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Replacement of Two Failed Indirect Restorations with Direct Bonded Restorations Using Minimally Invasive Strategy Kusumasari, Citra; Hatayama, Takashi; Shimada, Yasushi
Journal of Dentistry Indonesia Vol. 28, No. 3
Publisher : UI Scholars Hub

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Deciding on what treatment (repair or replacement) to provide for a failed indirect restoration can be challenging. Notably, the strength of the residual tooth structure could be improved after replacing the failed indirect restoration using a minimally invasive strategy. Objective: To describe the use of a minimally invasive strategy for the successful clinical replacement of two failed indirect metal restorations with direct composite restorations and the attainment of bonded restoration. Case Report: Case 1. A 52-year-old male patient came to the dental hospital complaining of discomfort when drinking cold beverages and food impaction on the proximal area of the upper left first molar. Case 2. A 45-year-old female patient complained about her debonded metal onlay and secondary caries in the upper right second molar. Both of these indirect restoration failures were treated with direct resin composite restoration. Both patients were highly satisfied with the results. Conclusion: This report presents the benefits of adopting a minimally invasive strategy approach for replacing failed indirect restorations (inlays and onlays) with direct-bonded composite restorations. Minimally invasive direct restorations are designed to maximize the preservation of tooth structure, thereby ensuring a long-term bonded restoration and leaving future options open when a failure occurs.

Uncut Enamel for Optimizing Bonded Composite Restoration on Multiple Diastema Closure Cases Kusumasari, Citra; Hayashi, Meiken; Shimada, Yasushi
Journal of Dentistry Indonesia Vol. 29, No. 2
Publisher : UI Scholars Hub

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The main advantage of using a minimal invasive strategy concept by uncut enamel technique while doing direct composite restoration is to create a color and translucency close to the natural teeth with long-term bonding durability. Objective: This case report presents an uncut enamel technique for multiple diastema closure cases using direct composite restoration. Case Reports: an 18-year-old male and a 50-year-old female patient complained of diastema in their upper front teeth and requested aesthetic correction. Digital mock-up was made prior to the uncut enamel technique for showing the expected results to the patient and as a guidance for the clinician. Uncut enamel preparation was continued by free-hand restoration technique with a two-step self-etch adhesive system and composite resin application to correct the diastema. The teeth in the first and second cases were followed up after three months and four years, respectively. Conclusion: The uncut enamel preparation, free-hand restoration technique with two-step self-etch adhesive, and digital mock-up are viable options in the multiple diastema closure to re-create natural teeth and optimize bonding durability

Resin-Build-Up as A Direct Monoblock Concept for Root Canal Dentin, Core, and Crown Restoration on Anterior Endodontically Treated Tooth Kusumasari, Citra; Hatayama, Takashi; Tagami, Junji; Shimada, Yasushi, Prof.
Journal of Dentistry Indonesia Vol. 31, No. 2
Publisher : UI Scholars Hub

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The long-term clinical performance of restoration in endodontically treated teeth (ETT) is an essential yet complicated strategy to achieve it. A resin-build-up tooth with higher elastic moduli is a minimally invasive strategy to decrease the risk of catastrophic root fracture. Additionally, intracanal resin composite anchorage simplifies the restorative procedure and increases the bonding. Objective: This case report describes a resin-build-up tooth restoration using the direct monoblock concept to replace a failed metal post and core and porcelain fused to metal (PFM) crown on the maxillary right central incisor. Case report: A 50-year-old man attended a dental university hospital with a chief complaint about the repeated detachment of the old resin-veneered crown along with the metal post on his maxillary right central incisor. He has been using that aged restoration for five years. The measurement of crown preparation in thickness was 2 mm, core length was 9 mm, post length was 7 mm, remaining gutta-percha was 5 mm, and the length from the end of gutta-percha to the apex was 1 mm. A Direct monoblock restoration using flowable and packable resin composite with universal adhesive was chosen to save time and to achieve long-term bonded restoration. Conclusion: Endodontically treated teeth on the maxillary incisor were successfully restored using the resin-build-up direct monoblock concept. The adhesive intracanal resin composite anchorage to a depth of 7 mm using a flowable resin composite replaced the post for ETT with favorable results. Moreover, the four-year follow-up of the clinical examination and evaluation showed good results.

Effect of polishing paste on color stability of nanohybrid and spherical filler composite after immersion in black tea: a laboratory experiment Yasminadani, Widharaniputri; Meidyawati, Ratna; Kusumasari, Citra
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 36, No 3 (2024): Desember 2024
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v36i3.57127

Introduction: The characteristics of the composite filler directly affect the surface roughness and susceptibility to extrinsic staining. An esthetic composite restoration depends on the color stability, that can be attributed to the low surface roughness. Therefore, it is crucial to apply appropriate polishing procedures. This study aim to analyze the effect of polishing paste on color stability of nanohybrid and spherical filler composite after immersion in black tea: a laboratory experiment. Method: Forty-two cylinder-shaped with a diameter of 6mm and a thickness of 2mm were prepared from nanohybrid (Filtek Z250XT) and spherical filler composite resin (Palfique Omnichroma), then divided into four sub-groups subjected to different polishing treatments and two control sub-groups without polishing. The groups were as follows: nanohybrid without polishing (N-K), spherical filler without polishing (SF-K), nanohybrid polished with discs (N-Pd), spherical filler polished with discs (SF-Pd), nanohybrid polished with discs followed by paste (N-PdP), and spherical filler polished with discs followed by paste (SF-PdP). Specimens were immersed in black tea for 7 days. The initial and final color were measured using a colorimeter. Data were analyzed using One-Way ANOVA and Tamhane's Post Hoc test. Results: Immersion in black tea solution resulted in clinically unacceptable color changes, except for the N-PdP group. The N-K group exhibited the highest ∆E* value, while the N-PdP group showed the smallest ∆E* value. Conclusion: The use of polishing paste reduced color changes in composite resin due to black tea. Nanohybrid composite resin polished with a disc followed by paste demonstrates better resistance to color changes.Pengaruh pasta poles terhadap stabilitas warna komposit dengan filler nanohybrid dan spherical setelah perendaman di dalam teh hitam: eksperimental laboratorisPendahuluan: Karakteristik filler resin komposit secara langsung mempengaruhi kekasaran permukaan dan kerentanan terhadap pewarnaan ekstrinsik. Restorasi resin komposit yang estetik bergantung pada stabilitas warna, yang berkaitan dengan kehalusan permukaan. Oleh karena itu, penerapan pemolesan yang tepat sangatlah penting dalam restorasi resin komposit. Penelitian ini bertujuan untuk menentukan pengaruh pasta poles terhadap stabilitas warna komposit nanohybrid dan spherical setelah perendaman dalam teh hitam. Metode: Empat puluh dua spesimen berbentuk silinder dengan diameter 6mm dan tebal 2mm dipersiapkan dari resin komposit nanohybrid (Filtek Z250XT) dan spherical filler (Palfique Omnichroma) kemudian dibagi ke dalam 4 subkelompok yang diberikan perlakuan pemolesan berbeda dan 2 sub kelompok kontrol tanpa pemolesan. Kelompok tersebut adalah: nanohybrid tanpa pemolesan (N-K), spherical filler tanpa pemolesan (SF-K), nanohybrid dipoles dengan disc (N-Pd), spherical filler dipoles dengan disc (SF-Pd), nanohybrid dipoles dengan disc diikuti pasta (N-PdP), dan spherical filler dipoles dengan disc diikuti pasta (SF-PdP). Spesimen direndam dalam teh hitam selama 7 hari. Warna awal dan akhir diukur menggunakan colorimeter. Data dianalisis menggunakan uji One-Way ANOVA dan Post Hoc Tamhane. Hasil: Perendaman dalam teh hitam menghasilkan perubahan warna yang tidak dapat diterima secara klinis, kecuali pada kelompok N-PdP. Kelompok N-K menunjukkan nilai ∆E* terbesar, sementara kelompok N-PdP menunjukkan nilai ∆E* terkecil. Simpulan: Penggunaan pasta poles mengurangi perubahan warna resin komposit akibat teh hitam. Resin komposit nanohybrid yang dipoles menggunakan disc diikuti pasta menunjukkan ketahanan yang lebih baik terhadap perubahan warna.

Survey of Adhesive Systems Knowledge Among Conservative Dentistry Specialist Dentist in Indonesia Kusumasari, Citra; Aprillia, Iffi; Wijayanti, Wiku Melisa; Abdou, Ahmed
Journal of Indonesian Dental Association Vol 6 No 2 (2023): October
Publisher : Indonesian Dental Association

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Introduction: Knowledge of adhesive systems is an essential item in creating a successful tooth restoration. Adhesive systems are common among dentists in Indonesia, but no research has been found that evaluates the knowledge of the members of Indonesian Conservative Dentistry Association (IKORGI) - Central Jakarta Branch. Objectives: to determine dentists’ understanding regarding the use of adhesive systems during restorative procedures. Methods: This research used a descriptive study with a cross-sectional questionnaire design. One hundred and five dentist specialists in IKORGI - Central Jakarta Branch, completed an online survey form within two months comprising three sections: (a) demographics (6 items), (b) knowledge about the latest technology of adhesive systems (5 items), and (c) clinical implications of adhesive systems (10 items). Data was collected and analyzed using Microsoft excel and IBM SPSS. Results: The primary data was dominated by the female with the range of 0 to 5 years of experience since graduated from conservative dentistry program. They understood the adhesive system quite well, as seen from the maximum score of the respondents was 4.25. Among participants, 63.8% to 99% showed a strong knowledge about the adhesion terminology and type of adhesives. Conclusions: The understanding of adhesive systems knowledge among dentist specialists in IKORGI - Central Jakarta Branch is good, although there are some significant differences between the research variables. Further research is required to cover all areas of Indonesia with or without specialty in conservative dentistry.

Bioceramic cement as a reparative material in apexification of immature permanent tooth: a case report Hillary, Natasya; Kusumasari, Citra; Abdou, Ahmed
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 36, No 4 (2024): Januari 2024 (Suplemen 4)
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v36i4.49880

ABSTRACTIntroduction: Bioceramic cement is the latest material of choice that can be used in apexification, resorption case, perforation repair, and known as high-quality sealing material in regenerative endodontics. The treatment of apexification in immature teeth poses a considerable challenge due to the wide root canal, the absence of apical constriction, and thin dentin walls, thus requiring specialized techniques and materials for managing teeth with an open apex. The objective of this case report is to delineate the treatment of apexification in teeth with open apices using the latest bioceramic material (Bio-C® Repair). Case report: An 11-year-old female patient with chief complaints of swollen gums covering the cervical third of the crown after her front tooth was broken due to a fall two years ago. Radiographic examination showed a wide root canal with an open apex and radiolucency in the apical area. The apexification procedure with an apical plug was performed with Bio-C® Repair, followed by anatomical fiber post and direct composite restoration for the final restoration. In the 2-month and 4-month control, the periapical lesion showed signs of healing on radiographs. Bioceramic materials act as an artificial barrier in open apex management and provide various advantages, such as shortening treatment time, strengthening dentin structure, and possessing bioactive properties that can induce healing. The orthograde placement of bioceramic material is challenging in terms of length control. Using bioactive materials can reduce the risk of adverse impacts from material extrusion. Conclusion: A new bioceramic material (Bio-C® Repair) is recommended for the apexification procedure because it can overcome the limitations of MTA (e.g., tooth discoloration, handling difficulties, prolonged setting time, and the release of heavy metals.Keyword open apices, immature permanent tooth, apexification, bioceramic, apical barrier techniqueSemen biokeramik sebagai material apeksifikasi gigi permanen imatur: laporan kasusABSTRAKPendahuluan: Material biokeramik merupakan material pilihan yang digunakan untuk menangani prosedur apeksifikasi, resorpsi, perforasi, dan sebagai material regeneratif endodontik. Perawatan apeksifikasi pada gigi yang belum matang menimbulkan tantangan besar karena saluran akar yang lebar, tidak adanya konstriksi apikal, dan dinding dentin yang tipis, sehingga memerlukan teknik dan material khusus untuk merawat gigi dengan apeks terbuka. Tujuan laporan kasus ini adalah untuk menjelaskan perawatan apeksifikasi pada gigi dengan apeks terbuka menggunakan material biokeramik terbaru (Bio-C® Repair). Laporan kasus: Pasien perempuan 11 tahun datang dengan keluhan pembengkakan pada gusi yang menutupi sepertiga servikal mahkota gigi, setelah gigi tersebut patah karena terjatuh dua tahun yang lalu. Pemeriksaan radiografis menunjukkan saluran akar yang lebar dengan apeks terbuka serta radiolusensi pada area apikal. Prosedur apeksifikasi dilakukan dengan pembuatan penutupan apikal (apical plug) menggunakan material biokeramik Bio-C® Repair, yang diikuti pemasangan pasak fiber anatomis dan tumpatan resin komposit sebagai restorasi akhirnya. Pada kontrol 4 bulan, lesi periapikal menunjukkan tanda kesembuhan secara radiograf. Material biokeramik berperan sebagai penutupan apikal artifisial pada manajemen apeks terbuka dan memberikan berbagai keuntungan seperti mempersingkat waktu perawatan, menguatkan struktur dentin, dan memiliki sifat bioaktif sehingga dapat menginduksi penyembuhan. Penempatan material biokeramik pada ujung apeks secara orthograde merupakan prosedur yang cukup sulit terutama saat mengontrol panjang kerja. Penggunaan material bioaktif dapat menurunkan risiko dampak negatif dari ekstrusi material. Simpulan: Material biokeramik baru seperti Bio-C® Repair menjadi rekomendasi untuk tatalaksana prosedur apeksifikasi karena dapat mengatasi berbagai keterbatasan MTA seperti diskolorasi gigi, kesulitan handling, waktu pengerasan yang lama, dan pelepasan kandungan metal berat yang toksik.Kata Kunciapeks terbuka, gigi permanen imatur, apeksifikasi, biokeramik, teknik penutupan apikal

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