scholarly journals Root Canal Retreatment menggunakan Kombinasi Kalsium Hidroksida dan Chlorhexidine sebagai Medikamen Intra Kanal Insisivus Sentral Kiri Maksila

2014 ◽  
Vol 21 (2) ◽  
pp. 165
Author(s):  
Andina Novita Sari ◽  
Tri Endro Untara

Enterococcus faecalis adalah bakteri yang paling banyak terdapat pada infeksi saluran akar yang telah dirawat endodontik. Chlorhexidine mempunyai daya anti bakteri spektrum luas dan telah digunakan dalam endodontik sebagai bahan irigasi maupun medikasi intrakanal. Chlorhexidine mempunyai efek bakterisidal dan fungisidal karena chlorhexidine diserap ke dalam permukaan sel bakteri dan menyebabkan rusaknya integritas sel membran. Kalsium hidroksida digunakan karena mempunyai keuntungan seperti biokompatibel, bahan antimikroba dengan efek pH yang tinggi dan stimulasi jaringan keras. Campuran kalsium hidroksida dan chlorhexidine digunakan untuk alternatif melawan bakteri Enterococcus faecalis. Tujuan dari laporan kasus ini adalah untuk melaporkan kesuksesan perawatan saluran akar ulang pada gigi incisivus sentral kiri maksila dengan periodontitis periapikal akut menggunakan kombinasi kalsium hidroksida dan chlorhexidine sebagai medikamen intrakanal. Seorang pasien wanita 24 tahun datang dengan keluhan gigi insisivus sentral kiri atas yang terasa sakit sejak 4 tahun yang lalu. Gigi terasa sakit saat diperkusi, namun palpasi dan mobilitas normal. Gigi tersebut mengalami trauma dan patah 6 tahun yang lalu dan telah dilakukan perawatan endodontik. Pemeriksaan radiografi menunjukkan obturasi gigi 21 yang tidak hermetis dengan radiolusensi di periapikal dengan batas difus, pelebaran ligamen periodontal dan terputusnya lamina dura. Perawatan berupa perawatan saluran akar ulang menggunakan kombinasi kalsium hidroksida dan chlorhexidine sebagai medikamen intrakanal. Root canalretreatment dengan cleaning dan shaping ulang yang baik dengan menggunakan medikasi intrakanal berupa kombinasi kalsium hidroksida dan chlorhexidine 2% diharapkan mempunyai efek antimikroba yang sinergis untuk mencapai kesuksesan root canal retreatment. Root Canal Retreatment Using Calcium Hydroxide as Intra Canal Medicament On The Maxillary Left Incisor. Enterococcus faecalis bacteria is most abundant in the root canal infection treated endodontically. Chlorhexidine has a broad antibacterial spectrum and has been used as an endodontic irrigant and intracanal medication. Chlorhexidine has a bactericidal and fungicidal effect as chlorhexidine absorbed into the bacterial cell surface and cause damage to the integrity of the cell membrane. Calcium hydroxide is a biocompatible, antimicrobial agents with high pH effects and stimulates hard tissue formation. A mixture of calcium hydroxide and chlorhexidine is used to control bacteria Enterococcus faecalis alternative. The purpose of this case report is to report on the success of root canal treatment in the left maxillary central incisor with acute periapical periodontitis using a combination of calcium hydroxide and chlorhexidine as intracanal A 24 years old female patient presents with left upper central incisor tooth ache since 4 years ago. The tooth was hurt to percussion, but normal to pulpation as well as the mobility. The tooth has a history of previous trauma and broken 6 years ago and has performed endodontic treatment. Radiographic examination showed obturation teeth 21 are not hermetic with periapical radiolucency in diffuse boundaries, widening of the periodontal ligament and the dissolution of the lamina dura. Root canal re-treatment using a combination of calcium hydroxide and chlorhexidine as intracanal medicaments were performed. In conclussion, the root canal cleaning and shaping retreatment can be performed using a combination of calcium hydroxide and chlorhexidine as intracanal medication.

2016 ◽  
Vol 1 (1) ◽  
pp. 71
Author(s):  
Sania Dara Afiati ◽  
Pribadi Santosa

Masalah estetik dapat diatasi dengan pendekatan restorasi, ortodontik maupun kombinasi keduanya. Perawatan restorasi dapat dilakukan jika pasien menolak untuk dilakukan perawatan ortodontik. Perawatan restorasi mencakup pembuatan ilusi perubahan arah gigi tanpa merubah lokasi akar gigi. Kecelakaan iatrogenik yang disebabkan oleh hilangnya panjang kerja dapat menyebabkan perforasi apikal. Salah satu manajemen perawatan perforasi apikal adalah dengan Ca(OH)2. Tujuan dari artikel ini adalah menginformasikan keberhasilan perawatan restorasi untuk perbaikan estetik serta keberhasilan perawatan perforasi apikal menggunakan Ca(OH)2. Laki – laki berusia 20 tahun datang dengan fraktur gigi insisivus akibat kecelakaan 7 tahun yang lalu. Gigi insisivus maksila pertama kanannya telah dilakukan perawatan saluran akar dan direstorasi dengan resin komposit. 6 tahun kemudian, pasien merasakan sakit pada giginya, perkusi dan palpasi positif serta ditemukan mobilitas. Pasien juga merasakan gigi depannya berubah warna dan berjejal. Pada pemeriksaan radiografis ditemukan material obturasi yang overfilling disertai pelebaran ligamen periodontal. Perawatan perforasi apikal untuk gigi insisivus maksila pertama kanan dilakukan menggunakan Ca(OH)2, dilakukan juga perawatan saluran akar pada gigi insisivus maksila pertama kiri. Berjejalnya gigi depan diperbaiki dengan restorasi menggunakan resin komposit direk dengan penguat pasak fiber. Masalah estetik gigi depan dapat diperbaiki menggunakan pendekatan restoratif, serta perawatan saluran akar dengan perforasi apikal dapat dilakukan dengan menggunakan Ca(OH)2. ABSTRACT: Aesthetically Compromized Maxillary Central Incisor with Apical Perforation. Aesthetical problem may be corrected restoratively, orthodontically or with combination of both approaches. Restorative treatment could be done for a patient due to several reasons; one of them is when patients refuse orthodontic treatment. Restorative alternatives create the illusion of movement without altering the location of the tooth root. Iatrogenic accident as a result of the loss of working length could lead to apical perforation. One of the management for apical perforation is Ca(OH)2. The aim of this case report is to present the success of repairing aesthetically compromised tooth with fiber reinforced composite and root canal retreatment with apical perforation using Ca(OH)2 as a repair and sealing material. A 20 year old male patient had a fractured incisor following a traumatic incident 7 years previously. The maxillary right central incisor was endodontically treated and restored with composite resin. 6 years later, the patient felt pain in his two central incisor teeth and tenderness to percussion; palpation was positive and mobility was detected. The patient also felt discoloration and misalignment of his central incisor. The radiographic examination reveals an overfilling of obturation material with enlargement of periodontal ligament. A root canal retreatment for maxillary right central incisor with apical perforation using Ca(OH)2 as repair and seal material and root canal treatment for maxillary left central incisor was conducted. The aesthetically compromised maxillary central tooth was corrected restoratively using fiber reinforced composite. The aesthetically compromised central tooth was proven to be successfully corrected using fiber reinforced composite and the apical perforation successfully sealed using Ca(OH)2.


2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Shivani Utneja ◽  
Gaurav Garg ◽  
Shipra Arora ◽  
Sangeeta Talwar

Inflammatory external root resorption is one of the major complications after traumatic dental injury. In this case report, we describe treatment of a maxillary central incisor affected by severe, perforating external root resorption. An 18-year-old patient presented with a previously traumatized, root-filled maxillary central incisor associated with pain and sinus tract. Radiographic examination revealed periradicular lesion involving pathologic resorption of the apical region of the root and lateral root surface both mesially and distally. After removal of the root canal filling, the tooth was disinfected with intracanal triple antibiotic paste for 2 weeks. The antibiotic dressing was then removed, and the entire root canal was filled with mineral trioxide aggregate. The endodontic access cavity was restored with composite resin. After 18 months, significant osseous healing of the periradicular region and lateral periodontium had occurred with arrest of external root resorption, and no clinical symptoms were apparent.


2021 ◽  
Vol 14 (8) ◽  
pp. e241872
Author(s):  
Amandeep Kaur ◽  
Vijay Kumar ◽  
Ajay Logani

Avulsion injuries are usually seen in the anterior maxillary teeth as a result of trauma. Avulsion as an endodontic mishap is extremely rare. This report highlights an unusual instance of exarticulation of a recently traumatised maxillary central incisor tooth when the rubber dam was applied during a routine non-surgical endodontic procedure. The tooth was immediately repositioned and stabilised with wire composite splint. Endodontic treatment was initiated after rubber dam isolation with a modified technique. Calcium hydroxide was used as intracanal medicament dressing, and obturation was done after 2 weeks. The treatment was successful with uneventful periodontal healing at 24-month follow-up. The presence of well-demarcated periodontal ligament space and absence of any resorptive area on the radiograph could be defined as a successful outcome for the present case.


2012 ◽  
Vol 19 (1) ◽  
pp. 53
Author(s):  
Diatri Nari Ratih

Latar Belakang: Kegagalan perawatan saluran akar dapat menyebabkan nyeri yang persisten dan perubahan warna pada gigi, oleh karena itu dianjurkan untuk dilakukan perawatan ulang saluran akar, didikuti dengan bedah endodontik dan dilakukan restorasi yang estetis sehingga hasil perawatan dapat optimal. Tujuan penulisan artikel ini adalah untuk melaporkan kasus perawatan ulang saluran akar yang diikuti dengan reseksi apeks dan restorasi veneer direk dengan resin komposit padai insisivus sentralis kanan maksila. Kasus dan penanganannya: seorang pasien laki-laki berumur 17 tahun datang dengan keluhan rasa sakit yang terus-menerus dan perubahan warna pada giginya pada gigi insisivus sentral kanan maksila. Pemeriksaan klinis menunjukkan warn agigi kecoklatan, ada kerusakan pada email dengan garis putih pada permukaan labial, dan sebagian restorasi resin komposit telah hilang. Pada pemeriksaan perkusi gigi terasa sakit, pada pemeriksaan palpasi gigi tidak sakit dan tidak ada mobilitas. Pemeriksaan radiografis memperlihatkan bahwa obturasi saluran akar tidak hermetis dan terlihat adanya area radiolusen yang jelas di sekitar apeks akar. Perawatan yang dilakukan pada pasien tesebut adalah perawatan ulang saluran akar, kemudian diikuti reseksi apeks, dan restorasi secara veneer direk dengan resin komposit. Evaluasi hasil perawatan menunjukkan bahwa pasien tidak merasakan sakit lagi, tidak ada lesi periapikal, dan pasien puas dengan restorasi veneer direk. Kesimpulan: Dapat disimpulkan bahwa apabila perawatan ulang saluran akar tidak berhasil, bedah endodontik adalah pilihan perawatan yang tepat untuk mendapatkan penyembuhan lesi pariapikal yang optimal dan restorasi estetik merupakan pilihan sehingga keberhasilan jangka panjang dapat dicapai. Background: The failure of root canal treatment can cause persistent pain and discolored tooth. Therefore it is recommended to conduct root canal retreatment followed by endodontic surgery and to esthetically restore tooth in order to accomplish satisfactory clinical outcome. The purpose of this case report is to describe the root canal retreatment followed by root-and resection and direct veneer restoration with resin composite of maxillary right central incisor. Case and Treatment: A 17 year-old male patient was referred for endodontic treatment of his maxillary right central incisor. In the clinical examination, it was observed that the color of tooth was brownish, a defect of enamel with white line on the labial aspect, and a partial detach of resin composite restoration. The tooth was tenderness to percussion, but palpation and mobility were whitin normal limits. Radiographic examination revealed a lack of hermetic obturation and an apparent radiolucency around the root apex. Root canal retreatment followed by root-and resection was performed. Afterwards, direct veneering with resin composite was carried out to permanently restore the tooth. Recall evalution was showed that the patient was asymptomatic, periapical lesion disappeared and patient was satisfactory with the restoration. Conclusion: It can be concluded that when root canal retreatment is unsuccessful, endodontic surgery is an important treatment option to improve periapical healing and increase the long term success. The choice of aesthetic permanent restoration is also crucial consideration to overcome the unaesthetic problems, hence the optimal treatment outcome can be achieved.


2016 ◽  
Vol 04 (03) ◽  
pp. 156-164
Author(s):  
Deepak Bansal ◽  
Shruti Sharma ◽  
Manjit Kumar ◽  
Amrit Khosla

AbstractAn altered facial appearance is more difficult to face, than problems related to ill-fitting denture or eating. The selection of maxillary anterior teeth for complete denture has long posed problem in clinical practice and a controversy about the best method to employ still exists. An attempt is made in the present study to clinically correlate the face form with maxillary central incisor tooth form in males and females of Davangere population. In 1914, Leon William's projected the “the form method” where he classified facial forms as square, tapering, and ovoid. Maxillary central incisors were selected according to the facial forms.Of total 100 subjects four different tooth forms and face forms were evaluated. They are: square, ovoid, square-tapered, tapered. No significant correlation existed between face form in male and females. Females exhibited greater correlation between face forms and inverted tooth form but that correlation is not sufficient to serve as a guide for selection of anterior teeth.


2016 ◽  
Vol 10 (1) ◽  
pp. 733-738 ◽  
Author(s):  
Leopoldo Cosme-Silva ◽  
Breno Carnevalli ◽  
Vivien Thiemy Sakai ◽  
Naiana Viana Viola ◽  
Leon Franco de Carvalho ◽  
...  

Background: Iatrogenic complications such as accidental perforation of the root or the floor of the pulp chamber may occur. Case Report: Patient was referred for root canal retreatment of the mandibular left second molar with periapical lesion evidenced through radiographic examination. During post removal, iatrogenic perforation occurred at the mesial face of the distal root. After clinical localization of the perforation and bleeding control, MTA was applied. In a second appointment, the root canal filling was removed and the chemical-surgical retreatment of the canals was performed, followed by the obturation with gutta-percha and sealer. Patient returned after three days reporting no pain. After 6 months, 3, 7 and 10 years of follow-up. Conclusion: Absence of pain, normal periodontal probing and lack of radiolucent area at the region of perforation and the periapices were detected, which evidenced the successful repair of the tooth.


2007 ◽  
Vol 21 (4) ◽  
pp. 308-313 ◽  
Author(s):  
Eduardo Diogo Gurgel-Filho ◽  
Nilton Vivacqua-Gomes ◽  
Brenda Paula Figueiredo de Almeida Gomes ◽  
Caio Cezar Randi Ferraz ◽  
Alexandre Augusto Zaia ◽  
...  

The purpose was to assess the elimination of Enterococcus faecalis in vitro in human mandibular premolars after chemomechanical preparation with or without the use of a calcium hydroxide dressing. After 60 days of contamination with E. faecalis, the root canals were prepared using the Crown-Down technique combined with 2% chlorhexidine gel irrigation. Then, the specimens were divided into two experimental groups, treated in a single visit or in multiple visits, and two control groups. The multiple-visit group received a dressing with calcium hydroxide for 14 days (CalenTM) and the single-visit group did not receive any medication. In the two control groups, the canals were filled with BHI after chemomechanical preparation with 2% chlorhexidine gel or distilled water. Microbial samples were taken from the root canals for colony forming unit count for each phase of the treatment using sterile paper points inside the root canal lumen. Data were ranked and analyzed by the Kruskal-Wallis statistical test. The residual microbial colonies were then assessed. The results showed that chemomechanical preparation using 2% chlorhexidine gel with no intra-canal dressing reduced by 100% the E. faecalis contamination of the root canal lumen. The calcium-hydroxide group that received the 14-day intra-canal dressing allowed a small number of bacteria to grow between visits, but without statistical differences between groups.


2017 ◽  
Vol 21 (1) ◽  
pp. 12-18 ◽  
Author(s):  
Athina Dalopoulou ◽  
Nikolaos Economides ◽  
Vasilis Evangelidis

Summary Background: Extrusion of root canal sealers may cause damage to the surrounding anatomic structures. Clinical symptoms like pain, swelling and paresthesia or anesthesia may be present. The purpose of this presentation is to describe two cases of root canal sealer penetration into periapical tissues. A different treatment management was followed in each case. Case reports: A 55 year-old man underwent root canal retreatment of the right mandibular first molar tooth due to a periapical lesion. Postoperative periapical radiographs revealed the presence of root canal sealer (AH26) beyond the apex in the distal root in proximity to the mandibular canal. The patient reported pain for the next 7 days. Radiographic examination after 1 year showed complete healing of the periapical area and a small absorption of the root canal sealer. A 42 year-old woman was referred complained of swelling and pain in the area of the right maxillary first incisor. Radiographic examination showed extrusion of root canal sealer in the periapical area associated with a periapical lesion. Surgical intervention was decided upon, which included removal of the sealer, apicoectomy of the tooth and retrograde filling with MTA. After 1 year, complete healing of the area was observed. Conclusion: In conclusion, cases of root canal sealer extrusion, surgical treatment should be decided on only in association with clinical symptoms or with radiographic evidence of increasing periapical lesion.


2013 ◽  
Vol 14 (2) ◽  
pp. 345-347 ◽  
Author(s):  
Hamid Jafarzadeh ◽  
Amir Maghsoudlou ◽  
Maryam Forghani

ABSTRACT Aim This clinical report presents a rare case of maxillary central incisor with two separate roots. Background Unusual morphology of the roots and root canals may exist in any tooth. Recognition of the dental anatomy and its variations is necessary for successful endodontic therapy. It is well known that maxillary incisors are usually single-rooted teeth. Case report The root canals were instrumented with conventional hand files and Gates Glidden and obturated by using the lateral technique. Recall radiograph after 1 year shows the healing process of the preoperative apical periodontitis. Conclusion and clinical significance Clinicians should be aware of unexpected root canal morphology when performing root canal therapy. The present case demonstrated the importance of accurate preoperative radiograph and adequate access preparation. How to cite this article Maghsoudlou A, Jafarzadeh H, Forghani M. Endodontic Treatment of a Maxillary Central Incisor with Two Roots. J Contemp Dent Pract 2013;14(2):345-347.


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