The effect of ethanol extract of green meniran leaves (Phyllanthus niruri Linn) in a mixture of calcium hydroxide and 2% chlorhexidine digluconate on matrix metalloproteinase-9, transforming growth factor-1 levels, osteoclast, and osteoblast cells in Wist

Background: Infections of the dental pulp and periapical tissues involve bacteria which can induce and enhance the immune response of the dental pulp but are not effective in eliminating root canal bacteria. A study was conducted to determine the effect of giving ethanol extract of green meniran leaves (Phyllanthus niruri Linn) in a mixture of calcium hydroxide and 2% chlorhexidine digluconate on the chronic inflammatory response in periapical tissue by measuring MMP-9, TGF-β1 levels, osteoclast, and osteoblast cells count. Methods: An experimental design with a post-test-only control group design involving 24 right molars of male Wistar rats divided into 4 groups. Each group consisted of 6 rats (K-) bacteria, (K+) bacteria, calcium hydroxide and 2% chlorhexidine digluconate, (P1) bacteria, calcium hydroxide and 10% meniran extract, (P2) bacteria, calcium hydroxide, 2% chlorhexidine digluconate and 10% meniran extract}. Examination of MMP-9, TGF-β1 levels, and the number of osteoclasts and osteoblasts were evaluated until day 14. Results: The administration of ethanol extract of green meniran leaves (Phyllanthus niruri Linn) in a mixture of calcium hydroxide as an intracanal medicament (P1) which was evaluated for 14 days overall showed a significant difference between groups (p<0.005). This condition can be seen in the group (P1), which has a lower MMP-9 level of 2465.88 pg/mL compared to the group (P2), (K+), and (K-). The levels of TGF-β1 in the group (P1) were 181.57pg/mL, lower than the group (P2), (K+), and (K-). The number of osteoclast cells in the group (P1) was 1.67, which was lower than the group (P2), (K+), and (K-) was 5.00. The number of osteoblast cells in the (P1) group was 52.67, higher than the 32.17 group (P2), (K+), and (K-). Conclusion: Green meniran extract (Phyllanthus niruri Linn) and its role as an intracanal medicament in teeth with chronic apical periodontitis.