Effect of Ipomoea batatas L . Leaves Extract on Percentage Healing of Traumatic Ulcer in Oral Mucosa ( Rattus novergicus Strain Wistar )

Traumatic ulcer is a lesion common found in the oral cavity caused by trauma and can cause pain on eating, swallowing, and speaking. Ipomoea batatas L. leaf extract contains alkaloids, steroids, flavonoids, tannins, phenols, and saponins. The purpose of this study was to determine the effect of. Ipomoea batatas L. leaves extract on wide and percentage healing of traumatic ulcer in oral mucosa. The true experimental laboratory with post test only control group design was confirmed in this research. Twelve male rats (Rattus norvegicus) 2-3 months weight between 200-250 grams is burnt on the lower labial mucosa during one seconds using burnisher to produce an ulcer. Width of ulcer was measured the day after thermal trauma and healing percentage of ulcer was measured the day after extract was applied. Extract was applicated twice a day in every morning and afternoon for 10 days. he result of oneway ANOVA analysis showed that Ipomoea batatas L. leaves extract has no significant effect on percentage healing of traumatic ulcer with value p=0,285 (p < 0,05). It was conclude that Ipomoea batatas L. leaves extract has no significant effect on percentage healing of traumatic ulcer in oral mucosa.


INTRODUCTION
Ulcers can be interpreted as the oral epitel lesion which cause the free nerve ending on lamina propria opened and cause pain to patients. 1 Traumatic ulcer can be caused by thermal trauma as consuming hot food and drink. 2 Clinically, ulcers are varies, but generally appears as a single ulcer, pain, with the red surface or smooth and slight halo erythema. 3Traumatic ulcers often occur on the labial mucosa, buccal mucosa, palatum, the tongue edge limit, etc. 4 Traumatic ulcers can be healed without leaving scars in 6-10 days, spontaneously or after the causative factor is omitted. 3e of the alternatives treatment that has minimal side effects to overcome the traumatic ulcers is with the implementation of fitotherapy or therapy which using herbal plant. 5One of the herbal plants which are used to treat traumatic ulcers is the purple sweet potato leaves (Ipomoea batatas L.) Lamk). 6Ipomoea batatas L. leaves contain vitamin C and polyphenol which can catch free radicals to accelerate the ulcers healing. 7,8pomoea batatas L. leaves contain vitamin C, A, B 2 , protein and iron so that can help the formation of new collagen fibers. 9,10,11Ipomoea batatas L. leaves has secondary metabolites namely flavonoid and tannin. 12Flavonoid serves as the anti inflammatory by inhibiting the activity of Cyclooxygenase (COX) and Lipoxygenase enzymes so that can reduce inflammation and pain. 13,14Tannin is capable of forming a protective layer on the tissue which exposed to keep the wound from infection. 15is research aims to find out the effect of the Ipomoea batatas L. leaves extract on traumatic ulcers width and healing percentage on oral mucosa.

MATERIAL AND METHOD
This research is a laboratory experimental with post test only control group design.The samples which were used in this research were male Wistar rats (Rattus norvegicus) which were obtained from the Veterinary Faculty of Syiah Kuala University as much as 12 rats, divided into 3 groups consists of 4 rats of negative control group, 4 rats of positive control group and 4 rats of treatment group.
As much as 12 male Wistar rats (Rattus norvegicus) were kept for 1 weeks in a plastic cage sized 40 cm x 30 cm x 14 cm with rice husk covering the floor and the temperature was 24ºC in the 12 hours dark-light cycle, and the water and food were available. 16,17,18Then, they were given an intramuscular injection anasthesia in the gluteus muscle with combination of 0,1 Ketamine hydrochloride and 0,05 ml (2gr/100 ml) Xylazine hydrochloride from each 100 gr of body weight with the aim that the animals did not feel the sensation of pain at the time of wound forming. 19xt, rats were given thermal trauma to create the traumatic ulcers by using burnisher which had been heated up on the heater fueled with spiritus for 60 seconds.The labial mucosa at the bottom of rats was clamped with tweezers, and then the hot burnisher attached on the labial mucosa at the bottom of rats for 1 second (depth reached one third of burnisher).The making of lesion was characterized with white pale color, an area which was more sunken than the surrounding mucosa. 16 the treatment group, 0,13 ml of Ipomoea batatas L. leaves extract was given, positive control group was given Triamcinolone acetonide 0.1%, negative control group was given aquadest, which were applied topically to the whole ulcers' surface to exceed the ulcers' edge by using disposable micro applicators 2 times a day for 5 minutes in the morning and afternoon.Ulcers application and measurement were started from day 2 until day 11.After the research was complete, the trial animals Wistar rats were kept alive.
The measurement result of the control rats and treatment rats were analyzed statistically using SPSS program with 0,05 (p<0,05) significant level and 95% (a=0,05) confidence level.The steps of hypothesis test are data normality test, variant homogeneity test and One-way ANOVA test. 20

Research results
Traumatic ulcers healing could be seen from the percentage increase of healing (Table 1) Based on the normality test, the data was distributing normally (p>0.05) on all groups.Homogeneity test showed that the data variance on all groups were the same.From the result, oneway ANOVA test could be used and showed that the purple sweet potato leaves extract did not affect the healing percentage of traumatic ulcers on oral mucosa with p = 0,285 (p < 0.05).

DISCUSSION
The cleanliness of the rat's mouth could not be controlled because it was supported by the dirty cage environment which could cause secondary infections.An infection can extend the healing of inflammatory process which has potential on lesion area enlargement. 21Tannin and fenol which are located in the Ipomoea batatas L. leaves extract may inhibit secondary infections caused by bacteria with denaturing the protein of bacterial cells, inhibiting the function of the cell membrane and the synthesis of nucleic acids. 22Flavonoid can also inhibit the growth of bacteria by interfering the permeability of bacterial cell's wall which will cause the lysis on the cell. 23e healing percentage of traumatic ulcers on Ipomoea batatas L. leaves extract group was faster compared with Triamcinolone acetonide 0,1% control and aquadest control group, due to saponin, flavonoid, and amino acids are in the extract.Saponin is able to inhibit erythema and edema, antimicrobials, affects collagen, also improving and strengthen the skin cells. 24The role of flavonoid is as antiinflammatory, antioxidants and reducing the pain in case of bleeding or swelling. 25Amino acids especially glutamine and arginine can decrease the mediator production of pro-inflammatory so that the healing will accelerate. 26,27e healing of traumatic ulcers on the Triamcinolone acetonide 0.1% group was slower compared with aqaudest group.Triamcinolone acetonide 0,1% is a glucocorticoid class which can reduce or prevent the issue responses against inflammatory responses by inhibiting macrophages and phospholipase A and by pressing IL-1a on the inflammatory location. 28,29The inflammatory mediator inhibition can cause the healing process incomplete so that the traumatic ulcers healing becomes slower. 30 iamcinolone acetonide 0,1% can eliminate pain by inhibiting the phospholipase A 2 enzyme which can cause arachidonate acid cannot be formed and the protaglandin unformed.Prostaglandin plays a role in the inflammatory process, edema, local pain and redness. 29flammatory pain is one of the forms which was useful for accelerating the issue damage repairment. 31This could make the aquadest group experiencing the healing of traumatic ulcers faster than Triamcinolone acetonide 0.1% due to aquadest could not eliminate pain.

CONCLUSION
Ipomoea batatas L. leaves extract did not affect the traumatic ulcers healing percentage on oral mucosa.