Apeksifikasi dengan mineral trioxide aggregate dan perawatan intracoronal bleaching pada gigi insisivus sentralis kiri maksila non vital diskolorasi


I. Inajati(1*), Raphael Tri Endra Untara(2)

(1) Polrestabes Semarang, Semarang, Jawa Tengah, Indonesia
(2) Departemen Konservasi Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia
(*) Corresponding Author


Affecification with mineral trioxide aggregate and care of intracoronal bleaching on the non vital discoloration maxillary left central incisor. Maxillary anterior teeth in children and adults often experience trauma. This later makes the dental pulp roots that are not completely formed face the necrosis and apical closure stop later causing the apex wide and open. The opened apex can be coped with the care of affecification. Mineral Trioxide Aggregate (MTA) is the best material of affecification used for the formation of apical barrier. The purpose of this case report was to report the achievement of the apical sealing using MTA in the non-vital permanent maxillary left central incisor with the opened apical due to the trauma. The complaints of male patients aged 20 years was about the broken and discoloured left upper front teeth and becomes a traumatic event since the age of 10 years due to a fall and hit the cement floor. A clinical examination of non-vital teeth used the fracture Ellis IV class with wide open apex and discoloration. The radiographic image showed a widely opened apex with large root canal and there was a periapical radiolucency. The treatment given was affecification with MTA followed obturation with gutta-percha and sealer AH 26. In the following week it was continued with intracoronal bleaching with the application of sodium perborate and 30% hydrogen peroxide. Before treatment, the teeth were brownish (C4) and after treatment it turned into yellowish white (B2). A week after the bleaching treatment was completed and the installation of fibre post was done, followed by giving the composite resin restorations class IV cavity. The 2-week control later showed no abnormalities. In conclusion, the affecification treatment with MTA can accelerate treatment with the formation of apical barrier that stimulates the healing and may be followed by obturation with guttap percha followed by doing intracoronal bleaching and final restoration.



Gigi anterior rahang atas pada anak-anak maupun dewasa sering mengalami trauma. Akibatnya pulpa gigi yang akarnya belum terbentuk sempurna akan mengalami nekrosis, dan penutupan apeks terhenti yang menyebabkan apeks lebar dan terbuka. Apeks yang terbuka dapat diatasi dengan perawatan apeksifikasi. Mineral Trioxide Aggregate (MTA) adalah bahan pilihan terbaik yang dipakai sebagai bahan apeksifikasi untuk pembentukan apical barrier. Tujuan laporan kasus ini adalah untuk melaporkan keberhasilan penutupan apikal dengan menggunakan MTA pada gigi permanen insisivus sentralis kiri maksila non vital dengan apikal yang terbuka karena trauma. Pasien laki-laki usia 20 tahun dengan keluhan gigi depan atas kiri patah dan berubah warna. Kejadian trauma sejak usia 10 tahun karena jatuh dan terbentur lantai. Pemeriksaan klinis gigi non vital dengan fraktur Ellis kelas IV disertai apeks terbuka lebar dan diskolorasi. Pada gambaran radiografis menunjukkan apeks yang terbuka lebar dengan saluran akar besar serta terdapat radiolusensi periapikal. Perawatan yang dilakukan adalah apeksifikasi dengan MTA dilanjutkan obturasi dengan gutta percha dan sealer AH 26. Setelah seminggu kemudian dilakukan intracoronal bleaching dengan aplikasi sodium perborat dan hidrogen peroksida 30%. Sebelum perawatan, gigi berwarna kecoklatan (C4) setelah dilakukan perawatan menjadi warna putih kekuningan (B2). Seminggu setelah perawatan bleaching selesai kemudian dilakukan pemasangan pasak fiber, dilanjutkan dengan restorasi resin komposit kavitas kelas IV. Kontrol 2 minggu kemudian tidak menunjukkan adanya kelainan. Kesimpulan hasil perawatan apeksifikasi dengan MTA dapat mempercepat waktu perawatan dengan terbentuknya barier apikal yang merangsang penyembuhan dan dapat dilanjutkan dengan obturasi dengan gutta percha, kemudian dilakukan bleaching intracoronal bleaching dilanjutkan dengan restorasi akhir.



affecification, discoloration, intracoronal bleaching, MTA

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DOI: https://doi.org/10.22146/majkedgiind.11251

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