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

i
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.

ix
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.