Restorasi mahkota jaket porselen fusi metal dengan inti pasak tuang pada tiga gigi insisivus maksila nekrosis dan malposisi

WIDYAWATI, drg. Sri Daradjati S., SU.,Sp.KG

2006 | Tesis | PPDGS I Konservasi Gigi

Laporan kasus ini bertujuan untuk menginformasikan hasil evaluasi restorasi mahkota jaket porselen fusi metal dengan inti pasak tuang pada tiga gigi anterior maksila nekrosis dan malposisi yang sedang dalam perawatan orthodontik cekat. Pasien wanita 23 tahun, datang ke Klinik Konservasi Gigi Fakultas Kedokteran Gigi Universitas Gadjah Mada merupakan rujukan dari bagian orthodontik, pasien ingin memperbaiki tiga gigi depan atas yang berlobang, berubah warna dan memperbaiki posisi gigi. Pada pemeriksaan objektif gigi insisivus sentralis kanan maksila didapatkan karies mesio palatinal, sondasi dan tes chlor ethil tidak memberikan reaksi, perkusi dan palpasi tidak terdapat rasa sakit, gigi tersebut distoversi. Gigi insisivus lateralis kanan maksila terdapat karies mesio palatinal, sondasi dan tes chlor ethil tidak memberikan reaksi, perkusi dan palpasi tidak terdapat rasa sakit, gigi tersebut torsiversi. Gigi insisivus sentralis kiri maksila, didapatkan adanya karies servik pada palatinal, sondasi dan tes chlor ethil tidak memberikan reaksi, perkusi dan palpasi tidak terdapat rasa sakit, terdapat tumpatan yang besar, gigi distoversi. Gambaran radiograf tampak pada tiga gigi insisivus maksila tersebut terdapat area radiolusen di periapikal. Ke tiga gigi tersebut nekrosis pulpa dengan lesi periapikal. Rencana perawatan saluran akar satu kunjungan dan restorasi akhir mahkota jaket porselen fusi metal 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 porselen fusi metal. Satu minggu kemudian kontrol, tidak ada keluhan rasa sakit. Evaluasi setelah satu bulan, tiga gigi insisivus maksila tersebut dapat berfungsi dengan normal, terutama fungsi estetis dan pasien merasa puas, selanjutnya pasien dikembalikan ke bagian orthodontik untuk melanjutkan perawatan gigi-gigi yang lain

The purpose of this case report was to inform the evaluation result of porcelain fused to metal jacket crown with cast post and core on three maxillary incisors with mal position which was being conducted orthodontic treatment. A 23 year-old female came to the Conservative Dentistry Clinic Gadjah Mada University by the orthodontic, seeking for treatment on her three maxillary anterior teeth that suffered from caries and discoloration, also malposition. According to the objective examination on those teeth, it was found that maxillary right central incisor showed mesio-palatal caries, gave no response to vitality test, percussion and palpation, the gingival condition was normal, the tooth position was distovertion. The maxillary right lateral incisor showed mesio-palatal caries, vitality test, percussion and palpation did not give any response, the gingival condition was normal, and the tooth position was torsiversion. The maxillary left central incisor showed cervical caries, gave no response to vitality test, percussion and palpation, extended restoration on the labial surface and the tooth was distoversion. Preoperative radiograph showing periapical radiolucency in all three maxillary incisors. The diagnosis was pulp necrosis with periapical lesion. The treatment plan applied one visit root canal treatment, porcelain fused to metal jacket crown with cast post and core for the correction of malposition and discoloration. One visit root canal treatment was carried out at the first visit. At the second visit, crown stump and post space preparation followed by impression taking. Post and core insertion and cementation, followed by impression and shade selection using Vita Lumin shade guide were carried out at the third visit, and finally at the fourth visit, porcelain fused to metal jacket crown were inserted and cemented. No pain was found in evaluation visit one week later. One month recall visit found the tooth function has been back to normal, especially the esthetic function and the patient felt satisfied and then referred back to continue orthodontic treatment.

Kata Kunci : Restorasi Gigi,Inti Pasak Tuang,Mahkota Jaket Porselen Fusi Metal, pulp necrosis, malposition, one visit root canal treatment, porcelain fused metal, cast post and core