Restorasi mahkota jaket porselin fusi Metal-Porcelain Cervical Margin inti pasak tuang pada gigi insisivus sentralis maksila non vital disertai Gingival Enlargement

ARIANTI, Novy, drg. Endang Retnowati, M.Kes.,SpKG(K)

2007 | Tesis | PPDGS I Ilmu Konservasi Gigi

Tujuan perawatan kasus untuk mengetahui hasil perawatan restorasi mahkota jaket porselin fusi metal-porcelain cervical margin dengan inti pasak tuang pada gigi insisivus sentralis kiri maksila non vital disertai gingival enlargement pasca gingivektomi dan perawatan saluran akar ulang dalam mengembalikan fungsi gigi. Penderita pria 59 tahun, datang ke Klinik Konservasi Gigi FKG UGM, ingin memperbaiki gigi insisivus sentralis kiri maksila yang sudah lama lepas gigi tiruannya. Pada pemeriksaan klinis terdapat lebih dari ? mahkota telah hilang, permukaan labial mahkota tidak terlihat karena tertutup jaringan gingiva, sedangkan permukaan palatal jaringan gigi tersisa sekitar 1 mm supragingiva. Tidak ada rasa sakit ketika dilakukan tes termal, perkusi dan palpasi. Gambaran radiograf pengisian saluran akar tidak hermetis serta radiolusen pada apeksnya. Diagnosis gigi non vital pasca perawatan saluran akar disertai gingival enlargement. Prosedur perawatan dimulai dengan gingivektomi dan perawatan saluran akar ulang dengan teknik stepback. Pengisian saluran akar teknik kondensasi lateral dilakukan pada kunjungan berikutnya. Pasca pengisian saluran akar dilanjutkan pemasangan inti pasak tuang, preparasi tonggak. Selanjutnya insersi mahkota jaket porselin fusi metal-porcelain cervical margin menggunakan semen resin. Kontrol tidak ada keluhan sakit, tes perkusi dan palpasi negatif serta gigi insisivus sentralis kiri maksila dapat berfungsi dengan normal. Perawatan saluran akar ulang dan pembuatan restorasi mahkota porselin fusi metal-porcelain cervical margin pasca obturasi dapat mengembalikan fungsi gigi seperti semula.

The purpose of this case report was to find out the treatment outcome of restoration using porcelain fused to metal jacket crown-porcelain cervical margin custom with dowel core following gingivectomy and root canal re-treatment in reestablishing tooth function. A 59-year-old male seek for treatment due to detaching of prosthetic maxillary left central incisor. Clinical examination revealed that the crown of tooth was missing more than two-third, labial surface of crown was not recognized due to gingival tissue enlargement, whereas palatinal surface of crown was 1 mm left. No response to thermal test, no tenderness to percussion and palpation. Radiograph evident showed that root canal obturation was not hermetic, radiolucency at apical area. The diagnosis was non vital tooth after root canal treatment with periapical lesion as well as gingival enlargement. The sequence of the treatment procedures were undertaken as followed: gingivectomy, root canal re-treatment using step back technique, obturation using lateral condensation method. Subsequent to root canal obturation, dowel was inserted and core was prepared, followed by insertion of porcelain fused to metal–porcelain cervical margin. At the two-month evaluation, patient had no dental complain, no tenderness to percussion and palpation, and absence of gingival tissue inflammation, hence, the maxillary central incisor had normal function. Root canal re-treatment and restoration using porcelain fused to metal jacket crown-porcelain cervical margin with custom dowel core following root canal obturation is capable to reestablish tooth function.

Kata Kunci : Perawatan Saluran Akar Ulang,Gingival Enlargement, Root canal re-treatment, gingival enlargement, porcelain fused to metal jacket crown-porcelain cervical margin