Jurnal Kedokteran Gigi Universitas Padjadjaran (Aug 2022)
<p><strong>Penatalaksanaan restorasi overlay komposit pada gigi molar pertama kiri mandibula pasca perawatan saluran akar</p><strong><em>Management of composite overlay restoration of mandibular first molar post-root canal treatment</em><strong>
Abstract
ABSTRAK Pendahuluan: Proses karies gigi dan gigi yang telah dilakukan perawatan endodontik menyebabkan kehilangan substansi gigi sehingga lebih rentan terhadap fraktur. Frederico Ferraris mengatakan restorasi adhesif indirek posterior umum digunakan pada kasus kavitas dengan kerusakan koronal yang luas. Penggunaan overlay komposit indirek memberikan beberapa keuntungan, termasuk konservatif, sealing, fungsi dan estetik yang baik. Tujuan laporan kasus ini membahas penatalaksanaan restorasi overlay komposit indirek sebagai pilihan restorasi pasca perawatan saluran akar. Laporan kasus: Pasien perempuan berusia 47 tahun datang ke klinik dengan keluhan gigi geraham bawah kiri belakang berlubang dan seringkali terselip makanan sejak 2 minggu yang lalu. Pasien tidak memiliki riwayat nyeri spontan, pernah dilakukan penambalan sebelumnya ± 1 tahun lalu. Pemeriksaan objektif menunjukkan gigi 36 tes vitalitas, tes perkusi dan tes tekan negatif, tidak terdapat kegoyangan gigi dengan jaringan sekitar dalam batas normal. Pemeriksaan radiografis menunjukkan terdapat gambaran radioopak menyerupai tambalan dari enamel hingga kamar pulpa dan mendekati bifurkasi, pelebaran membran periodontal, penebalan lamina dura disertai gambaran radioopak di sekitar apikal akar gigi. Jaringan karies dihilangkan dan pembukaan akses kavitas gigi 36, irigasi dengan NaOCl 5,25% dan agitasi menggunakan Eddy® tip, dan preparasi saluran akar dengan teknik crown down menggunakan nikel titanium rotary Protaper GoldTM dan restorasi follow up overlay komposit indirek. Pemeriksaan radiografis bitewing dilakukan pasca pemasangan overlay komposit indirek untuk mengevaluasi keberhasilan perawatan. Simpulan: Restorasi overlay komposit menunjukkan keberhasilan perawatan restorasi pasca endodontik dengan penyembuhan jaringan periapikal serta respon jaringan yang baik. Kata kunci: perawatan saluran akar; overlay; komposit indirek ABSTRACT Introduction: Dental caries processes and endodontically treated teeth (ETT) cause tooth loss, making it more susceptible to fracture. Frederico Ferraris showed that posterior indirect adhesive restoration (PIAR) is commonly used in cases with widespread coronal damage. The indirect composite overlay restoration provides several advantages, including conservative, sealing, function and pleasing aesthetics. This case report discusses the management of indirect composite overlay restoration as a treatment of restoration for post-root canal treatment. Case report: 47-years-old female patient came to the clinic with complaints of cavities in the left lower molar and food impaction 2 weeks ago. The patient has no history of spontaneous pain and had restoration fillings performed 1 year ago on this tooth. Objective examination showed non-vital teeth 36, percussion test and pressure test were negative, and there was no mobility of teeth with the normal surrounding tissue. Radiographic examination shows radiopaque of the crown from enamel towards the pulp chamber and approaching the bifurcation, widening of periodontal membrane, and thickening of lamina dura, accompanied by a radiopaque appearance around the apical root. Removal of caries tissue and access opening of the cavity was performed, irrigation with 5.25% NaOCl and agitation using an Eddy® tip, and root canal preparation with the crown down technique using nickel-titanium rotary Protaper GoldTM™ and indirect composite overlay restorations as a follow-up. Bitewing radiograph is carried out after cementation of indirect composite overlay to evaluate the success of dental treatment. Conclusion: The indirect composite overlay adhesive restoration showed success in restoration post endodontic treatment with the healing of periapical tissue and good tissue response. Keywords: root canal treatment; overlay; indirect composite
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