Pasak Customized Fiber Reinforced Composite Indirect pada Gigi Incisivus Lateralis Kiri Atas dengan Dinding Saluran Akar yang Tipis

https://doi.org/10.22146/majkedgiind.9030

Monika Prima Dewi Ayuningtyas Subroto(1*), Ema Mulyawati(2), Pribadi Santoso(3)

(1) Program Studi Konservasi Gigi, Program Pendidikan Dokter Gigi Spesialis Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(2) Bagian Konservasi Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Bagian Konservasi Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Gigi pasca perawatan saluran akar (PSA) biasanya mengalami kehilangan struktur gigi yang luas oleh karena karies, faktor iatrogenik, restorasi sebelumnya dan fraktur. Pengurangan dentin di dalam saluran akar akan menyebabkan saluran akar menjadi tipis, sehingga restorasi konvensional dengan pasak logam dapat menyebabkan fraktur akar. Untuk meminimalkan fraktur akar tersebut, telah dikenal pasak fiber yang memiliki modulus elastisitas yang sama dengan dentin. Pada saluran akar yang lebar dan ireguler serta struktur mahkota yang minimal, dibutuhkan pasak customized fiber reinforced composite dengan inti yang dapat memperkuat struktur gigi yang sudah lemah. Studi kasus ini melaporkan
kasus restorasi gigi non vital pasca PSA dengan dinding saluran akar tipis, yang berhasil dirawat dengan customized fiber reinforced composite indirect. Seorang pasien wanita usia 27 tahun dirujuk ke Bagian Konservasi Gigi karena mengalami over instrumentasi saluran pasak pada gigi incisivus lateralis kiri atas. Pada pemeriksaan radiograf, tampak
dinding saluran akar sangat tipis. Restorasi ini dilakukan dalam 3 kali kunjungan. Pada kunjungan pertama dilakukan pencetakan saluran pasak dengan teknik double impression. Pasak customized fiber reinforced composit indirect, dibuat dalam cetakan saluran pasak menggunakan resin komposit Premise Indirect (Kerr) yang diperkuat dengan pita fiber (Construct, Kerr). Inti dan pasak yang sudah dibentuk, disinar menggunakan Light Cure selama 20 detik di setiap sisi, lalu polimerisasi disempurnakan dengan oven selama 20 menit. Pada kunjungan kedua dilakukan insersi pasak dan pencetakan mahkota jaket dengan teknik double impression. Pada kunjungan ketiga dilakukan insersi mahkota jaket. Gigi non vital pasca PSA dengan dinding saluran pasak yang tipis dapat direstorasi dengan customized fiber reinforced
composite indirect dengan baik.

 

Indirect Customized Fiber Reinforced Composite Post In Upper Left Lateralis Incisivus With Thin-Walled Root. Excessive tooth structure loss after root canal treatment is usually present due to caries lesion, iatrogenic factor, previous restoration, and fracture. Intra-radicular dentin removal during root canal treatment may result in thin root canal wall structures, therefore conventional restoration using metallic post frequently leads to irreparable root fractures. In order to minimize the root fracture risk, fiber post has been known as an ideal choice because of its similar modulus elasticity characteristic to dentin. The wide and irregular root canal accompanied with minimum remaining tooth structure needs a customized fiber reinforced composite post to strengthen the preserved tooth structure. This article reports a succesful
restoration of a non vital post root canal treatment tooth with thin root canal walls using indirect customized fiber-reinforced composite post. A 27-year-old female patient with over instrumentation in root canal of the upper left lateral incisor was referred to the Department of Conservative Dentistry. The radiograph examination finds that there was a very thin wall of the remaining root canal structure. The restoration was carried out in 3 visits. In the first visit, post canal impression was obtained using double impression technique. Indirect customized fiber reinforced composite post was made in the mold using composite resin Premise Indirect (Kerr) reinforced with fiber band (Construct, Kerr). The formed post and core were light cured for 20 seconds, and then refined by oven polymerization for 20 minutes. In the second visit, the post was inserted and crown impression was obtained using double impression technique. In the third visit, the jacket crown was inserted. The root canal treated tooth with remaining thin post canal wall could be restored with indirect customized fiber reinforced composite.


Keywords


Gigi non vital; dinding saluran akar tipis; customized fiber reinforced composite indirect; Non vital tooth; thin root canal wall; indirect customized fiber reinforced composite

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DOI: https://doi.org/10.22146/majkedgiind.9030

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