Kontribusi Lapisan Hidroksiapatit pada Purwarupa Implan Titanium terhadap Nilai Osseointegrasi Melalui Removal Torque Test

Gunawarman Gunawarman, Jon Affi, Ilhamdi Ilhamdi, Nuzul Ficky Nuswantoro, Djong Hon Tjong, Menkher Manjas

Abstract


Biomaterial titanium mulai banyak digunakan sebagai bahan implan karena mempunyai kekuatan tinggi, lentur, tahan korosi dan biokompatibilitas yang baik. Namun demikian, titanium bersifat bioinert yang membuatnya tidak bisa berinteraksi dan menyatu dengan jaringan hidup. Untuk menutup kelemahan ini, titanium perlu dilapisi dengan bahan yang mempunyai bioaktivitas tinggi seperti biokeramik hidroksiapatit (HA). Pada studi ini, pelapisan HA telah dilakukan pada purwarupa implan berbentuk sekrup yang terbuat dari paduan titanium tipe β yang relatif baru dikembangkan, yakni Ti-29Nb-13Ta-4.6Zr (TNTZ). Proses pelapisan dilakukan dengan menggunakan metode Electrophoretic Deposition (EPD). Lapisan HA pada permukaan TNTZ meningkatkan bioaktivitas implan logam ini sehingga memicu proses penyatuan implan dengan jaringan hidup (osseointegration). Parameter yang digunakan untuk menentukan nilai osseointegrasi ini adalah besarnya gaya puntiran (torsi) yang dibutuhkan untuk melepaskan sekrup dari tulang dengan menggunakan alat removal torque tester (RTT). Untuk itu, sekrup TNTZ berukuran M3x0.5 yang tidak dilapisi HA (tanpa HA) dan yang sudah dilapisi HA (lapis HA) ditanamkan pada paha atas (tibia) hewan uji mencit Rattus norvegicus Wistar kemudian dipelihara selama 2 (dua) minggu. Setelah itu, hewan uji dimatikan, dan besaran torsi untuk melepaskan masing-masing sekrup dari tibia mencit diukur dengan alat RTT tersebut, dan dilanjutkan dengan analisis histopatologi pada jaringan bekas pemasangan implan. Hasil studi menunjukkan bahwa implan TNTZ dengan lapis HA memiliki nilai osseointegrasi yang jauh lebih tinggi (470%) dari implan tanpa HA. Analisis histopatologi menunjukkan bahwa proses pembentukan jaringan baru (osteogenesis) yang jauh lebih banyak pada jaringan tulang yang dipasangi implan TNTZ lapis HA dibandingkan dengan tanpa HA. Disamping itu, adanya lapisan  HA pada permukaan implan juga mampu mengurangi reaksi inflamasi yang berlebihan pada jaringan tulang hewan uji dalam waktu yang relatif singkat.

Titanium biomaterials are starting to be widely used as implant materials because they have high strength, flexibility, corrosion resistance and good biocompatibility. However, titanium is bioinert which makes it unable to interact and blend with living tissue. To cover this weakness, titanium needs to be coated with a material that has high bioactivity such as hydroxyapatite (HA) bioceramic. In this study, HA coating was carried out on a screw-shaped implant prototype made of a relatively recently developed -type titanium alloy, namely Ti-29Nb-13Ta-4.6Zr (TNTZ). The coating process is carried out using the Electrophoretic Deposition (EPD) method. The HA layer on the TNTZ surface increases the bioactivity of these metallic implants thereby triggering the process of implant integration with living tissue (osseointegration). The parameter used to determine the osseointegration value is the amount of torsion required to remove the screw from the bone using a removal torque tester (RTT). For this reason, TNTZ screws measuring M3x0.5 which were not coated with HA (without HA) and which had been coated with HA (HA coated) were implanted in the upper thigh (tibia) of Rattus norvegicus Wistar mice and then reared for 2 (two) weeks. After that, the test animals were turned off, and the magnitude of the torque to remove each screw from the tibia of mice was measured with the RTT device, and continued with histopathological analysis of the implanted tissue. The results of the study showed that TNTZ implants with HA coating had a much higher osseointegration value (470%) than implants without HA. Histopathological analysis showed that the process of new tissue formation (osteogenesis) was much more abundant in bone tissue with HA-coated TNTZ implants compared to those without HA. In addition, the presence of an HA layer on the surface of the implant was also able to reduce the excessive inflammatory reaction in the bone tissue of the test animals in a relatively short time.


Keywords


hydroxyapatite titanium implant osseointegration removal torque test

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DOI: https://doi.org/10.18196/jmpm.v5i2.13904

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