Endodontic retreatment is an attempt to reachieve a healthy periapical after it was previously been carried out an inadequate or reinfected endodontic retreatment that has been filled due to the leakage of apical and coronal. One stage in this retreatment is an uptake of obturasi material using hedstrom file (H-file). The solvent material used in this endodontic retreatment is xylol. Case report. A 22-year-old male patient came to the Clinic of Conservative Dentistry Dental Hospital Prof. Soedomo, Faculty of Dentistry, Gadjah Mada University (UGM) wanted to treat his mandibular second right premolar (45) that has been painful since two months ago. The tooth had root canal treatment one year ago. The pain suddenly appears and disappears as soon as the patient consumes painkillers. Dental preoperative (periapical) radiograph tooth 45 showed a picture of gutta percha root canals and radiolucent images at the tip of the root of the tooth. Diagnosis of tooth 45 is non-vital tooth after root canal treatment accompanied by apical, symptomatic periodontitis. The operator performed a root canal treatment by dismantling the restoration on the occlusal part of tooth 45 and taking gutta percha using a hedstrom file followed by treatment of the root canal, crown lengthening, installation of individual formable fiber post and porcelain fused to metal crown. Conclusion. Retreatment of root canal treatment with non-surgical methods still can be conducted effectively and obtain good results with the final treatment results in smaller lesions in the apical portion of tooth 45.
Perforation is one of iatrogenic factors responsible for endodontic failure. Root canal perforation can occur at the cervical, mid-root, or apical levels. Non-surgical (conservative) perforation repair offers less tissue destruction and easy isolation during treatment. Objective: To explain the management of apical third root perforation using the conservative technique. Case Report: This case report describes a 29-year-old patient who came for management of right maxillary lateral incisor with apical third root perforation on the labial aspect. The location of apical third root perforation was evaluated using cone beam computed tomography (CBCT). Root perforation was sealed using mineral trioxide aggregate (MTA). MTA was applied in conservative technique with hand filling. MTA was dispensed into the original canal while maintaining the patency of the perforated canal, followed by dispensed of MTA into the perforated canal. Conclusion: Root perforation should be identified as soon as possible and could be easily examined using CBCT. Non-surgical root perforation treatment is recommended in intact periodontal attachment and in absence of inherent complication. Repairing the root perforation promote the proper healing of the periapical tissue and increase the success rate of retreatment.
Four rooted maxillary second molar is a rare condition. A research of 1,200 maxillary second molars found only 0.4% of the sample with this condition. In a tooth with two palatal roots, one of them is the normal palatal root, while the other is a supernumerary structure which can be found mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). Objective: to describes a successful root canal treatment of a maxillary second molar with radix mesiolingualis. Final restoration using a short fiber-reinforced composite as the bottom structure under the onlay composite direct restoration. Case report: A 39-year old female patient complained of pain continuously for the past two weeks in her right maxillary second molar (tooth #17). Clinical examination revealed a deep mesioocclusal caries lesion and presence of extra cusps on the palatal surface of the crown. Conclusion: Crown with extra cusps relatively larger compared to a normal crown. It could be indicated the additional palatal roots. Those variations could be identified by clinical and radiographic examination, while more accurate assessment with CBCT imaging. The right material was required to support function and strengthen the tooth after root canal treatment.
Replantasi intensional merupakan salah satu cara untuk mempertahankan gigi yang mengalami fraktur vertikal. Replantasi gigi dengan fraktur vertikal memerlukan kerapatan pada sisi fraktur dengan baik. Hal ini dapat dicapai dengan cara penempatan perekat fragmen fraktur yang tepat yang dapat diterima tubuh agar dicapai penyembuhan yang baik. Tujuan penelitian ini adalah untuk mengetahui reaksi regenerasi jaringan periradikuler dengan indikator pembentukan kolagen tipe I pada penggunaan self-adhesive resin cement dan mineral trioxide aggregate (MTA) sebagai bahan penutup garis fraktur. Penelitian menggunakan 27 ekor kelinci New Zealand jantan yang dibagi menjadi 3 kelompok perlakuan. Kelompok I tanpa aplikasi bahan (kontrol), kelompok II dengan aplikasi MTA dan kelompok III dengan aplikasi self-adhesive resin cement. Pengamatan pembentukan kolagen tipe I dilakukan pada hari ke-7 (minggu I), hari ke-14 (minggu II) dan hari ke-21 (minggu III). Serum diambil dari darah kelinci melalui vena auricularis. Kadar kolagen tipe I diamati dengan rabbit collagen type I kit menggunakan teknik ELISA. Data dianalisis dengan analisis variansi dan post hoc LSD dengan tingkat kepercayaan 95%. Hasil uji statistik dengan analisis variansi menunjukkan bahwa terdapat pengaruh yang signifikan (p < 0,05) penggunaan self-adhesive resin cement dan MTA sebagai penutup garis fraktur pada replantasi intensional fraktur gigi vertikal terhadap pembentukan kolagen tipe I. Pembentukan kolagen tipe I kelompok dengan aplikasi MTA lebih tinggi dari kelompok kontrol maupun kelompok self-adhesive resin cement pada pengamatan minggu II dan minggu III (p < 0,05). Berdasarkan penelitian yang telah dilakukan dapat diambil kesimpulan bahwa pembentukan kolagen tipe I pada aplikasi MTA lebih tinggi daripada self-adhesive resin cement.
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