Rehabilitasi Intra Radicular dan Estetika Sesudah Apeksifikasi dengan Mineral Trioxide Agregat pada Apeks Blunderbluss

Root canal treatment in necrosis blunderbluss apices difficult to treat and to obtain a good apical seal. A therapy called apexification is required to induce the formation of a calcified apical barrier. The aim of this case report is to demonstrate apexification blunderbluss apices by the use of mineral trioxide agregat (MTA) as an apical plug and follow up fiber reinforced composite (FRC) after bleaching and direct composite. A 18 year old male patient reported with fractured right central incisor on the incisal with blunderbluss apices and the tooth has brown discoloration. MTA as an apical plug was used after the root canals had been debrided and rinsed with 2,5% NaOCl. Calcium hydroxide paste was placed in the canal before the apical portion of the canal was filled with the MTA apical plug. Bleaching before a FRC was placed in the remaining portion of the canal, core build-up was done and direct composite filled over it. At 6 month follow-up period the clinical and radiographic appearance of the teeth had healed successfully. MTA appears to be a promising alternative to calcium hydroxide apexification because of its superior sealing ability, high biocompatibility, and reduced treatment time. The reinforcement of the composite resins by fibers improves their fracture toughnes and resistance. Bleaching and direct composite to make coronal sealing and tooh color returned to the original color. MTA in apexification is valuable method if the quality of coronal sealing can be enhanced

<p>Penatalaksanaan diskolorisasi gigi pasca perawatan endodontik dengan teknik walking bleach</p><p>Management of post-endodontic tooth discolouration with the walking bleach technique</p>

Pendahuluan: Diskolorisasi gigi setelah perawatan endodontik dapat disebabkan oleh bahan pengisi saluran akar. Bahan endodontik yang tertinggal di dalam kamar pulpa akan menginfiltrasi tubulus dentin sehingga menyebabkan pewarnaan. Diskolorisasi intrinsik akibat bahan pengisi saluran akar seringkali terlihat pada sepertiga servikal gigi yang telah dirawat endodontik. Walking bleach merupakan teknik bleaching internal yang digunakan pada kasus diskolorasi pasca perawatan endodontik. Tujuan laporan kasus ini adalah memaparkan tentang penatalaksanaan diskolorisasi gigi pasca perawatan saluran akar dengan teknik walking bleach. Laporan kasus: Pasien perempuan berusia 20 tahun datang ke RSGM Unpad dengan keluhan gigi depan atas kiri berwarna kecoklatan dan mengganggu penampilan. Pemeriksaan klinis menunjukkan gigi 21 terdapat tumpatan komposit pada mesiobukal disertai diskolorisasi intrinsik dengan warna kecoklatan tampak dominan pada daerah servikal. Hasil tes vitalitas, perkusi dan palpasi negatif. Pemeriksaan radiologis menunjukkan gambaran radiopak menyerupai bahan pengisi saluran akar dari kamar pulpa hingga 2/3 panjang saluran akar. Diagnosis pada kasus ini adalah Previously Treated gigi 21. Perawatan ulang saluran akar dilakukan dan diikuti prosedur bleaching internal dengan teknik walking bleach. Gutta-percha dihilangkan 3 mm di bawah orifice kemudian dibuat barrier semen glass ionomer. Pasta H2O2 35% diletakkan diatas barrier lalu ditutup tumpatan glass ionomer. Setelah 1 minggu didapatkan warna yang sesuai, kalsium hidroksida diaplikasikan pada kamar pulpa. Gigi direstorasi dengan resin komposit 2 minggu kemudian. Aplikasi pasta H2O2 35% dengan teknik walking bleach terbukti dapat mengembalikan warna gigi tersebut. Simpulan: Teknik walking bleach merupakan salah satu pilihan perawatan yang dapat mengatasi diskolorisasi intrinsik pada gigi non vital pasca perawatan endodontik secara efektif. Kata kunci: Diskolorisasi intrinsik, bleaching internal, teknik walking bleach.   ABSTRACT Introduction: Tooth discolouration post-endodontic treatment can be caused by root canal filling materials. The endodontic material left in the pulp chamber will infiltrate the dentinal tubules, thus causing staining. Intrinsic discolouration due to root canal filling is frequently seen in an endodontically-treated third cervical. Walking bleach is an internal bleaching technique used in post endodontic discolouration cases. The purpose of this case report was to describe the management of post-endodontic root canal discolouration with the walking bleach technique. Case report: A 20-year-old female patient came to Universitas Padjadjaran Dental Hospital (RSGM Unpad) with complaints that her maxillary anterior left teeth were brownish and disturbing her appearance. Clinical examination showed that tooth 21 had a mesiobuccal composite fill with intrinsic discolouration, in which the brownish colour was appearing predominantly in the cervical area. Vitality, percussion and palpation test results were negative. Radiological examination showed a radiopaque image resembling a root canal filling material from the pulp chamber to two-thirds of the root canal length. The diagnosis was previously treated tooth. Root canal re-treatment was carried out and followed by an internal bleaching procedure using the walking bleach technique. The gutta-percha was removed 3 mm below the orifice, and a glass ionomer cement barrier was made. 35% H2O2 paste was placed above the barrier and then covered with a glass ionomer spill. After one week of obtaining the appropriate colour, calcium hydroxide was applied to the pulp chamber. The tooth was restored with composite resin two weeks after. The application of 35% H2O2 paste using the walking bleach technique was proven to be able to restore the teeth colour. Conclusion: The walking bleach technique is one treatment option that can effectively treat intrinsic discolouration of non-vital teeth post-endodontic treatment. Keywords: Intrinsic discolouration, internal bleaching, walking bleach technique

Comparison of surface roughness of nanofill and nanohybrid composite resin polished by aluminum oxide and diamond particle paste

Introduction: The adequate finishing and polishing procedures might occur the restoration longivity, the color retention, and the good integrating with the surrounding environment. Methods: This study was conducted to determine the surface roughness of the nanofill composite with the nanohybrid composite polished by the aluminum oxide pastes and diamond polishing paste. This study was a pure experimental-in vitro study. The results of polishing on the resin composite surfaces was observed using the optical microscope at 500x magnification and given the score. The Krusskal-Wallis test was conducted to depict the data analysis. Result: The results showed that the resin composite group of the nanohybrid polished by both aluminum oxide and diamond particle had smoother surface than the resin composite of the nanofill. Conclusion: The conclusions of this study depicted that there were differences of polishing results using the aluminium oxide and diamond particle paste between the nanofill and nanohybrid resin composite surface roughness

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

Teeth re-whitening effect of strawberry juice on coffee stained teeth

Many people favor coffee. However, regarding health and aesthetic dentistry, coffee gives a negative effect. Tanin in coffee causes a brown stain on the tooth surface. Therefore, in aesthetic dental care, teeth whitening has become popular matter. One of the natural ingredients used for teeth whitening treatment is strawberry. The purpose of this study was to obtained data regarding the effect of strawberry juice on the re-whitening process of the coffee-stained tooth enamel surface. This study was a pure experimental in-vitro using Friedman and Wilcoxon Matched Pairs Tests for statistical analysis. The population of this study was anterior teeth. The samples were maxillary central incisors. The sampling technique using sample size determination based on the testing formulas of the difference of two average data pairs resulted in 11 specimens. The result of the research showed that all coffee-stained teeth sample had an increasing enamel colour index. The samples were then applied with strawberry juice resulted in a significant average difference colour index value indicated by p<0.001. The conclusion of this research indicated that there was an effect of strawberry juice on the coffee-stained teeth re-whitening process

Surface roughness comparison of methacrylate and silorane-based composite resins after 40% hydrogen peroxide application

The change of the tooth colour could be restored with bleaching. The tooth bleaching will affects the surface roughness of the composite resins. Recently, the material basis for composite resins has developed, among others are methacrylate-based and silorane based composite resins. The objective of this study was to distinguish the surface roughness value of methacrylate-based composite resin and silorane based composite resins. This research was quasi-experimental. The sample used in this study were methacrylate and silorane based composite resins in discs form, with the size of 6 mm and the thickness of 3 mm, manufactured into 20 specimens and divided into 2 groups. The control group was immersed in the artificial saliva, and the treatment group was applied with 40% hydrogen peroxide. The result of the experiment analyzed using unpaired sample t-test showed significant differences in the average value of the surface roughness after the application of 40% hydrogen peroxide. The average value of methacrylate and silorane based composite resins were 2.744 μm and 3.417 μm, respectively. There was a difference in the surface roughness of methacrylate and silorane based composite resin compounds after the application of 40% hydrogen peroxide. The surface roughness value of the silorane-based composite resin was higher than the methacrylate-based

Direct composite restoration of permanent anterior teeth uncomplicated crown fractures

An uncomplicated crown fracture is a fracture that involves only the tooth enamel or the dentin and tooth enamel without any damage or exposure to the pulp. Crown fracture of the anterior teeth usually caused by traumatic forces such as falls, accidents, violence, or sports activities. Traumatic injuries of the oral region frequently involve the anterior teeth, especially maxillary incisors due to the anatomic factors which may affect the functional and aesthetical values of the teeth. The objective of this literature study was to know more about uncomplicated crown fracture of the anterior teeth and its restoration. This research was a literature study performed by researching, highlighting various interesting facts and compiling the relevant published journals. The most common and ideal direct restoration of the anterior teeth was the composite resin restoration. The anterior teeth restoration was considered to be a complex and challenging case to solves due to the fact that besides reconstructing the tooth and regaining the function, the aesthetical aspect was also becoming the main objectives. The permanent anterior teeth uncomplicated crown fracture was the most common case of tooth fractures which was mainly caused by traumatic injuries such as falls, accidents, excessive forces, violence, and also sports activities. Dental injuries of the anterior teeth also affected the aesthetical properties and the function of the tooth. Composite resin restoration was able to performed directly on the permanent anterior teeth uncomplicated crown fracture