Penatalaksanaan distilasi molar pertama permanen bawah kanan dengan Open Coil berkekuatan 230 gram pada anak perempuan umur 10 tahun :: Laporan kasus

RAHAYU, Siti, drg. V.J. Soedarsono, SU.,Sp.KGA(K)

2007 | Tesis | PPDGS I Ilmu Kedokteran Gigi Anak

Premature loss gigi molar kedua desidui dapat berakibat berkurangnya lengkung perimeter karena pergerakan molar pertama permanen ke mesial. Open coil springs sering digunakan untuk distalisasi molar agar memperoleh ruang kembali, akan tetapi kekuatan yang digunakan tidak diketahui dengan pasti. Laporan kasus ini bertujuan melaporkan keberhasilan distalisasi gigi molar satu permanen bawah kanan dengan open coil springs berkekuatan 230 gram pada anak perempuan umur 10 tahun. Distalisasi gigi molar pertama permanen untuk mendapatkan ruang bagi erupsi gigi premolar kedua bawah kanan dilakukan dengan open coil springs sepanjang jarak buccal tube molar pertama permanen dan bracket premolar pertama bawah kanan ditambah 4,1 mm; sehingga diperoleh kekuatan tetap 230 gram. Open coil springs disisipkan pada arch wire antara buccal tube molar pertama permanen dan bracket premolar pertama bawah kanan serta ligasi pada gigi-gigi premolar pertama bawah kanan sampai kaninus permanen bawah kiri agar diperoleh kekuatan dorong ke arah distal. Seminggu sekali dilakukan evaluasi klinis, pemeriksaan oklusi dan palpasi, pengukuran ruang dan penggantian open coil springs. Hasil perawatan menunjukkan ruang bertambah 1,23 mm dalam waktu 12 minggu. Pertambahan terbesar terjadi pada minggu pertama yaitu 0,35 mm; kemudian berangsur-angsur menurun menjadi 0 pada minggu kelima. Pada evaluasi klinis seminggu sekali tidak ditemukan nyeri palpasi dan perkusi. Pemeriksaan Röntgent foto periapikal pada akhir distalisai menunjukkan jaringan pendukung gigi dalam batas normal. Disimpulkan bahwa open coil springs berkekuatan 230 gram berhasil untuk distalisasi molar pertama permanen bawah kanan pada anak perempuan umur 10 tahun.

Premature loss of the deciduous second molar might decrease the dental arch perimeter due to mesially drifting of the first permanent molar. Open coil springs are often used to distalize the first permanent molar in order to regain the space, however, the force magnitude is not certainly known. The aim of this study was to report the achievement of the lower right first permanent molar by using open coil springs with 230 gram magnitude in 10 year-old girl. The distalization of the lower right first permanent molar had been done to obtain the space for erupting of the lower right second premolar. Open coil springs with the length of the distance between the distal side of the lower right first premolar bracket to the mesial side of the lower right permanent first molar buccal tube added by 4.1 mm for created 230 gram force was coated to the arch wire between the both teeth. To create distally force for the lower right permanent first molar, the teeth, lower right first premolar to lower left canine, were ligated. Clinical examination, dental percussion and soft tissue palpation, measurement of the space progression and replacement of the coil spring were done weekly. The result showed that the space was regained 1.23 mm in 12 weeks, with biggest regained on the first week, namely 3.5 mm. The space gained was gradually decreased to 0 mm on the fifth week. No clinical symptom was found during weekly examination control and from the periapical radiograph vision there was nothing particular on the supporting tissue. It may be concluded that distalization of the lower right first permanent molar using open coil springs with 230 gram force magnitude was successfully obtained in the 10 year-old girl.

Kata Kunci : Distilasi Molar,Perawatan Open Coil Springs