Penatalaksanaan Kasus Impaksi Premolar, Ektopik Caninus dan Asimetri Rahang dengan Teknik Edgewise

Abstract

Pencabutan dini pada gigi desidui seringkali menyebabkan perpendekan lengkung sehingga ruang yang dibutuhkan untuk erupsi gigi permanen kurang. Kaninus ektopik, impaksi premolar dan asimetri rahang adalah kasus yang sering terjadi akibat kurangnya ruang untuk erupsi gigi. Pasien perempuan usia 20 tahun, mengeluhkan gigi gingsul dan tidak rapi. Pemeriksaan objektif menunjukkan crowding rahang atas dan rahang bawah, kaninus maksila kanan atas ektopik, premolar mandibula kanan impaksi, disertai pergeseran midline. Maloklusi Angle kelas I dengan hubungan skeletal kelas I, overbite 1 mm, overjet  1,3 mm, crowding mandibula dan maksila, ektopik kaninus unilateral, impaksi premolar unilateral, asimetri rahang dan pergeseran midline. Pencabutan dilakukan pada 2 gigi premolar pertama rahang atas dan 2 gigi molar pertama rahang bawah yang mengalami nekrosis. Perawatan menggunakan alat cekat teknik Edgewise dengan multiloop. L loop digunakan untuk ekstrusi gigi kaninus ektopik dan menarik impaksi premolar. Asimetri rahang dikoreksi dengan ekspansi lengkung gigi menggunakan mainarchwire. Setelah 7 bulan perawatan, gigi kaninus yang ektopik, impaksi premolar dan crowding terkoreksi. Overjet dan overbite menjadi 2,5 mm. Perawatan masih berlangsung hingga saat ini. Penggunaan multiloop pada teknik Edgewise efektif untuk mengoreksi crowding gigi dan L loop efektif untuk mengekstrusi gigi kaninus ektopik dan impaksi premolar.

ABSTRACT: Management of Impacted Premolar, Ectopic Canine and Jaw Asymmetry Case Using Edgewise Technique. The premature loss of primary teeth may reduce the arch length required for permanent teeth eruption. Ectopic canine, premolar impaction and jaw asymmetry are often encountered due to the lack of space for permanent teeth eruption. A twenty-year-old female patient complained an ectopic canine and crowding of upper and lower teeth. The objective examination found maxilla and mandibula crowding, ectopic right maxilla canine, mandibular premolar impaction, and midline shift of maxilla and mandibula. Angle class I malocclusion, overbite 1 mm, overjet 1.3 mm, maxilla and mandibula crowding, unilateral ectopic canine, unilateral premolar impaction, jaw asymmetry and midline shift occurred. Extraction of 2 maxillary first premolars and 2 necrose mandibular first molars was conducted followed by a treatment using fixed orthodontic appliance Edgewise technique with multiloop. The ectopic canine and premolar impaction were extruded using L loop. Jaw asymmetry was corrected by expanding the dental arch using the expanded main archwire. Ectopic canine, premolar impaction, maxilla and mandibula crowding were corrected after 7 months of treatment. The overjet and overbite reached 2.5 mm. The treatment is still ongoing. The multiloop edgewise archwire technique is found effective to overcome dental crowding, and L loop is effective to extrude the ectopic canine and premolar impaction.