Penatalaksanaan Lesi Endo-Perio dengan Perawatan Endodontik Non Bedah

Abstract

Secara anatomis pulpa dan periodontal saling berhubungan. Pada keadaan tertentu bisa terjadi inflamasi di pulpa dan periodontal. Hal ini disebut dengan lesi endodontik-periodontal. Perkembangan dan progresi lesi endo-perio ini dipengaruhi oleh faktor etiologi seperti bakteri, jamur, dan virus serta faktor pendukung seperti trauma, resorpsi akar, perforasi, dan malformasi gigi. Pada lesi endo-perio diperlukan rencana perawatan yang tepat agar prognosis perawatan dari gigi tersebut dapat baik. Artikel ini bertujuan memaparkan perawatan kasus lesi endo-perio yang berhasil setelah manajemen endodontik tanpa dilakukan bedah endodontik. Seorang pasien laki-laki berusia 21 tahun datang ke RSGM dengan keluhan gigi belakang kiri bawah sakit. Gigi tersebut pernah ditumpat 1 tahun yang lalu.Pada gambaran radiograf terdapat lesi radiolusen luas pada tulang alveolar sekitar akar distal. Perawatan endodontik dilakukan dengan pergantian bahan dressing kalsium hidroksida sebanyak 3 kali. Pada kontrol bulan kedua terlihat terjadi penulangan pada bagian lesi periodontal tersebut dan pasien tidak mengeluhkan rasa sakit. Kesimpulan hasil perawatan lesi endodontik periodontal dapat dirawat dengan perawatan endodontik non bedah.

Management of Nonsurgical Endodontic Treatment on A Combined Endo-period Lesion. The pulp and periodontium have anatomic interrelationships. As the tooth matures, and the root is formed, three main avenues are created between pulp and periodontal ligament, i.e. dentinal tubules, lateral and accessory canals, apical foramen. These are the pathways that may provide a means by which pathological agent pass between the pulp and periodontium, thereby creating the endo - period lesion. Etiologic factors such as bacteria, fungi, and viruses as well as contributing factors such as trauma, root resorption, and dental malformations play a significant role in the development and progression of such lesions. In the endodontic - periodontal lesion is necessary to plan appropriate dental treatment that can lead to a better prognosis. This paper presents satisfactory healing of combined endo - period lesion treatment after nonsurgical endodontic management.A 21 years man came to the Conservative Dentistry Clinic, Prof. Soedomo Dental Hospital with pain complaint on left mandible posterior tooth. One year ago, this tooth already restored with resin composite restoration.Radiographs showed an extensive radiolucent lesions on 36 bifurcations extending to the distal root. After thorough cleaning and shaping, calcium hydroxide was applied intracranial and periodically renewed up to three times. Two months after root canal obturation radiograph evaluation showed ossification at the bifurcation 36. Endodontic Periodontal lesion can be treated with nonsurgical endodontic management.