Penatalaksanaan impaksi gigi premolar kedua bawah kiri tanpa exposure bedah pada perawatan ortodonti cekat<p></p>Non-surgical exposure management of impacted lower left second premolar in orthodontic treatment<p>

Abstract

ABSTRAK Pendahuluan: Impaksi gigi premolar kedua bawah sering dijumpai, prevalensi di peringkat ketiga setelah gigi molar ketiga dan kaninus atas. Beberapa cara penatalaksanaan gigi impaksi dapat dilakukan. Pemilihan rencana perawatan tergantung pada posisi, jarak dengan bidang oklusal, tahap perkembangan, dan hubungan gigi impaksi dengan gigi-gigi di dekatnya, kebutuhan perawatan ortodonti, usia pasien, serta respons penyembuhan jaringan keras dan lunak setelah tindakan bedah. Pasien dirawat tanpa tindakan exposure bedah, dilakukan pencabutan gigi 34 yang menghalangi jalur erupsi gigi 35, dilanjutkan perawatan ortodonti cekat guna membuka ruang bagi gigi 35 dan menarik gigi 35 masuk ke dalam bidang oklusal. Tujuan laporan kasus menyampaikan penatalaksanaan perawatan ortodonti impaksi gigi premolar kedua bawah kiri tanpa exposure bedah. Laporan kasus: Pasien wanita usia 20 tahun dengan maloklusi skeletal kelas II divisi 1 disertai bimaksilaris dentoalveolar protrusion, tipe wajah brachyfacial, profil cembung dan terdapat impaksi gigi 35. Pemasangan breket MBT slot 0,22” dilakukan setelah gigi 14, 24 dan 34 dicabut. Ruangan untuk erupsi gigi 35 dijaga dengan memasang open coil spring di antara gigi 33 dan 36. Setelah terdapat ruang yang cukup bagi gigi 35, dilakukan penarikan gigi 35 ke dalam lengkung gigi. Total waktu perawatan adalah 21 bulan. Gigi 35 yang impaksi sudah masuk ke dalam bidang oklusal, profil jaringan lunak pasien membaik, bibir atas menjadi lebih kompeten dan tercipta lip seal karena overjet berkurang. Simpulan: Penatalaksanaan pasien perawatan gigi impaksi premolar kedua bawah tanpa exposure bedah efektif dan senyum pasien lebih estetik dengan posisi gigi anterior terhadap profil yang terkoreksi dengan baik. Kata kunci: gigi impaksi; gigi premolar; exposure bedah ABSTRACT Introduction: Impacted lower second premolars are typical cases in the third rank after third molars and upper canines. There are several ways to treat impacted teeth. The choice of treatment plan depends on the position, distance to the occlusal plane, developmental stage, relationship of the impacted tooth to adjacent teeth, orthodontic treatment needs, patient age, and the healing response of hard and soft tissues after surgery. The patient was treated without surgical exposure. Tooth 34 was extracted, which blocked the eruption path of tooth 35, followed by fixed orthodontic treatment to open space for tooth 35 and pull tooth 35 into the occlusal plane. This case report aims to present the management of impacted orthodontic treatment of the left lower second premolar without surgical exposure. Case report: A 20-year-old female patient with skeletal class II division 1 malocclusion, bimaxillary dentoalveolar protrusion, brachyfacial facial type, convex profile, and impacted tooth 35. MBT bracket insertion of 0.22" slot was performed after teeth 14, 24 and 34 were extracted. The space for the eruption of tooth 35 was maintained by placing an open coil spring between teeth 33 and 36. Once there was sufficient space for tooth 35, tooth 35 was pulled into the dental arch. The total treatment time was 21 months. The impacted tooth 35 had entered the occlusal plane, the patient's soft tissue profile improved, the upper lip became more competent, and a lip seal was created due to reduced overjet. Conclusion: Management of patients with impacted lower second premolars without adequate surgical exposure and the patient's smile is more aesthetically pleasing with the position of the anterior teeth in a well-corrected profile. Keywords: impacted tooth; premolars; surgical exposure

Keywords

• gigi impaksi
• gigi premolar
• exposure bedah