Bicuspidization and crown lengthening on mandibular second molar

https://doi.org/10.22146/mkgk.49229

Putu Mariati Kaman Dewi(1*), Raphael Tri Endra Untara(2)

(1) Program Studi Konservasi Gigi Program Pendidikan Dokter Gigi Spesialis, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta
(2) Departemen Konservasi Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Endodontically treated teeth were more susceptible to fractures due to loss of coronal sections caused by caries, trauma, and root canal treatment itself. Posts are used to increase the retention of the restoration on the tooth with extensive defect. Radix Anchor system is one of metal post that has a high elastic modulus and with the excessive mastication forces, it can lead to fractures. This article reported the result of surgical endodontic treatment followed by porcelain fused to metal crown on endodontically treated tooth which fracture after being restored with Radix Anchor post. A 46 years old male patient came with complaints of pain in the lower right molar after eating a solid food. Root canal treatment was conducted on
the same tooth 2 years ago. According to subjective, objective and radiograph examination, diagnosis of this case is non-vital tooth after root canal treatment with class VI Ellis fracture and grade 2 bifurcation lesion. The treatment for this case is bicuspidization and crown lengthening of the tooth 47. The tooth was restored with full porcelain fused to metal crown and fiber post on mesial root. One month after treatment, the symptoms diminished and the tooth was normally
functioned. Bicuspidization was an alternative treatment to avoid extraction and preserve remaining tooth strucure to build a functional restoration.

 

ABSTRAK
Gigi pasca perawatan saluran akar rentan mengalami fraktur karena kehilangan bagian koronal yang cukup banyak akibat karies, trauma, serta perawatan saluran akar itu sendiri. Pasak digunakan untuk meningkatkan retensi restorasi pada gigi dengan kerusakan yang luas. Radix anchor adalah salah satu pasak metal yang memiliki modulus elastisitas yang tinggi sehingga tekanan pengunyahan yang berlebihan dapat menyebabkan terjadinya fraktur. Studi kasus ini
melaporkan hasil perawatan bikuspidisasi dan crown lengthening yang diikuti restorasi mahkota porselin fusi metal pada gigi pasca perawatan saluran akar yang mengalami fraktur setelah direstorasi dengan pasak Radix Anchor. Seorang pasien laki-laki usia 46 tahun datang dengan keluhan gigi geraham kanan bawah sakit saat mengunyah setelah makan makanan keras. Gigi tersebut pernah dilakukan perawatan saluran akar 2 tahun yang lalu. Berdasarkan pemeriksaan subjektif, objektif dan radiografis, diagnosis dari kasus ini adalah gigi nonvital pasca perawatan saluran akar disertai fraktur Ellis kelas VI dan lesi pada bifurkasi derajat 2. Perawatan yang dilakukan adalah bikuspidisasi gigi 47 dan crown lengthening, kemudian gigi direstorasi dengan mahkota penuh porselin fusi metal dengan pasak fiber pada akar mesial. Satu bulan pasca perawatan menunjukkan bahwa gejala sakit saat mengunyah sudah tidak ada dan gigi dapat berfungsi dengan normal. Bikuspidisasi merupakan perawatan alternatif untuk menghindari pencabutan gigi dan menjaga jaringan keras yang tersisa untuk membangun restorasi yang fungsional.


Keywords


bicuspidization; crown lengthening; mandibular second molar

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DOI: https://doi.org/10.22146/mkgk.49229

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