The Effectiveness of Milkfish (Chanos Chanos) Scales Chitosan on Soft and Hard Tissue Regeneration Intooth Extraction Socket: A Literature Review

Background: Milkfish (Chanoschanos) is a superior fishery product of South Sulawesi, but fish scales wastehas not been used optimally. Chitosan from chitin extracted from milkfish scales is a non-toxic, biocompatible, and biodegradable polymer material. Tooth socket healing is a pathophysiological process that involves proliferation, cell migration and tissue remodeling. It is hoped that the effectiveness of chitosan in tissue regeneration can be used as a regeneration material for soft tissue and scaffold to increase bone regeneration. Objective: To discuss the potential of chitosan in milkfish scales waste for soft and hard tissue regeneration in post extraction socket. Literature Review: Milkfish scales can be used as a source of chitosan. Chitosan (poly-β- 1,4-glucosamine) is a natural polysaccharide that provides anti-inflammatory effects by inhibiting prostaglandin E2 and cyclooxygenase-2 protein expression and weakening pro- inflammatory cytokines, as well as increasing anti inflammatory cytokines. Chitosan can accelerate wound healing, stimulate the production of growth factors, antibacterial, increase angiogenesis and the function of inflammatory cells. Chitosan also has potential as a scaffold because it is biocompatible, degrades with tissue formation, without inflammatory and allergic reactions, adequate porosity, and low degradation products. Discussion: Milkfish scales chitosan shows biocompatible, anti inflammatory, and osteoconductive properties. However, chitosan itself has low water solubility at neutral or high pH and low mechanical properties therefore requires modification of the surface of chitosan or combining chitosan with other biomaterials. Conclusion: The use of milkfish scales chitosan has potential as an anti-inflammatory agent, stimulates the activity of fibroblasts, osteoblasts and differentiation of mesenchymal stem cells, as well as osteoconductive bone regeneration scaffold, but in use it is better combined with polymers / biomaterials, and / or other bioactive molecules to improve mechanical properties, absorption of protein and biomineralization of chitosan.