Apikoektomi gigi insisivus sentralis maksila pasca perawatan saluran akar disertai lesi periapikal

https://doi.org/10.22146/mkgk.32014

Praditya Wisang Irwandana(1*), Yulita Kristanti(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


Kegagalan perawata

n saluran akar disebabkan oleh beberapa hal, antara lain pengisian saluran akar over filling yang menyebabkan rasa nyeri setelah perawatan saluran akar selesai. Apikoektomi merupakan pilihan perawatan untuk menangani kasus tersebut. Tujuan penulisan ini adalah untuk menginformasikan keberhasilan apikoektomi gigi insisivus sentralis kanan maksila pasca perawatan saluran akar disertai lesi  periapikal dengan resorpsi akar eksternal. Pasien perempuan berusia 27 tahun datang dengan keluhan gigi depan kanan atas yang telah dilakukan perawatan saluran akar 3 tahun yang lalu tidak menunjukkan keberhasilan dan pasien merasa gusi langit-langit bengkak. Gusi tersebut bengkak sejak 3 bulan terakhir namun tidak sakit. Gigi terkadang sakit saat dipakai mengigit. Pemeriksaan radiograf menunjukkan adanya area radiolusen berbatas jelas di daerah periapical dan tampak obturasi perawatan saluran akar sebelumnya yang over filling. Perawatan dimulai dengan membuka flap dan tulang alveolar. Jaringan granulasi dikuret sampai bersih lalu bagian apikal gigi dipotong ± 3 mm, dilanjutkan pengisian retrograde menggunakan Mineral Trioxide Aggregate (MTA). Bone graft dan membran diaplikasikan pada regio yang telah dikuretase dan diakhiri dengan penjahitan untuk mengembalikan flap dan ditutup dengan periodontal pack. Satu minggu setelah tindakan periodontal pack dibuka dan jahitan dilepas. Kontrol pada 3 bulan pasca tindakan menunjukkan radiolusen pada apikal berkurang dan pasien tidak ada keluhan. Apikoektomi merupakan perawatan yang tepat untuk menangani gigi insisivus sentral maksila yang mengalami kegagalan perawatan saluran akar oleh karena pengisian yang over filling.

ABSTRACT: Apicoectomy of Central Incisivus Post Endodontic Treatment with Periapical Lesion. Root canal treatment failures can be caused by over-filling obturation that cause pain after root canal treatment is completed. Apicoectomy is the choice of treatment for dealing with such cases. The objective is to inform the success of apicoectomy on right maxillary central incisor after root canal treatment with periapical lesions and external root resorption. The 27-year-old female patient came with complaints of right upper front teeth that had root canal treatment done 3 years ago. Painless swelling on anterior palate since 3 months was also reported. Sometimes pain reported when it used to bite. Radiographs showed a radiolucent bounded area in the periapical and appear the obturation of root canal treatment is over filling. Treatment begins by opening the flap and the alveolar bone. Granulation tissue was curretaged and apical part of the tooth is cutted ± 3 mm. It followed by retrograde filling using Mineral Trioxide Aggregate (MTA). Bone graft and membrane applied to the region that has curettaged and ends with suturing to restore flap and closed with periodontal pack. One week after treatment, periodontal pack is opened and the stitches removed. Controls at 3 months and 6 months post treatment radiolucent on the apical reduced and the patient had no complaints. Apicoectomy is an appropriate treatment to treat the maxillary central incisor root canal treatment failure due to over filling obturation.



Keywords


apikoektomi, over filling, perawatan saluran akar, apicoectomy, over filling, root canal treatment

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DOI: https://doi.org/10.22146/mkgk.32014

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