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PERAWATAN SALURAN AKAR DISERTAI MAHKOTA PENUH PORSELIN FUSI METAL DENGAN PASAK TAPERED SERRATED PADA GIGI MOLAR SATU

KIRI MANDIBULA PULPA NEKROSIS

KARYA TULIS ILMIAH PPDGS-1

Untuk memenuhi sebagian persyaratan mencapai sebutan Dokter Gigi Spesialis-I

Program Studi Ilmu Konservasi Gigi Kelompok Ilmu Kedokteran Gigi

Diajukan oleh: Christiana Siwi Dwiharsanti

312/KG/SP/05

Kepada

PROGRAM PENDIDIKAN DOKTER GIGI SPESIALIS I FAKULTAS KEDOKTERAN GIGI UNIVERSITAS GADJAH MADA

YOGYAKARTA 200�

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PERAWATAN SALURAN AKAR DISERTAI MAHKOTA PORSELIN FUSI METAL DENGAN PASAK TAPERED- SERRATED PADA GIGI MOLAR SATU

KIRI MANDIBULA PULPA NEKROSIS

INTISARI Tujuan laporan kasus ini adalah untuk menginformasikan manfaat dan cara penggunaan pasak tapered serrated sebagai retensi dan resistensi restorasi mahkota penuh porselin fusi metal pada molar satu kiri mandibula pulpa nekrosis disertai lesi periapikal dan area bifurkasi. Pasien wanita 16 tahun, datang ke Klinik Konservasi Gigi FKG UGM, ingin merawatkan gigi molar satu kiri mandibula yang sakit sejak satu bulan sebelumnya. Pemeriksaan objektif terdapat karies disto linguo oklusal, pulpa terbuka, terdapat gingiva polip yang menutup ± seperlima kavitas. Sondasi, palpasi, tes vitalitas semua negatif, perkusi positif. Probing daerah mesiolingual masuk ±3mm, daerah distal masuk ± 4 mm, pada daerah bifurkasi tidak masuk.Pemeriksaan radiograf tampak penebalan lamina dura pada akar mesial dan distal, radiolusen di area bifurkasi diameter ± 1 mm Diagnosis adalah pulpa nekrosis karies disto linguo oklusal disertai lesi periapikal dan area bifurkasi. Perawatan gigi tersebut adalah perawatan saluran akar, restorasi mahkota penuh porselin fusi metal dengan retensi pasak tapered serrated inti resin komposit. Hasil perawatan saluran akar baik, satu bulan pasca perawatan saluran akar sudah tidak ada keluhan, radiolusen di area bifurkasi sudah berkurang, pasien dirujuk ke bagian periodonsia untuk pemeriksaan dan perawatan poket. Setelah poket sembuh dilakukan pemasangan pasak tapered serated (Filpost), pembuatan inti resin komposit dan pencetakan inti. Pada kunjungan ke tujuh dilakukan pengepasan dan sementasi mahkota penuh porselin fusi metal. Pada saat kontrol, tidak ada kontak prematur, tidak ada kondisi traumatik, keadaan gingiva normal, perkusi negatif, warna gigi serasi dengan warna gigi sebelahnya, gigi dapat berfungsi kembali. Kata kunci : Perawatan saluran akar, mahkota porselin fusi metal, pasak tapered- serrated, pulpa nekrosis.

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ROOT CANAL TREATMENT ACCOMPANIED BY RESTORATION USING PORCELAIN FUSED TO METAL CROWN AND TAPERED SERRATED POST

ON MANDIBULLARY LEFT FIRST MOLAR WITH PULP NECROSIS

ABSTRACT The purpose of this case report was to inform the benefit and the procedure of using tapered serrated post as a retention and resistance of porcelain fused to metal full crown restoration on mandibullary left first molar with pulp necrosis in conjunction with periapical and bifurcation lesion. A 16-year-old female, who had suffered from pain on mandibullary left first molar since a month earlier, presented for treatment to Conservative Dentistry Clinic, Faculty of Dentistry, Gadjah Mada University. Objective examination showed caries occurred on disto linguo occlusal surface leading to open pulp chamber and approximately the one-fifth of the cavity was covered by gingival polyp. No tenderness to sondation and palpatio as well as no response to thermal test, on the other hand tenderness to percussion. Probing on mesiolingual, distal and bifurcation area revealed that probe was able to be inserted approximately 3 mm, 4 mm, and 0 mmdepth respectively. Radiographic examination exhibited thickening of lamina dura on both mesial and distal root, teh diameter of radiolucency on bifurcation areas was approximately 1 mm. The diagnosis was disto linguo occlusal caries with pulp necrosis along with periapical and bifurcation lesion. The treatment carrying out was root canal treatment followed by restoration using porcelain fused to metal full crown and tapered serrated post for retention with resin composite core. The outcome of the treatment was excellent, no dental complain one month subsequent root canal treatment, radiolucency at bifurcation area reduced and teh patient was referred to periodontic clinic for pocket treatment. After healing of pocket, several procedures were undertaken to finishing the restoration as followed: root canal preparation, post placement, resin composite core build-up, and core impression. At seventh recall, try-in and cementation of porcelain fused to metal full crown were done. During recall evaluation several conditions were observed i.e., the absence of premature contact and traumatic condition as well as gingival tissue inflammtion, no tenderness to percussion, matching color with adjacent tooth and ultimately normal tooth function can be reestablished. Keyword : Root canal treatment, porcelain fused to metal crown, tapered serrated post, pulp necrosis.