dan Bahan

Lampiran 4. Tabel Hasil Penelitian

Lampiran 5.Hasil Uji Statistik



Documents

SKRIPSI - repository.unair.ac.idrepository.unair.ac.id/29185/1/KG. 141-16 Les e - HALAMAN DEPAN... · Seluruh dosen dan staf Departemen Bedah Mulut dan Maksilofasial Fakultas Kedokteran