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. 2023 Jun 13:15:109-119.
doi: 10.2147/CCIDE.S408158. eCollection 2023.

The Role of Asiatic Acid in Preventing Dental Pulp Inflammation: An in-vivo Study

Arlina Nurhapsari  1   2 , Risya Cilmiaty  3 , Adi Prayitno  3 , Bambang Purwanto  4 , Soetrisno Soetrisno  5
Affiliations

The Role of Asiatic Acid in Preventing Dental Pulp Inflammation: An in-vivo Study

Arlina Nurhapsari et al. Clin Cosmet Investig Dent. .

Abstract

Purpose: Acute dental pulp inflammation necessitates early treatment to alleviate inflammation and pain. In the inflammatory phase, a substance is required to lower the inflammatory mediators and reactive oxygen species that play a crucial role in that phase. Asiatic acid is a natural triterpene obtained from the Centella asiatica plant with a high antioxidant value. This study examined the effect of Asiatic acid's antioxidant, anti-inflammatory, and antinociceptive properties on dental pulp inflammation.

Methods: The research is an experimental laboratory, with a post-test only with a control group design. The study utilised 40 male Wistar rats weighing 200-250 grams and aged 8-10 weeks. Rats were divided into five groups (control, eugenol, Asiatic Acid 0.5%; 1%; 2% group). Dental pulp inflammation was created in the maxillary incisor after six hours of administration of lipopolysaccharides (LPS). The dental pulp treatment then continued with the administration of eugenol and three different Asiatic acid concentrations (0.5%, 1% and 2%). In the next 72 hours, the teeth were biopsied, and the dental pulp was analysed using the enzyme-linked immunosorbent assay (ELISA) to measure the level of MDA, SOD, TNF-α, beta-endorphins and CGRP. Histopathological examination and the Rat Grimace Scale were utilised to determine the level of inflammation and pain, respectively.

Results: The effect of Asiatic Acid on MDA, TNF-α, and CGRP levels decreased significantly compared to the control group (p=<0.001). On the SOD and beta-endorphin levels, Asiatic acid treatment resulted in a considerable rise (p =<0.001).

Conclusion: Due to its antioxidant, anti-inflammatory, and antinociceptive characteristics, Asiatic acid can reduce inflammation and pain in acute pulp inflammation due to its ability to decrease MDA, TNFα, and CGRP levels while raising SOD and beta-endorphin levels.

Keywords: Asiatic acid; CGRP; MDA; SOD; TNF-α; beta endorphins; pulp inflammation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
An illustration of the dental pulp inflammation procedure and the treatment procedure.
Figure 2
Figure 2
The result of pain assessment using the RGS scale. The differences between parameters were analysed using Kruskal Wallis and the post hoc test. *p<0.05 and ns = not significant (not shown). The replication of the group was 5.
Figure 3
Figure 3
Inflammation reaction based on the intensity of inflammatory cells. Score 1 (0–20 cells), score 2 (21–40 cells), score 3 (41–80 cells). The replication of the group was 5.
Figure 4
Figure 4
The histopathology of dental pulp to assess the inflammation after treatment with Asiatic acid. The blue box indicated the coronal-pulp chamber and pointed as an area of observation H&E staining. Yellow arrows represent vascular leakage, characterised by erythrocyte discharge from blood vessels, while black arrows represent inflammatory cells. The replication of the group was 3.
Figure 5
Figure 5
ELISA examination results from pulp tissue that had been treated for 72 hours. Examination of MDA (A) and SOD (B) levels. The differences between parameters were analysed using One Way ANOVA and the post hoc test. **p<0.001; ***p<0.0001; ****p<0.0000 and ns = not significant (not shown). The replication of the group was 5.
Figure 6
Figure 6
ELISA examination for TNF-α levels from pulp tissue that had been treated for 72 hours. The differences between parameters were analysed using One Way ANOVA and the post hoc test. **p<0.001; ***p<0.0001; ****p<0.0000 and ns = not significant (not shown). The replication of the group was 5.
Figure 7
Figure 7
ELISA examination of beta-endorphins (A) and CGRP (B) from pulp tissue that had been treated for 72 hours. The differences between parameters were analysed using One Way ANOVA and the post hoc test. * p<0.05; ** p<0.01; ***p<0.001; ****p<0.0001 and ns = not significant (not shown). The replication of each group was 5.
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