Perawatan Multidisiplin Pasca Endodontik dengan Surgical Crown Lengthening, dan Estetik Rehabilitasi: Laporan Kasus
DOI:
https://doi.org/10.35790/eg.v15i1.66937Keywords:
trauma gigi; nekrosis pulpa; gingival enlargement; mahkota jaket PFM; inklinasi mahkotaAbstract
Abstract: Untreated crown fractures can lead to pulp necrosis, periapical lesions, gingival enlargement caused by chronic inflammation due to pulp necrosis, and changes in tooth position and occlusal relationship. This case report aimed to describe the multidisciplinary management of a post-endodontic case with gingival enlargement. We reported a 26-year-old male patient presented with complaints of maxillary anterior tooth fractures due to trauma experienced 15 years ago. Clinical and radiographic examinations revealed crown fractures in teeth 21 and 22 accompanied by pulp necrosis, gingival enlargement, periapical lesions, and edge-to-edge occlusal relationship. Management was carried out in stages including root canal treatment, fiber post placement, crown lengthening surgery to improve the condition of the periodontal tissue, and esthetic rehabilitation using porcelain-fused-to-metal (PFM) jacket crowns with crown inclination correction. In conclusion, the multidisciplinary management shows that periodontal tissue, relationships, and occlusion improved, resulting in improved function and aesthetics and providing good long-term result.
Keywords: dental trauma; pulp necrosis; gingival enlargement; PFM jacket crown; crown inclination
Abstrak: Fraktur mahkota yang tidak segera ditangani dapat menimbulkan nekrosisi pulpa, lesi periapikal, gingival enlargement yang disebabkan karena inflamasi kronis akibat nekrosis pulpa, serta perubahan posisi dan relasi oklusi gigi. Laporan kasus ini bertujuan untuk memaparkan penatalaksanaan multidisiplin pada kasus pasca endodontik disertai gingival enlargement. Kami melaporkan seorang pasien laki-laki berusia 26 tahun datang dengan keluhan fraktur gigi anterior maksila akibat trauma yang dialami 15 tahun lalu. Pemeriksaan klinis dan radiografis menunjukkan terdapat fraktur mahkota pada gigi 21 dan 22 disertai dengan nekrosis pulpa, gingival enlargement, lesi periapikal, serta relasi oklusal edge-to-edge. Penatalaksanaan dilakukan secara bertahap meliputi perawatan saluran akar, pemasangan pasak fiber, tindakan surgical crown lengthening untuk memperbaiki kondisi jaringan periodontal, serta rehabilitasi estetik menggunakan mahkota jaket porcelain fused to metal (PFM) dengan koreksi inklinasi mahkota. Simpulan kasus ini ialah perawatan multidisiplin menunjukkan terjadinya perbaikan jaringan periodontal, relasi, dan oklusi gigi yang lebih baik sehingga terjadi peningkatan fungsi dan estetika dan memberikan hasil jangka panjang yang baik.
Kata kunci: trauma gigi; nekrosis pulpa; gingival enlargement; mahkota jaket PFM; inklinasi mahkota
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