Sys Rev Pharm 2021;12(1):1479-1486 A multifaceted review journal in the field of pharmacy 1479 Systematic Reviews in Pharmacy Vol 12, Issue 1, January 2021 Potential Effect of Jellyfish Aurelia aurita Collagen Scaffold Induced Alveolar Bone Regeneration in Periodontal Disease Ranny Rachmawati 1,2* , Mohammad Hidayat 3 , Nur Permatasari 4 , Sri Widyarti 5 1 Doctoral Program of Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia 2 Departement of Periodontics, Faculty of Dentistry, Universitas Brawijaya, Malang, Indonesia 3 Departement of Orthopaedics, Syaiful Anwar General Hospital, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia 4 Departement of Oral Biology, Faculty of Dentistry, Universitas Brawijaya, Malang, Indonesia 5 Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Brawijaya, Malang, Indonesia ABSTRACT Periodontal disease is an inflammation disease that can cause alveolar bone resorption and make tooth mobility, eventually tooth loss. One of the important things in regeneration therapy of alveolar bone is the design and manufacture of a scaffold as osteoconductor. Collagen is an ideal choice to be used as scaffold because it has low immunity, good pores structure and permeability, biocompatible, and can be degraded. Aurelia aurita jellyfish is one of the potential marine animals for the development of collagen scaffold due to its high content of collagen. The aim of this research is to determine the potential of A. aurita jellyfish collagen scaffold as the new biomaterial in assisting the repair process of alveolar bone defect. Collagen was extracted from jellyfish by sonication, while scaffold was prepared by freeze-drying, and cross-linking with N-(3-dimethyl aminopropyl)-N’-ethyl-carbodiimide hydrochloride (EDC). This research was conducted on 10 male rats which is divided into two experimental groups. K+ is group that has alveolar bone defects and not given any treatment. KP is group that has alveolar bone defects and A. aurita jellyfish collagen scaffold is implanted. Then the calculation of osteoblast, osteoclast, STRO-1, and osteocalcin expression were conducted with immunohistochemistry. This resulted on significantly more osteoblast and less osteoclast cells on KP than on K+ group. The mean of STRO-1 and osteocalcin expressions was also significantly more on KP than on K+ group. Therefore, it can be concluded that the A. aurita jellyfish collagen scaffold is effective in helping regenerate alveolar bone. Keywords: Collagen Scaffold, Jellyfish Aurelia aurita, Alveolar Bone Regeneration, Periodontal Disease Correspondence: Ranny Rachmawati Doctoral Program of Medical Science, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia Department of Periodontics, Faculty of Dentistry, Universitas, Brawijaya, Malang, Indonesia Email: rannyperio.fk@ub.ac.id INTRODUCTION Periodontal disease is most commonly occurred disease in the community. Research of The World Oral Health Report on 2003 showed that periodontal disease ranked number 4 as the most expensive disease in terms of treatment cost. Survey conducted in USA showed that 75% of population once suffered periodontal disease. As survey from ministry of health, the prevalence of periodontal disease in Indonesia has reached 60%. Periodontal disease is an inflammation disease on tooth supporting tissue which covers gingiva, cementum, periodontal ligament, and alveolar bone (Laine & Crielaard, 2012). The etiology of periodontal disease might be caused by bacterial plaque or mechanical trauma. Both etiologies can cause alveolar bone resorption which can makes tooth mobility and tooth loss (Carranza, Camargo, & Takei, 2012; Michael G., Takei, R. Klokkevold, & Carranza, 2018). The cause of trauma on periodontal issue can be categorized into two main causes, unintentional trauma and intentional trauma. Unintentional trauma can happen due to fall incident, sport accident, traffic accident, improper usage of teeth such as pen biting and bottle opening. Intentional trauma can happen due to physical abuse on children and iatrogenic procedure done by the dentist (Auerkari et al., 2014; Farani & Nurunnisa, 2018). To prevent tooth loss, regeneration therapy is needed to re-grow the damaged alveolar bone. Alveolar bone defect treatment aims to improve bone healing process and recover the function by tissue engineering effort which comprises three main components; natural bone growth, presence of cell and growth factor, and ideal scaffold (Peter et al., 2010). One of the important things in the development of artificial bone tissue is the design and the manufacture of a scaffold as osteoconductor which can speed up the alveolar bone regeneration process. Scaffold is a framework that acts as a microenvironment for stem cells that will carry out adhesion, proliferation, and differentiation which eventually produces the tissue we expect. Scaffold must also meet standard criteria such as being biocompatible, biodegradable, supporting cell adhesion, and having an extracellular matrix structure of alveolar bone so that the role of scaffold as an osteoconductor can be obtained (Horst et al., 2010). Scaffold material can be obtained from synthetic and natural sources. Collagen is an ideal choice of natural ingredients to be used as scaffold because it has low immunity factor, good pores structure, good permeability, is biocompatible with surrounding tissues, and can be degraded well (Addad et al., 2011; Dong & Lv, 2016). So far, the source of collagen used for scaffold production comes from various organisms. Collagen from cows and pigs is a material that has long been used in the community as a scaffold, but the higher demand of collagen causes a shortage of collagen raw material originating from land animals, resulting in an increase in the price of raw materials in the market. This condition can be a major threat to the global needs. Religious constraints also limit Muslims, Hindus and Jews to using products made from pork and beef (Azizur Rahman, 2019; Gomez-Guillen et al., 2011; Silvipriya et al., 2015). Collagen sources that come from cows can cause a risk of infection such as bovine spongiform encephalopathy (Hoyer et al., 2014). As potential solution to reduce the demand for raw materials from land animals, it is possible to use other materials from the sea which are abundant, low price, and still underutilized (Hoyer et al., 2014; Khong et al., 2016). In this study, it underlies the selection of jellyfish as the basic material for scaffold development.