Apeksifikasi disertai restorasi direct veneering pada gigi insisivus lateralis kiri maksila dens invaginatus

ALBERTUS, Krisnovianto, drg. Endang Retnowati, M.Kes., Sp.KG(K)

2008 | Tesis | S2 PPDGS I - Ilmu Konsevasi Gigi

Laporan kasus ini bertujuan untuk menginformasikan cara merawat dan evaluasi hasil perawatan gigi insisivus lateralis kiri maksila dens invaginatus tipe 2 pulpa nekrosis apeks terbuka disertai abses periapikal, yang dilakukan perawatan apeksifikasi secara orthograde menggunakan MTA disertai restorasi direct veneering. Paien wanita, 22 tahun, gigi insisivus lateralis kiri maksila dens invaginatus tipe 2 pulpa nekrosis, apeks terbuka disertai abses periapikal dan gingiva disekitar apeks gigi bengkak. Perawatan diawali dengan menghilangkan gigi invaginasi dengan cara preparasi biomekanik konvensional untuk mendapatkan akses lurus ke apeks menggunakan bur bulat tangkai panjang yang dilanjutkan dengan file nomor 90-149. Dilakukan dressing menggunakan Ca(OH)2 selama 3 minggu, kemudian dilakukan apeksifikasi secara orthograde menggunakan MTA dengan alat MAP dengan ketebalan 4 mm dari apeks. Obturasi dilakukan 3 hari kemudian mengunakan resin komposit (Core Max), selanjutnya dilakukan restorasi direct veneering menggunakan resin komposit dengan teknologi nanofil. Hasil evaluasi klinis setelah pengunaan MTA selama 17 hari menunjukkan tidak ada rasa sakit, tidak ada peradangan, tidak ada kerusakan jaringan pendukung gigi, secara radiograf menunjukkan pengurangan area radiolusen dengan skor PAI 2 yang berarti perawatan berhasil.

The objectives of this case report were to describe the treatment procedure and evaluate the treatment result of a type 2 dens invaginaus left maxillary lateral incisor with immature apex necrotic pulp and periapicall abcess which was treated by orthograde apexificatio using MTA and direct veneering restoration. A-22 years old woman performed type 2 dens invaginatus left maxillary lateral incisor with immature apex and an assocated with periapical abcess. The apex area showed the swelling of the gingiva. The treatment was initially by removing invagination ot the tooth with a conventional biomechanical preparation to obtain a straight line to the apex with the use of long shank round bur and following by files from size 90 to 140. Calcium hydroxide was placed as dressing material for 3 weeks. Orthograde apexification was done by using MTA which was carried with MAP. The thickness of MTA was 4 mm from tooth apex. Three days later the resin composite (Core Max) was obturated. The restoration was done with nanofiller resin composite. Clinical evaluation after 17 days of MTA placement showed there was no inflammation, normal supporting tooth tissue and the patient remained free of pain. The assesment of radiolucent area, radiographically revealed PAI 2 score whereas indicated a successful treatment.

Kata Kunci : Aspeksifikasi,Direct veneering,Orthograde MTA,Dens invaginatus,dens invaginatus, apexification, MTA, orthograde, direct veneering