Perawatan ortodontik pada kasus periodontitis kronis dengan kerusakan tulang infraboni secara menyeluruh

https://doi.org/10.22146/mkgk.32005

Stephanie Adelia Susanto(1*), Cendrawasih Andusyana Farmasyanti(2), Kuswayuning Kuswayuning(3)

(1) 
(2) Departemen Ortodonsia, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(3) Departemen Ortodonsia, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author

Abstract


Penyakit periodontal merupakan penyakit inflamasi yang mempengaruhi jaringan periodontal dan menyebabkan hilangnya perlekatan jaringan ikat dengan tulang alveolar. Peningkatan kedalaman probing dengan kombinasi faktor usia pasien, onset dan kecepatan perkembangan penyakit, dan kondisi psikologis akan mempengaruhi rencana dan prognosis perawatan. Pergerakan gigi secara ortodontik pada individu dewasa dengan kondisi periodontal perlu disertai dengan kontrol akumulasi plak secara berkala dan penyesuaian mekanika alat ortodonsi selama perawatan berlangsung. Laporan kasus ini bertujuan untuk mengamati perawatan interdisipliner antara bidang ortodonsi dan periodonsi pada pasien dewasa dengan kondisi periodontitis kronis menyeluruh. Pasien perempuan usia 36 tahun datang ke klinik periodonsi mengeluhkan gigi goyah. Pasien didiagnosa dengan kondisi periodontitis kronis disertai kerusakan tulang infraboni dan keterlibatan bifurkasi, serta disarankan untuk menjalani perawatan ortodontik untuk mengkoreksi traumatik oklusi yang menjadi salah satu faktor predisposisi. Pemeriksaan objektif menunjukkan adanya crowding gigi atas dan bawah, edge to edge bite dan crossbite pada gigi anterior. Kondisi periodontal mencakup resesi menyeluruh, poket periodontal 18, 17, 16, 12, 11, 22, 23, 26, 27, 38, 37, 36, 33, 32, 31, 41, 42, 43, 46, 47, keterlibatan bifurkasi 36, 46, fistula pada bukal gingiva 32, serta kegoyahan gigi derajat 1 pada 17, 16, 12, 11, 22, 26, 36, 31, 41, 46 dan derajat 2 pada gigi 32. Crowding, crossbite anterior dan edge to edge bite telah terkoreksi dengan perawatan ortodontik cekat yang masih berlangsung saat ini. Tidak terdapat perubahan kondisi periodontal selama perawatan.

ABSTRACT: Orthodontic treatment in chronic periodontitis case with generalized infrabony damage. Periodontal disease refers to an inflammatory condition of the periodontal tissue causing attachment loss between the connective tissue and alveolar bone. Increased probe depth with combination of various factors, such as patient’s age, onset and progression rate of the disease, as well psychologycal state, determine the treatment plan and prognosis. Orthodontic tooth movement in periodontally compromised adult should be performed with scheduled plaque accumulation control and adjustment of orthodontic appliance mechanics during the treatment. This case report aims to observe interdisciplinary treatment between orthodontics and periodontics in adult patient with generalized chronic periodontitis. A 36 year old woman visited periodontic department with a chief complaint of generalized loose teeth. Patient was diagnosed as generalized chronic periodontitis with infrabony bone damage and bifurcation involvement. The patient was referred to orthodontist to correct the traumatic occlusion which is one of the predisposing factors. Objective examination shows upper and lower arch crowding teeth, edge to edge bite and anterior crossbite. Periodontal findings show generalized recession, periodontal pocket 18, 17, 16, 12, 11, 22, 23, 26, 27, 38, 37, 36, 33, 32, 31, 41, 42, 43, 46, 47, bifurcation involvement of 36 and 46, 32 buccal gingiva fistule, first degree luxation of 17, 16, 12, 11, 22, 26, 36, 31, 41, 46 and second degree of 32. Teeth crowding, anterior crosbite and edge to edge bite has been resolved using fixed orthodontic appliance and the treatment is still currently in progress. There are no significant changes on the periodontal status during orthodontic treatment.


Keywords


generalized periodontitis, gigi goyah, ortodontik, periodontitis kronis, generalized periodontitis, loose teeth, orthodontic treatment, chronic periodontitis

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References

1. Kalia S. Interdisciplinary approach to adult orthodontic care. Journal of Orthodontics. 2001; 28: 191 – 196.

2. Taner TU, Germec D, Er N, Tulunoglu I. Interdisciplinary treatment of an adult with old extraction site. Angle Orthodontist. 2006; 76(6): 1066 – 1073.

3. Newman MG, Takei H, Klokkevold PR, Carranza FA. Carranza’s Clinical Periodontology. 11th edition. St.Louis,MO: Elsevier. 2012.

4. Proffit WR, Ackerman JL. Proffit WR (ed.) Contemporary Orthodontics (4th ed). St. Louis, MO: Mosby.

5. Matthews DP, Kovich VG. Managing treatment for the orthodontic patient with periodontal problems. Semin Orthod. 1996; 2: 31 – 38.

6. Bansai K, Lodha S, Bansai N. Interdisciplinary treatment of a periodontally compromised adult. The Journal of Indian Orthodontic Society. 2013; 47(2): 100 – 106.

7. Willmott D. Orthodontic Treatment and the Compromised Periodontal Patient. European Journal of Dentistry. 2008; 2: 1 – 2.

8. Eliasson LA, Hugoson A, Kurol J, SIwe H. The effect of orthodontic treatment on periodontal tissue in patients with reduced periodontal support. European Journal of Orthodontics. 1982; 4: 1 – 9.

9. Steffenson B, Storey AT. Orthodontic intrusive forces in the treatment of periodontally compromised incisors: a case report. Int J Perio Rest Dent. 1993; 13: 433 – 441.

10. Ackerman JL. The challenges of adult orthodontics. J Clin Orthod. 1985; 12: 43-48.

11. Melsen B, Agerbaek N, Markenstam G. Intrusion in incisors in adult patient with marginal bone loss. Am J Orthod Dentofacial Orthop. 1988; 94(2): 104 – 116.

12. Hom BM, Turley PK. The effects of space closure of the mandibular first area in adults. Am J Orthod. 1984; 85: 457 – 469.

13. Zachrisson BU. Clinical implications of recent orthodontic-periodontic research findings. Semin Orthod. 1996; 2: 4 – 12.



DOI: https://doi.org/10.22146/mkgk.32005

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