Perawatan saluran akar ulang non-bedah gigi insisivus lateral kanan rahang atas pada pasien geriatri  Non-surgical root canal re-treatment of maxillary right lateral incisor in geriatric patient

Prima Dianiawati Nur Anisa; Diani Prisinda

doi:10.24198/jkg.v32i3.29548

Perawatan saluran akar ulang non-bedah gigi insisivus lateral kanan rahang atas pada pasien geriatri
Non-surgical root canal re-treatment of maxillary right lateral incisor in geriatric patient

Prima Dianiawati Nur Anisa, Diani Prisinda

Abstract

Pendahuluan: Kegagalan perawatan endodontik umumnya terjadi akibat obturasi yang tidak adekuat dan kebocoran pada restorasi akhir. Kegagalan tersebut dapat diatasi dengan perawatan saluran akar ulang. Perawatan tersebut pada pasien geriatri memerlukan berbagai pertimbangan penatalaksanaan sesuai dengan kondisi fisiologis dan sistemik pasien. Tujuan laporan kasus ini untuk menjelaskan perawatan saluran akar ulang non-bedah gigi insisif lateral kanan atas pada pasien geriatri. Laporan kasus: Perempuan berusia 69 tahun datang ke Instalasi Rawat Jalan Spesialistik Konservasi Gigi Rumah Sakit Gigi dan Mulut Universitas Padjadjaran (RSGM Unpad) untuk memperbaiki tambalan gigi atas depan kanan yang pecah dan untuk merawat gigi tersebut karena terasa tidak nyaman saat digunakan untuk mengunyah. Gigi pernah dilakukan perawatan saluran akar dan penambalan sewarna gigi sekitar empat tahun yang lalu. Pemeriksaan intraoral menunjukan perkusi positif pada gigi insisif lateral kanan rahang atas. Pemeriksaan radiografis periapikal memperlihatkan bahan pengisi saluran akar tidak adekuat, pelebaran membran periodontal di sepertiga apikal, serta terputusnya lamina dura di sepertiga apikal. Rencana perawatan adalah perawatan saluran akar ulang non bedah. Perawatan berlangsung dalam enam kali pertemuan singkat, dengan tahapan pengambilan gutta-percha menggunakan file hedstrom, preparasi saluran akar dengan instrumen rotary, obturasi saluran akar dengan gutta-percha serta sealer resin plus dan restorasi akhir veneer direk berbahan komposit. Simpulan: Perawatan saluran akar ulang non-bedah pada gigi insisif lateral kanan atas berhasil dilakukan dengan ditandai hilangnya keluhan pasien, perbaikan pada gambaran radiografis serta gigi dapat berfungsi secara normal. Keberhasilan perawatan dipengaruhi oleh rencana perawatan yang tepat dengan mempertimbangkan faktor etiologi kegagalan perawatan endodontik serta perubahan fisiologis dan kondisi patologis yang terdapat pada pasien.

Kata kunci: Perawatan saluran akar ulang, insisif lateral, pasien geriatri.

ABSTRACT

Introduction: Endodontic treatment failure generally results from inadequate obturation and leakage at the final restoration. This failure can be relieved by re-root canal treatment. Such treatment in geriatric patients requires various management considerations according to the patient’s physiological and systemic conditions. This case report was aimed to describe the non-surgical root canal re-treatment of maxillary right lateral incisor in a geriatric patient. Case report: A 69-years-old woman came to the Conservative Dentistry Specialist Outpatient Unit of the Universitas Padjadjaran Dental Hospital (RSGM Unpad) to repair a broken maxillary right front tooth fill and to treat the tooth due to the uncomfortable feeling each time the mastication was performed. The tooth was treated with root canals and tooth-coloured fillings about four years ago. Intraoral examination revealed positive percussion of the maxillary right lateral incisor. The periapical radiograph showed inadequate root canal filling, dilation of the periodontal membrane in the third apical, and severed lamina dura in the third apical. The treatment plan was non-surgical root canal re-treatment. The treatment took place in six short sessions, with the steps of gutta-percha collection using a Hedstrom file, the root canal preparation with a rotary instrument, and the root canal’s obturation with gutta-percha plus resin sealer and final restoration of a composite direct veneer. Conclusion: Non-surgical root canal treatment of the upper right lateral incisor was successfully performed as indicated by the absence of the patient’s complaints, improvement in the radiographic image, and the teeth’ normal function. The treatment's success is influenced by a proper treatment plan considering the aetiological factors of endodontic treatment failure, the physiological changes, and pathological conditions present in the patient.

Keywords: Root canal re-treatment, lateral incisor, geriatric patient.

Keywords

Perawatan saluran akar ulang; insisif lateral; pasien geriatri; root canal re-treatment; lateral incisor; geriatric patient

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DOI: https://doi.org/10.24198/jkg.v32i3.29548