Penatalaksanaan instrumen jarum patah di gigi molar kedua kanan bawah

Jarum patah di dalam saluran akar dapat disebabkan oleh penggunakan instrumen jarum endodontik yang tidak tepat saat melakulan preparasi biomekanis. Beberapa hal yang dapat menyebabkan patahnya jarum adalah teknik preparasi yang tidak tepat, kekuatan fisik jarum yang sudah melebihi limit batas waktu pemakaian, akses yang tidak adekuat, anatomi saluran akar yang rumit, dan cacat pabrik. Terdapat tiga pendekatan dalam penanggulangan instrumen patah yaitu, membiarkannya di tempat (leave in situ), mengupayakan untuk melampaui fragmen (bypass), dan mengeluarkan fragmen. Seorang pasien perempuan berusia 22 tahun mengeluhkan sakit pada gigi belakang kanan bawah saat digunakan untuk mengunyah. Gigi tersebut pernah dilakukan perawatan saluran akar tetapi belum selesai. Pada pemeriksaan klinis terlihat adanya sisa tambalan sementara pada gigi 47 dengan karies mencapai pulpa di bagian distooklusal dan pada pemeriksaan radiologis terlihat gambaran radioopak pada saluran mesiobukal berupa jarum patah sepanjang 2 mm. Jarum endodontik pada gigi 47 patah diduga karena penggunaan file protaper handuse F2 yang dipaksakan pada saluran yang sempit, sehingga ujung file terjepit di dinding saluran akar danmenyebabkan jarum endodotik patah. Teknik bypass berhasil digunakan dengan cara menyusuri celah antara dentin saluran akar dengan jarum yang patah menggunakan Kfile #8-#15 dan dilanjutkan sampai file protaper Handuse F1,disertai irigasi NaOCl dan EDTA gel. Pengisian saluran akar dilakukan menggunakan guttapercha dan sealer Ahplus. Restorasi akhir berupa pasak dengan mahkota Porcelain Fuse to Metal. Teknik bypass dapat menjadi pilihan pada kasus jarum patah dan memberikan hasil perawatan yang baik

Penggunaan Pita Fibre Reinforced Composite (FRC) Sebagai Pasak pada Gigi 21 dengan Bentuk Saluran Akar yang Lebar

The primary purpose of a post is to retain a core and restoration on a tooth with extensive loss of coronal structure. However, preparation of a post space may increase the risk of the root canal fracture, especially in a large root canal. For reducing that, the new concepts was developed. the main idea was to build up a post that can be following anatomical form of the root canal, using minimal invasive preparation and made from the material which is modulus of elasticity closed to the dentinal. Its can be achieved by using custom fibre reinforced composite post. The aim of these case report was to inform the usage of custom fibre reinforced composite as root canal post on the endodontically treated tooth 21 with a large root canal. A 15 years old boy came to department of conservatif dentistry RSGM UNPAD to make a restoration for his endodontically treated tooth. The clinical examination revealed fracture horizontal on tooth 21 with less a half remaining coronal tooth tisue and discolorisation. Radiological examination showed radioopaque in whole of the root canal with increased width of the root canal to the coronal. Periapikal area was normally condition. The tooth was restored using custom fibre reinforced composite post and all porcelain crown as a final restoration. Custom FRC post was a good alternative for endodontically treated tooth with a large of the root canal that could be tailored to specific need, enabling preservation of tooth structure, and using minimal invasive preparatio

EFFECT OF LATEX AND EXTRACT OF JATROPHA CURCA LINN ON EXPRESSION OF SUBSTANCE P (SP) AND CYCLOOXYGENASE-2 OF DENTAL PULP: EFEK LATEKS DAN EKSTRAK JATROPHA CURCA LINN TERHADAP EKSPRESI SUBSTANSI P DAN COX2 PULPA GIGI

Inflammatory pulpal pain may arise due to the increased pressure inside the pulp or the release of prostaglandin E2(PGE2). In the inflamed pulp, levels of PGE2 and substance P (SP) is higher than those of normal pulp. PGE2 sensitizes all nociceptor while SP can induce the activity of cyclooxygenase-2 (COX- 2) and is an exitatory neurotransmitter. Jatropha curcas Linn latex is widely used for pulpal pain relief. The aim of this study was to evaluate the effect of the latex and extract of J. curcas on the dental pulp expression of COX-2 and SP. Thirty-six pulpitis-induced dental pulp of Macaca fascicularis , were divided into 3 groups: Group 1 served as controls, Group 2 was given latex, and Group 3 was given extracts. The ELISA assay was used to determine the levels of SP and COX-2. SP data was analyzed with ANOVA (p <0.05) while the COX-2 data was analyzed with Mann Whitney. The results showed that the levels of SP (pg/mL) of the control, latex, and extract group were 28.94; 26.22; 28.89 respectively, while levels of COX-2 (ng/ml) of control, latex, and extract group were 0.04; 0.08; 0.10 respectively. In conclusion , J. curcas can reduce the levels of SP, J. curcas latex has lower levels of SP than extract, but does not provide clear results in decreased levels of COX- 2. Further study requires the mechanism of SP, and the concentration of COX- 2 needs to be further investigated using different methods

Endocrown Restoration on Postendodontics Treatment on Lower First Molar

Restoration is one of the most important things in the field of dentistry, in restoration, there are two main things that must be considered, that was esthetic factors and functional factors. A tooth after endodontics treatment require more complex restoration than normal tooth, because lot of factors needed to be observed first, one of which is tissue residue, root canal anatomy, and even the economics condition of the patient. Post, cores, and crowns themselves have several contra indications in their use, therefore a dentist must be able to have other alternatives in the choice of restoration. Endocrown is an alternative that can be used by a dentist in performing postendodontics restoration

<p>Perbedaan kebersihan sepertiga saluran akar dari debris setelah diirigasi menggunakan jarum bevel dan jarum side-vent</p><p>Differences of the one third of the root canal cleanliness after irrigation using bevel needles and side-vent needles</p>

Pendahuluan: Pembersihan saluran akar merupakan tahapan penting yang mempengaruhi keberhasilan perawatan saluran akar. Irigasi saluran akar menggunakan irigan yang dihantarkan melalui spuit dan jarum irigasi. Desain ujung jarum yang digunakan dapat mempengaruhi kebersihan saluran akar yang diirigasi. Bagian sepertiga apikal saluran akar merupakan bagian yang paling sulit untuk dibersihkan, terutama jika irigasi dilakukan dengan menggunakan spuit dan jarum. Tujuan penelitian ini adalah untuk mengetahui perbedaan kebersihan sepertiga apikal saluran akar dari debris setelah diirigasi menggunakan jarum bevel dan jarum side-vent. Metode: Sampel yang digunakan sebanyak 30 gigi insisif sentral rahang atas yang telah diekstraksi. Gigi dibagi dua kelompok untuk diinstrumentasi dengan jarum protaper dan diirigasi menggunakan NaOCl 2,5%. Kelompok pertama diirigasi menggunakan jarum bevel dan kelompok kedua diirigasi menggunakan jarum side-vent. Kebersihan sepertiga saluran akar diukur melalui skor debris. Skor debris dari masing-masing kelompok kemudian diuji dengan uji t tidak berpasangan. Hasil: Hasil penelitian menunjukan bahwa kelompok yang diirigasi jarum side-vent dapat menghasilkan rata-rata skor debris lebih rendah (0,091) dibandingkan kelompok yang diirigasi jarum bevel (0,117). Uji statistik terhadap rata-rata skor debris menghasilkan nilai p>0,05 (p=0,095). Simpulan: Simpulan penelitian ini adalah tidak terdapat perbedaan signifikan pada kebersihan sepertiga apikal saluran akar dari debris setelah diirigasi menggunakan jarum bevel dan jarum side-vent. Kata kunci: Debris, irigasi saluran akar, jarum bevel, jarum side-vent.   ABSTRACT Introduction: Root canal cleaning is an important part which will determine the success of root canal therapy. Cleaning is done by irrigating root canal with irrigant delivered by syringe and irrigation needle. Needle’s tip design can affect the result of root canal cleanliness after irrigation. One-third root canal apical would be the most challenging part to be cleaned, especially if the irrigation was done by syringe and needle. This study was aimed to find out the difference of the one-third root canal apical cleanliness from debris after irrigation using a bevel and a side-vent needle. Methods: This study used 30 extracted maxillary central incisors as samples. The teeth were then divided into two groups; each group was instrumented and irrigated with 2.5% NaOCl. The first group was irrigated using a bevel needle and the second group was irrigated using a side-vent needle. The first group was irrigated using a bevel needle and the second group was irrigated using a side-vent needle. The cleanliness of one-third of the root canal was measured through a debris score. Debris scores from each group were then tested by an unpaired t-test. Result: Result of this study showed that the group irrigated using a side-vent needle had a lower debris score (0.091) than the group irrigated using a bevel needle (0.117). Statistic test of the debris score mean resulted in p > 0.05 (p = 0.095). Conclusion: In conclusion, there was no significant difference in the one-third root canal apical cleanliness from debris after irrigation using a bevel and a side-vent needle. Keywords: Bevel needle, debris, root canal irrigation, side-vent needle

<p>Modifikasi mahkota metal porselen pada restorasi paska perawatan endodontik gigi premolar atas kanan</p><p>Modification of porcelain metal crowns in post-endodontic restoration in upper right premolar teeth</p>

Pendahuluan: Gigi yang telah dirawat endodontik dapat mengalami perubahan baik secara makro maupun mikrostruktur, sehingga menjadikannya lebih rentan terhadap fraktur. Restorasi gigi yang telah dirawat endodontik perlu mempertimbangkan sisa jaringan yang tersedia agar restorasi dapat bertahan lama. Tujuan laporan kasus ini untuk memaparkan bahwa restorasi modifikasi mahkota metal porselen dapat menjadi alternatif pilihan pada gigi pasca perawatan endodontik. Laporan kasus: Wanita berusia 43 tahun dirujuk dari departemen prostodonti untuk dilakukan perawatan saluran akar pada gigi premolar atas kanan. Pemeriksaan klinis menunjukan gigi 14 dengan sisa tambalan komposit dan hilangnya dinding palatal. Tes vitalitas tidak berespon, pada pemeriksaan perkusi, tekan dan palpasi memberikan hasil negatif. Pemeriksaan radiografis memperlihatkan saluran akar yang telah terisi gutta-percha yang inadekuat. Diagnosis untuk gigi 14 adalah previously treated tooth. Perawatan endodontik ulang dilakukan dan dipersiapkan untuk restorasi akhir berupa mahkota penuh dengan pasak fiber. Berdasarkan rencana perawatan dari departemen prostodonti, mahkota penuh dibuat dengan bahan metal porselen modifikasi bahan metal pada permukaan oklusal karena pasien mengalami bruksisme dan sedang dalam perawatan menggunakan splin oklusal. Simpulan: Modifikasi mahkota metal porselen pada gigi pertama rahang atas paska perawatan endodontik merupakan alternatif pilihan terbaik dan memberikan hasil yang memuaskan. Kata kunci: Mahkota metal porselen, restorasi, gigi paska perawatan endodontik.   ABSTRACT Introduction: Endodontically-treated teeth can change both macro and microstructure, making them more susceptible to fracture. Restorations of endodontically-treated teeth need to consider the remaining tissue available, thus makes the restoration last longer. This case report was aimed to demonstrate that modified porcelain metal crown restoration could become a choice in post-endodontic teeth treatment. Case report: A 43-year-old woman was referred from the prosthodontics department for her maxillary right premolar root canal treatment. Clinical examination revealed that tooth 14 with remaining composite filling and loss of the palatal wall. The vitality test did not respond. On percussion examination, pressure and palpation gave negative results. Radiographical examination showed a root canal filled with insufficient gutta-percha. The diagnosis for tooth 14 was previously treated tooth. Re-endodontic treatment was performed and prepared for the final restoration of a full crown with fibre posts. According to the prosthodontics department’s treatment plan, the full crown was made of metal modified porcelain for the occlusal surface because the patient had bruxism and was being treated with occlusal splints. Conclusion: Modification of porcelain metal crown on the maxillary first premolar after endodontic treatment is the best alternative and gives satisfactory results. Keywords: Porcelain metal crown, restoration, post-endodontic dental treatment

The remineralization potential of cocoa (Theobroma cacao) bean extract to increase the enamel micro hardness

Introduction: Remineralization is the process of returning mineral ions into a hydroxyapatite structure characterized by mineral deposition on the enamel surface. The presence of mineral deposition would affect the microhardness of tooth enamel. Fluorine, as the remineralization agent is known with side effects such as fluorosis. Cocoa bean extract contains theobromine that can be used as an alternative remineralization ingredients. The objectives were to determine enamel microhardness after remineralization using cocoa bean extract as natural material and to compare with fluorine as synthetic material. Methods: Thirty-six maxillary first premolar tooth crowns was cut and planted in the epoxy resin. Teeth were then immersed in demineralization solution at pH 4 for 6 hours. The sample were divided into 2 groups, 18 for the fluorine group and the remaining group of cocoa extract. Vickers microhardness test was used before treatment, both after demineralized and remineralized. Results: The value of enamel microhardness before treatment in the fluorine group was 376.17 VHN as average value and the cocoa extract group was 357.33 VHN. After demineralization in fluorine group was 268.13 VHN and cocoa extract group was 235.93 VHN. After remineralization in fluorine group and cocoa extract group, respectively, 321.08 VHN and 293.86 VHN. The results of the analysis revealed that the level of enamel microhardness after remineralization was not significantly different in both groups (p>0.05). Conclusions: The findings indicated the ability of cocoa extract to increase the microhardness of enamel and implies the potential as a fluorine substitution for remineralization

E-Max Restoration on an Endodontically Treated Maxillary Lateral Incisor Using an Intra-Oral Digital Scanner

Full crown is the most appropriate restoration of endodontically treated tooth with extensive loss of dental structure. A proper crown requires accurately impression and precision by virtual digital intra-oral scanner technique to get patient satisfaction. An all-ceramic crown (e-max) provides excellent aesthetics that is indicated for restoring anterior teeth. This case report discussed restoration of endodontically treated left-upper lateral incisor. In the examination, there was loss of half coronal dental structure. The radiograph presents radiopaque images through the hermetical root canal. A fibre post was cemented with dual cure resin cement, and then core was created. Virtual impression performed with a digital intraoral scanner aimed to acquire tooth preparation accurately. Furthermore, e-max crown was performed and cemented with dual cure resin cement. Anterior teeth with extensive loss of coronal tooth structures required crown aesthetics restoration (e-max) with a fiber post to increase retention and resistance. Virtual impression with a digital intraoral scanner was more effective to precisely and accurately record tooth preparation than conventional impression techniques. E-max restoration of endodontically treated left-upper lateral incisor with a digital intra-oral scanner results in excellent dental aesthetics and patient satisfaction

Knowledge level of the elementary school of Arjasari students after education regarding natural background radiation and oral health care

Introduction: Environment and behaviour are the main factors affecting the health status of a human being. People living in high natural radiation exposure area (radon zone), which is as much as 85% of the air content, characterized by many presents of granite rocks. The village of Arjasari is an area with many granite rocks presence. The objective of this study was to determined the knowledge level of the elementary school students after education regarding natural background radiation and oral health care. Methods: The research was a descriptive survey research, with data sampling taken by using questionnaires towards as much as 150 elementary students. Previously, respondents were given first education regarding natural background radiation and oral health care. Instruments in this study using questionnaires that was tested for validation and reliabilities. Data analysis used was a descriptive survey technique processed by using computer program. Data was percentages of three rating categories, which were high, medium and low. Results: The results showed that the knowledge level of student regarding natural background radiation and oral health care. was as much as 14% in the high category; as much as 45% in the moderate category; and as much as 41% in the low category. Conclusion: Knowledge level of student after education about natural radiation and the effect of oral health was in the moderate category level

Osteoinduction Ability of Human Adipose-Derived Mesenchymal Stem Cell with Chitosan Scaffold Combination Towards Blood Serum Phosphorus Levels

ologous tissue can cause problems in the repair of extensive tissue damage, so the principle of tissue engineering is used as an alternative to reconstruct damage to the tissue because it has many advantages. The combination of Human Adipose-Derived Mesenchymal Stem Cell (hADMSC) and chitosan scaffold is expected to trigger osteoinduction that can be expressed by osteogenic markers such as phosphorus levels in blood serum. Objectives to prove osteoinduction in a combination of hADMSC and chitosan scaffold using blood serum phosphorus levels. This study used 12 groups with 5 sample each. Groups 1 to 4 were the negative control group at day 1,3,7, and 14. While groups 5 to 8 were the positive control group at day 1,3,7, and 14. Groups 9 to 12 were treatment groups at day 1,3,7, and 14. In the negative control group bone was only removed, in positive control group, bone was removed and chitosan scaffold was added, and in treatment group, bone was removed then, hADMSC and chitosan scaffold combination was added. Blood collection will be carried out in each group for examination of phosphorus levels in the blood serum. There were differences in phosphorus levels in blood serum in each group even though statistically there were only significant differences on day 14. The combination of hADMSC and chitosan scaffold caused a significant change in blood serum phosphorus levels on day 14 which means it triggers osteoinduction