Potential Analysis of Belimbing Wuluh (Averhoe bilimbi L.) leaf extract on increasing Fibroblasts, TGFß1 expression and density of Collagen fibers in the Periodontal ligament during Orthodontic Tooth Movement

Background: Orthodontic treatment is a treatment to correct malocclusion. The periodontal ligament plays an important role in preventing recurrence after orthodontic treatment. Fibroblast cells play a role in the regeneration of the periodontal ligament to maintain the stability of orthodontic treatment. Fibroblast cells play a role in the formation of collagen fibers that will connect teeth to bones. TGFß1 is a growth factor that plays a role in inducing the proliferation and transformation of fibroblasts into myofibroblasts and stimulates the accumulation of matrix proteins, including laminin, collagen 1 and 3, and fibronectin. Orthodontic treatment takes a long time so we need a method to speed it up. Belimbingwuluh leaf extract (Averrhoa bilimbi L.) contains antioxidants and anti-inflammatories which are expected to increase the number of fibroblasts and the density of collagen fibers. Objective : To analyze the potential of belimbingwuluh leaf extract in increasing the number of fibroblasts, TGFß1 expression and collagen fiber density during orthodontic tooth movement. Method: using 36 rats divided into 6 groups. The control group was fitted with orthodontic appliances without extracts, and the treatment group was fitted with orthodontic appliances and starfruit leaf extract for 7 days, 14 days and 21 days. An orthodontic appliance in the form of a closed coil spring Ni-Ti was installed to move the maxillary first molars mesially with orthodontic mechanical force. Histological preparations were made on M1 RA teeth with their periodontal ligament, then the tissue was stained with HE to observe fibroblasts, and Trichome Mallory staining for collagen fiber density and immunohistochemical staining to examine TGFß1 expression. Observation of fibroblasts and TGFß1 expression using a microscope and collagen density were observed using a microscope using the Adobe CS 6.0 application. Results: showed a significant increase in the number of fibroblasts, TGFß1 expression and density of collagen fibers in the 7, 14 and 21 day treatment group compared to the control group (p<0.05). Conclusion: BelimbingWuluh leaf extract increases fibroblasts, TGFß1 expression and collagen fiber density in the periodontal ligament during orthodontic tooth movement.