Laporan kasus ini bertujuan untuk menginformasikan hasil perawatan saluran akar satu kunjungan dengan restorasi mahkota jaket porselin fusi metal dengan inti pasak tuang pada gigi insisivus sentralis kiri maksila fraktur kelas III Ellis nekrosis dengan abses periapikal disertai fistula. Pasien pria berumur 24 tahun, datang ke Klinik Konservasi Gigi Fakultas Kedokteran Gigi Universitas Gadjah Mada, ingin menambalkan gigi depan atas kiri yang patah dan berubah warna. Pada pemeriksaan objektif diketahui bahwa gigi insisivus sentralis kiri maksila fraktur mahkota kelas III Ellis, berwarna abu-abu kecoklatan, perkusi negatif, palpasi positif, pada bagian labial gingiva ditemukan fistula, keluar cairan pus. Pemeriksaan radiograf terdapat gambaran radiolusen di periapikal. Diagnosis gigi insisivus sentralis kiri maksila adalah nekrosis pulpa dengan abses periapikal disertai fistula. Rencana perawatan gigi insisivus sentralis kiri maksila fraktur kelas III Ellis adalah perawatan saluran akar satu kunjungan dilanjutkan restorasi mahkota jaket porselin fusi me tal dengan inti pasak tuang. Kunjungan pertama dilakukan perawatan saluran akar satu kunjungan. Kunjungan ke dua preparasi tonggak, preparasi saluran pasak dan pencetakan tonggak. Kunjungan ke tiga pengepasan inti pasak, penyemenan inti pasak dan pencetakan inti serta menentukan warna gigi dengan Vita Lumin Shade guide. Kunjungan ke empat pengepasan dan penyemenan mahkota jaket porselin fusi metal. Satu minggu kemudian kontrol, tidak ada keluhan rasa sakit. Evaluasi setelah satu bulan, fistula sembuh dan dengan pemeriksaan radiograf abses tidak mengalami perbesaran, gigi insisivus sentralis kiri maksila dapat berfungsi dengan normal. Kesimpulan kasus gigi insisivus sentralis kiri maksila fraktur kelas III Ellis nekrosis dengan abses periapikal disertai fistula dapat dikembalikan fungsi gigi dengan perawatan saluran akar satu kunjungan dilanjutkan dengan restorasi mahkota jaket porselin fusi metal dan inti pasak tuang.

The objective of this case report was to eva luate the success of one visit root canal treatment of necrotic, class III Ellis fractured maxillary left central incisor with periapical abscess and sinus tract followed by porcelain fused to metal jacket crown with cast post and core. A 24 year-old male came to the Conservative Dentistry Clinic of Gadjah Mada University seeking for treatment on his fractured and discolored maxillary left central incisor. The objective examination on the maxillary left central incisor found a class III Ellis fracture, brownish-grey discoloration, negative response to pulp testing, negative response to percussion, positive response to palpation, and there was a sinus tract on the labial gingiva and the presence of radio graphically observable apical radiolucency. The class III Ellis fractured maxillary left central incisor was diagnosed as pulp necrosis with periapical abscess and sinus tract. The treatment of choice was a one visit root canal treatment followed by porcelain fused to metal jacket crown restoration with cast post and core. The root canal treatment was carried out on the first visit, while post space preparation and impression taking were carried out on second visit. Post and core insertion and shade matching using Vita Lumin Shade guide were carried out on the third visit. The crown insertion was finished on the fourth visit. Evaluation after one week found no pain and after one month the sinus tract was disappeared and no increase on the size of periapical radiolucency. The maxillary left central incisor showed normal function. It was concluded that one visit root canal treatment performed on necrotic, class III Ellis fractured maxillary left central incisor with periapical abscess and sinus tract showed satisfactory healing and a normal tooth function was present after it has been restored with porcelain fused to metal crown with cast post and core.

Kata Kunci : Perawatan Saluran Akar Satu Kunjungan,Nekrosis, necrosis, periapical abscess, fistula, one visit root canal treatment, porcelain fused to metal jacket crown, cast post and core