Keywords
tooth extraction - mandibular incisors - alveolar bone healing
Introduction
Currently, many studies are using animals to examine wound healing. Some of them use
rats, dogs, rabbits, and even monkeys. Animals that are often used to find new types
of medicines for wound healing in research studies are rats.[1]
[2] Wound healing in tooth extraction is needed in animal models so that the effect
of drugs given can contribute to faster recovery. The process of wound healing in
hard tissue that involves the alveolar bone is very complex because it involves soft
and hard tissues. What is required is a drug that can accelerate the healing of tooth
extraction wounds. Several models of tooth extraction using molar teeth in both the
maxilla and mandible have been performed, but models that use incisors are still rarely
used because it is feared that they will be difficult to use, considering the Wistar
incisors are quite long and thin. So, they will break easily when the tooth is extracted.
The use of incisors as animal models is attempted in wound healing research, giving
some advantages to the long root tooth socket, allowing the drug to last long in the
socket, and making it effective to know the role of the drug. Wistar rats were also
able to chew food using the remaining three incisors and molar teeth. Wistar rats
have four incisors, so removing one incisor does not cause death in these animals.[3]
[4]
[5]
[6]
[7]
Materials and Methods
We used a new technique to extract the incisors of Wistar rats used in research to
find wound-healing remedies for tooth extraction. Fifty Wistar rats were used in this
study. All research procedures were approved by the Airlangga University Ethics Committee.
Animals were obtained from the Faculty of Veterinary Medicine, Airlangga University
(animals breeding), were chosen to homogenize with male sex, age 3 months, body weight
150 to 200 g, healthy with agile movements, feathers not easily fall off, no injuries
to all parts of the body and decay teeth. Experimental animals that met the criteria
were then separated and put into a cage for adaptation for 1 week. Experimental animals
in the adaptation process were fed and provided water ad libitum, with husk replacement
every 2 days. Before the treatment started, rats were randomized into cages of size
40 × 30 × 20 cm, containing 2 mice per cage with a baffle.[7]
[8]
Wistar rats were given anesthesia using ketamine combined with xylazine intraperitoneally
as much as 0.1 mL/10 g body weight (BW). Dose was prepared by mixing 1.0 mL of 100
mg/mL ketamine with 0.5 mL of 20 mg/mL xylazine. The volume of the existing ketamine
and xylazine mixture was added to saline solution to reach 10 mL in total. From this
10 mL, the total combination of ketamine and xylazine was used as much as 0.1 mL/10
g BB. After the anesthesia stage was reached, with the condition of the animal being
sound asleep, the extraction of the tooth began ([Figs. 1]
[2]). The incisors and surrounding areas were cleaned with iodine, and then extraction
was performed on the left lower incisors using a PT2 (Hu-Friedy) periotome, using
special modifications and forceps. Tooth extraction sockets were filled with drug
ingredients to be studied ([Fig. 3]). The extracted mandibular incisors area was then closed using a 5.0 suture monofilament
thread.[7]
[9]
[10]
[11]
Fig. 1 Wistar rat lower incisor extraction.
Fig. 2 Wistar rat lower incisor teeth.
Fig. 3 Application of medicinal ingredients studied in tooth extraction sockets.
Results
Extraction of mandibular incisors in Wistar rats was performed by carefully refining
the lower mandibular, so that the animals did not experience excessive trauma other
than that caused by tooth extraction. The process of extraction using special tools
was also performed with caution; this was indicated by the incidence of very small
tooth roots (2%) and the remaining fracture could be removed intact again. The bleeding
that occurred (3%) was stopped by pressing gauze on the wound after extraction and
suturing with nylon needle 5.0.
Discussion
The animal selection process tries to pay attention to replacement, reduction, and
refinement. Replacement is the need to use carefully tested experimental animals,
both from previous experience and literature. Reduction is the use of animals in research
as little as possible, but still getting optimal results. Refinement is humane animal
treatment, keeping the animal well, not hurting the animal or minimizing painful treatment
to ensure the comfort of the animal until the end of the study.
The use of special tools such as the PT2 (Hu-Friedy) periotome, a modified bein, special
pulling pliers are very important for the successful extraction of Wistar rat teeth.
Other things that also play an important role in this study include the age of the
experimental animals; for example, young adults Wistar rats should be selected, so
that tooth extraction is easier. This is because in older animas, cementum root levels
are increased, making the extraction of Wistar rat teeth difficult and increasing
the potential for fracture. At the time of extraction of the Wistar incisors, the
periodontal ligament in the tooth needs to be damaged first by means of a modified
bein inserted into the gingiva of the incisors, then after it is felt sufficient,
the forceps are used with a semicircular pull.[12]
[13]
[14] After the tooth extraction is completed, each treatment group is immediately given
the material to be researched in each mice group using a blunt-pointed needle. The
former extraction area is then closed using a 5.0 monofilament thread, so that the
medicinal ingredients to be studied do not flow out of the retractable socket, because
Wistar rats are animals that eat through front teeth.
In this study, the level of tooth fracture in extraction was much smaller than the
research conducted by Zecchin et al.[6] No animals died from anesthesia and infection as the extraction was performed on
a single root and the experimental animals used were still young, with the alveolar
bone more elastic and less cementum ([Table 1]). This technique allows researchers to find a drug that can cure tooth extraction
wounds faster, as well as study for bone grafts in the alveolar bone.
Table 1
Incidence of complications during extraction of Wistar rat incisors
|
Extraction of incisors
|
Number of Wistar rats
|
|
Root tooth fracture
|
1
|
|
Death from anesthesia and infection
|
0
|
|
Hemorrhage
|
6
|
|
Total
|
50
|
Conclusion
The new techniques of extraction can be useful for studying mucosal and alveolar bone
healing, specifically finding new types of drugs to accelerate wound healing during
alveolar bone post extraction.
