PENGARUH BAHAN PENCAMPUR KALSIUM HIDROKSIDA DENGAN TEKNIK IRIGASI AGITASI TERHADAP SISA KALSIUM HIDROKSIDA PADA SEPERTIGA APIKAL DINDING SALURAN AKAR (Penelitian Laboratoris)

EMMAWATI PRAWITASARI, drg. Diatri Nari Ratih, M.Kes., Sp.KG.,Ph.D.

2013 | Tesis | S2 Ilmu Konservasi Gigi

Medikamen intrakanal yang paling banyak dipakai saat ini yaitu kalsium hidroksida (Ca(OH)2), namun demikian sisa Ca(OH)2 dalam saluran akar harus dihilangkan sebelum dilakukan obturasi. Sisa Ca(OH)2 pada dinding saluran akar dapat menyebabkan kebocoran apikal. Hal ini disebabkan dimensi Ca(OH)2 yang tidak stabil, menurunkan daya alir dan working time siler, serta menurunkan pelekatan siler dan gutaperca terhadap dinding saluran akar. Penelitian ini bertujuan untuk mengetahui pengaruh bahan pencampur Ca(OH)2 dengan teknik irigasi agitasi terhadap sisa Ca(OH)2 pada sepertiga apikal dinding saluran akar. Subjek penelitian menggunakan 24 gigi premolar pertama mandibula. Gigi dipotong di bawah cemento enamel junction (CEJ) dengan panjang 14 mm dari apikal. Seluruh gigi dilakukan preparasi saluran akar menggunakan teknik Step Back sampai didapatkan master apikal file (MAF) #40. Subjek penelitian dikelompokkan menjadi IA dan IB diaplikasikan pasta Ca(OH)2+ khlorheksidin diglukonat 2% (CHX) dilanjutkan dengan teknik agitasi manual dan ultrasonik pasif untuk menghilangkan Ca(OH)2 dari dalam saluran akar. Kelompok IIA dan IIB diaplikasikan pasta Ca(OH)2+ gliserin dilanjutkan dengan teknik irigasi agitasi manual dan ultrasonik pasif. Seluruh subjek penelitian dipotong dalam arah sagital, selanjutnya difoto dibawah mikroskop stereo dengan pembesaran 120x. Perhitungan luas sisa Ca(OH)2 menggunakan progran UTHSCSA versi 3. Data dianalisis menggunakan ANOVA dua jalur dengan tingkat kemaknaan 95%. Hasil penelitian menunjukkan sisa Ca(OH)2 paling sedikit tampak pada kelompok aplikasi pasta Ca(OH)2 +CHX dengan teknik irigasi agitasi ultrasonik pasif. Sisa Ca(OH)2 paling banyak terdapat pada kelompok aplikasi Ca(OH)2+ gliserin dengan teknik irigasi agitasi manual. Kesimpulan dari penelitian ini menunjukkan bahan pencampur dan teknik irigasi agitasi berpengaruh terhadap sisa Ca(OH)2.

The most widely used intracanal medicament is calcium hydroxide (Ca(OH2). However, the residue of Ca(OH)2 in the root canal must be removed prior to obturation. The residue of Ca(OH)2 in the root canal walls would result in apical leakage. This is due to the unstable dimension of Ca(OH)2, reduced flow and working time of the sealers, and decreased adhesion of sealers and gutta percha to root canal walls. This study aimed to determine the effect of Ca(OH)2 vehicles and agitation irrigation techniques on the residue of Ca(OH)2 in the apical third of the root canal walls. Twenty four extracted mandibular first premolars were used in this study. The crowns of the teeth were removed at the apical part of cemento enamel junction ( CEJ ) with a length of 14 mm from the apical. The canals were prepared with a Step Back technique to obtain Master Apical File ( MAF ) # 40. The specimens were randomly devided into 4 groups of 6 each. In groups IA and IB, the pastes of Ca(OH)2+ chlorhexidine digluconate 2% (CHX) mixture were applied, followed by manual agitation and ultrasonic passive techniques for eliminating Ca(OH)2 from the root canal . In groups IIA and IIB, the pastes of Ca (OH)2+ glycerin were applied, followed by manual agitation and ultrasonic passive techniques. Each specimen of the study was sectioned in the sagittal direction, then was photographed under a stereo microscope at 120x magnification. The percentages of Ca(OH)2 residue were calculated using UTHSCSA image tool 3 software. Data were analyzed using two-way ANOVA at 95% level of significance. The results revealed that the group of Ca(OH)2+ CHX paste with passive ultrasonic agitation irrigation technique showed the lowest number of residual Ca(OH)2. The group of Ca(OH)2+ glycerin paste with manual agitation irrigation technique showed the highest number of residual Ca(OH)2. The conclusion of this study was that the vehicles and the agitation irrigation techniques affected the total residue of Ca(OH)2.

Kata Kunci : kalsium hidroksida, agitasi manual, agitasi ultrasonik pasif, khlorheksidin diglukonat 2%, gliserin, sisa Ca(OH)2.