Perawatan Estetik pada Insisivus Sentral Maksila dengan Perforasi Apikal

https://doi.org/10.22146/mkgk.11925

Sania Dara Afiati(1*), Pribadi Santosa(2)

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

Abstract


Masalah estetik dapat diatasi dengan pendekatan restorasi, ortodontik maupun kombinasi keduanya. Perawatan restorasi dapat dilakukan jika pasien menolak untuk dilakukan perawatan ortodontik. Perawatan restorasi mencakup pembuatan ilusi perubahan arah gigi tanpa merubah lokasi akar gigi. Kecelakaan iatrogenik yang disebabkan oleh hilangnya panjang kerja dapat menyebabkan perforasi apikal. Salah satu manajemen perawatan perforasi apikal adalah dengan Ca(OH)2. Tujuan dari artikel ini adalah menginformasikan keberhasilan perawatan restorasi untuk perbaikan estetik serta keberhasilan perawatan perforasi apikal menggunakan Ca(OH)2. Laki – laki berusia 20 tahun datang dengan fraktur gigi insisivus akibat kecelakaan 7 tahun yang lalu. Gigi insisivus maksila pertama kanannya telah dilakukan perawatan saluran akar dan direstorasi dengan resin komposit. 6 tahun kemudian, pasien merasakan sakit pada giginya, perkusi dan palpasi positif serta ditemukan mobilitas. Pasien juga merasakan gigi depannya berubah warna dan berjejal. Pada pemeriksaan radiografis ditemukan material obturasi yang overfilling disertai pelebaran ligamen periodontal. Perawatan perforasi apikal untuk gigi insisivus maksila pertama kanan dilakukan menggunakan Ca(OH)2, dilakukan juga perawatan saluran akar pada gigi insisivus maksila pertama kiri. Berjejalnya gigi depan diperbaiki dengan restorasi menggunakan resin komposit direk dengan penguat pasak fiber. Masalah estetik gigi depan dapat diperbaiki menggunakan pendekatan restoratif, serta perawatan saluran akar dengan perforasi apikal dapat dilakukan dengan menggunakan Ca(OH)2.

 

ABSTRACT: Aesthetically Compromized Maxillary Central Incisor with Apical Perforation. Aesthetical problem may be corrected restoratively, orthodontically or with combination of both approaches. Restorative treatment could be done for a patient due to several reasons; one of them is when patients refuse orthodontic treatment. Restorative alternatives create the illusion of movement without altering the location of the tooth root. Iatrogenic accident as a result of the loss of working length could lead to apical perforation. One of the management for apical perforation is Ca(OH)2. The aim of this case report is to present the success of repairing aesthetically compromised tooth with fiber reinforced composite and root canal retreatment with apical perforation using Ca(OH)2 as a repair and sealing material. A 20 year old male patient had a fractured incisor following a traumatic incident 7 years previously. The maxillary right central incisor was endodontically treated and restored with composite resin. 6 years later, the patient felt pain in his two central incisor teeth and tenderness to percussion; palpation was positive and mobility was detected. The patient also felt discoloration and misalignment of his central incisor. The radiographic examination reveals an overfilling of obturation material with enlargement of periodontal ligament. A root canal retreatment for maxillary right central incisor with apical perforation using Ca(OH)2 as repair and seal material and root canal treatment for maxillary left central incisor was conducted. The aesthetically compromised maxillary central tooth was corrected restoratively using fiber reinforced composite. The aesthetically compromised central tooth was proven to be successfully corrected using fiber reinforced composite and the apical perforation successfully sealed using Ca(OH)2.


Keywords


estetik komplek; perawatan saluran akar ulang; perforasi apikal; kalsium hidroksid; esthetic complex; fiber reinforced composite; root canal retreatment; apical perforation; calcium hydroxide

Full Text:

PDF


References

1. Ferrari M. Fiber post and endodontically treated teeth: A compendium of scientific and clinical perspective 1st ed. Singapore: Modern Dentistry Media; 2008. H. 80-83.

2. Tronstad. Clinical endodontics, a textbook. New York: Thieme Stuttgard; 2003. H. 55-60.

3. Freedman. Contemporary esthetic dentistry. Missouri: Mosby An Imprint of Elsevier; 2012. H. 219-231.

4. Blank JT. Case selection criteria and a simplified technique for placing and finishing direct composite veneers. Compend Contin Educ Dent. 2002; 23(1): 10-17.

5. Ahmad I. Anterior dental aesthetics: Facial perspective. BDJ. 2005a; 199(1): 15-21.

6. Ahmad I. Anterior dental aesthetics: Dentofacial perspective. BDJ. 2005b; 199(2): 81-88.

7. Blitz N. Steel C. Willhite C. Diagnosis and treatment evaluation in cosmetic dentistry, a guide to accreditation criteria [Internet]. AACD: Walton Commons West Suite, Madison; 2010 [cited 2013 March 25]. Available from Netlibrary: http://dentalbooks-drbassam.blogspot.com/2010/02/diagnosis-and-treatment-evaluation-in.htm.

8. Goldstein RE. Esthetics in Dentistry 2nd ed. London: BC Decker Inc; 2002. H. 733-52.

9. Tsesis I, Fuss Z. Diagnosis and treatment of accidental root perforation. Endodontic Topics. 2006; 13: 95-107.

10. Mohammadi Z, Dummer MH. Properties and applications of calcium hydroxide in endodontics and dental traumatology. IEJ. 2011; 44: 697-730.

11. Hatkar P. Perserving natural tooth structure with composite resin, accreditation clinical case report, case type v: six or more direct resin veneers. J of Cos Dent. 2010; 26(3): 26-36.



DOI: https://doi.org/10.22146/mkgk.11925

Article Metrics

Abstract views : 868 | views : 6413

Refbacks

  • There are currently no refbacks.




Copyright (c) 2016 Majalah Kedokteran Gigi Klinik



Currently, Majalah Kedokteran Gigi Klinik indexed by:

site
stats