Diatri Nari Ratih
Departemen Ilmu Konservasi Gigi, Fakultas Kedokteran Gigi, Universitas Gadjah Mada, Yogyakarta, Indonesia

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Prevalence and characteristics of aggressive periodontitis Nariratih, Diatri; Rusjanti, Janti; Susanto, Agus
Padjadjaran Journal of Dentistry Vol 23, No 2 (2011): July
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (295.048 KB) | DOI: 10.24198/pjd.vol23no2.14020

Abstract

Aggressive Periodontitis is one of periodontal disease that generally affects individuals less than 30 years old, with a rapid attachment loss and alveolar bone destruction. Special features of the disease are affected incisors and first molars with symmetrical bilateral destruction. The purpose of this study was to determine the prevalence and characteristics of Aggressive Periodontitis at Student Clinics, Faculty of Dentistry Padjadjaran University on May to July 2010. Based on accidentally sampling, 415 new patients at Dental and Oral Hospital, Faculty of Dentistry Padjadjaran University and Dental and Oral Polyclinic at RSUP dr. Hasan Sadikin Bandung participated in this study. Each subject filled out the questionnaire and did a clinical examination. Patients with attachment loss ≥ 4 mm were referred for radiographic and microbiologic examination to support the diagnosis. The results showed that there were 13 patients who have the diagnostic criteria of Aggressive Periodontitis. Nine patients were diagnosed as Localized Aggressive Periodontitis, and 4 patients as Generalized Aggressive Periodontitis. It is concluded that the prevalence of Aggressive Periodontitis was 3.13%, and indicated low prevalence. Characteristics of Localized Aggressive Periodontitis patients were female in 20-29 age range, whereas characteristics of Generalized Aggressive Periodontitis patients were male in 30-39 age range.
Acidic Environment Effect on the Push-out Bond Strength of Mineral Trioxide Aggregate Mixed with Different Liquids Ratih, Diatri Nari; Putri, Asri Riany
Journal of Dentistry Indonesia Vol. 22, No. 1
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Mineral trioxide aggregate (MTA) as retrograde filling is always in contact to inflamed tissues in periradicular area. Objective: To investigate the effect of acidic environment on push-out bond strength of MTA mixed with sterile water, local anesthetic, and 5% CaCl2. Methods: Thirty middle third of mandibular premolar roots were randomly assigned into 3 groups of 10 each. MTA mixed with sterile water (Group 1), local anesthetic (group 2), 5% CaCl2 (group 3). Each group was then divided into group A: soaked in synthetic tissue fluid with pH 5, and group B: pH 7.4. Specimens were stored in an incubator with a temperature of 370C for 72 hours, undertaken a push-out test, and observed under a stereo-microscope. Results: A two-way ANOVA showed that acidic environment reduced the push-out bond strength of MTA mixed with either sterile water, local anesthetic or 5% CaCl2 (p <0.05). The predominantly failure was a mixture of adhesive and cohesive type. Conclusion: The acidic environment reduced the push-out bond strength of MTA mixed with either sterile water, local anesthetic or 5% CaCl2. MTA mixed with 5% CaCl2 produced the greatest push-out bond strength, whereas MTA mixed with local anesthetic had the lowest push-out bond strength.
APIKOEKTOMI GIGI INSISIVUS KANAN DISERTAI KISTA RADIKULER: LAPORAN KASUS Agustin, Yuniari; Arifati, Azizah; Indrapradana, Adyaputra; Hadriyanto, Wignyo; Ratih, Diatri Nari
E-Prodenta Journal of Dentistry Vol 5, No 2 (2021)
Publisher : Fakultas Kedokteran Gigi UB

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.eprodenta.2021.005.02.9

Abstract

LATAR BELAKANG: Proses inflamasi periapikal yang berlanjut dapat merangsang sisa epitel malassez di ligamentum periodontal. Granuloma dapat terbentuk sebagai pertahanan pertama terhadap nekrosis pulpa yang selanjutnya dapat menjadi abses periapikal. Kista radikuler dapat terjadi jika kondisi sebelumnya tidak segera ditangani. TUJUAN: Studi kasus ini bertujuan untuk mengevaluasi apikoektomi yang diikuti dengan enukleasi kista radikuler. KASUS: Seorang pria berusia 24 tahun datang dengan rujukan ke Klinik Bagian Konservasi Gigi Universitas Gadjah Mada untuk memeriksakan giginya dan melanjutkan perawatan saluran akar gigi. Keluhan utama adalah perubahan warna gigi dan seringkali muncul benjolan besar pada gusi gigi dengan riwayat trauma (kecelakaan) kurang lebih 12 tahun yang lalu yang tidak segera dilakukan untuk diperiksa dan dirawat. MANAJEMEN: Enukleasi kista yang terlihat pada foto rontgen dan CBCT dilakukan setelah perawatan saluran akar selesai. Kapsul dan kuretase jaringan granulasi kista dikirim ke bagian patologi anatomi. Apikoektomi dilakukan sekitar 3 mm dari apeks dilanjutkan dengan preparasi kavitas, pengisian retrograde menggunakan mineral trioxide aggregate dan aplikasi bone graft. Evaluasi dilakukan satu minggu pasca operasi dan dilanjutkan pembuatan restorasi akhir berupa pasak dowel dan mahkota zirkonia. KESIMPULAN: Apikoektomi diikuti dengan enukleasi kista radikuler yang dilakukan setelah perawatan saluran akar menunjukkan keberhasilan dalam proses penyembuhan yang ditandai dengan pengurangan lesi periapikal pada foto rontgen.
Influence of Exposing Root Canal Dentin to Calcium Hydroxide on Its Flexural Strength Diatri Nari Ratih
The Indonesian Journal of Dental Research Vol 1, No 3 (2011)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (381.514 KB) | DOI: 10.22146/theindjdentres.10063

Abstract

Calcium hydroxide has been used extensively in endodontic treatments, for instance as an intra-canal dressing; however, the exposure of root canal dentin to calcium hydroxide may affect its flexural strength and could have important clinical implications for endodontic treatment. The purpose of this in vitro study was to investigate the influence of calcium hydroxide on the flexural strength of root canal dentin.Seventy-two extracted single-rooted human mandibular premolars were used in this study. Each tooth was instrumented using crown-down technique and was irrigated using sterile saline. The teeth were assigned into three groups of 24 each. The prepared root canal system of each tooth was filled with calcium hydroxide mixed with sterile saline (group 1), a calcium hydroxide commercially available product (UltraCal®) (group 2) or saline solution (group 3, as control). The apices and access opening were sealed using composite resin, and the teeth were immersed in artificial saliva. After 7, 14 and 30 days of immersion, the inner root canal dentin of 8 teeth respectively from each group were sectioned to create dentin bars (1 X 1 mm, with 7 mm in length). Each dentin bar then was subjected to a three-point bending flexural test using MTS (Universal Testing Machine). Data gathered were then analyzed using two-way ANOVA, followed by Tukey’s test with the level of significance of 95%. The results showed that exposure to calcium hydroxide either using calcium hydroxide mixed with sterile saline or UltraCal® for 14 and 30 days can reduce flexural strength of root canal dentin compared to control group (p<0.05). In contrast, after 7 days exposure, there was no significantly different of flexural strength between three groups (p>0.05).   It can be concluded that calcium hydroxide reduced the flexural strength of root canal dentin. The longer the exposure to calcium hydroxide would produce a greater effect on flexural strength of root canal dentin.   
Mahkota Porselin Fusi Metal dengan Parallel Self-Threading Dowel Pasca Perawatan Saluran Akar Gigi Premolar Maksila Asri Riany Putri; Diatri Nari Ratih
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 1, No 1 (2015)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.453 KB) | DOI: 10.22146/mkgk.11921

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Gigi premolar maksila merupakan gigi yang mendapat tekanan pengunyahan besar dan rentan mengalami fraktur terutama setelah dilakukan perawatan saluran akar (PSA). Gigi yang telah dilakukan PSA akan menjadi sangat rapuh dan rentan fraktur karena telah kehilangan kelembaban dan banyak jaringan kerasnya. Gigi premolar juga mendapat tekanan pengunyahan yang besar karena bentuk dan letaknya yang lebih dekat dengan aksis horizontal transversal. Penggunaan parallel self-threading dowel dan mahkota penuh porselen fusi metal akan mendistribusikan beban pengunyahan keseluruh bagian akar dan meningkatkan ketahanannya terhadap fraktur. Tujuan laporan kasus ini adalah untuk menunjukkan keberhasilan penggunaan parallel self-threading dowel dengan mahkota penuh porselen fusi metal sebagai restorasi pasca PSA pada gigi premolar kedua maksila nekrosis pulpa dengan lesi periapikal. Pasien wanita berusia 30 tahun dirujuk untuk PSA pada gigi premolar kedua kanan maksila nekrosis pulpa dengan lesi periapikal. Pasien merasakan sakit saat gigi digunakan untuk makan. Perkusi dan palpasi positif namun mobilitas normal. Pemeriksaan radiografik menunjukkan gambaran radiopak yang telah mengenai ruang pulpa dan radiolusensi pada periapikal gigi. PSA dan restorasi mahkota penuh dilakukan dengan parallel self-threading dowel. Parallel self-threading dowel dan mahkota penuh PFM sebagai restorasi akhir menunjukkan keberhasilan perawatan pada gigi premolar kedua maksila pasca PSA. ABSTRACT: Porcelain Fused to Metal Crown with Parallel Self-Threading Dowel Post Root Canal Treatment On Maxillary Premolar. Maxillary premolar teeth have great chewing forces and prone to fracture, especially after root canal treatment (RCT). Teeth that have RCT done will be very brittle and fracture prone because it has lost moisture and lost most of its hard tissue. Premolars also receive great chewing forces because its shape and location are closer to the horizontal transverse axis. The use of parallel self-threading dowel and full porcelain fused to metal crowns will distribute the load of mastication throughout the roots and improve resistance to fracture. The aim of this case report was to demonstrate the success of the use of parallel self-threading dowel with full porcelain fused to metal crown restoration aftera RCT on maxillary second premolar with pulp necrosis and periapical lesion. A 30-year-old female patient was referred for RCT on the maxillary right second premolar with pulp necrosis and periapical lesion. Patient felt pain when the tooth was used to eat. There was tenderness to percussion and palpation but the mobility was normal. A radiographic examination showed radiopaque image that entered pulp chamber and periapical radiolucency on tooth. RCT and full crown restoration with parallel self-threading dowel had been performed. Parallel self-threading dowel and full porcelain fused to metal crown as the final restoration after RCT on the maxillary second premolar showed a successful treatment outcome.
Restorasi direk resin komposit preparasi onlei pada gigi pasca perawatan saluran akar Sylvia Widhihapsari; Diatri Nari Ratih
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 2, No 3 (2016)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.1 KB) | DOI: 10.22146/mkgk.32013

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Gigi pasca perawatan saluran akar lebih rapuh daripada gigi vital karena  kehilangan integritas struktur gigi akibat dari preparasi akses atau karies. Hal ini menjadi pertimbangan utama untuk menentukan kualitas restorasi pada gigi pasca perawatan saluran akar. Direk restorasi komposit merupakan salah satu desain alternatif restorasi yang dapat dilakukan pada gigi pasca perawatan saluran akar. Keuntungan dari restorasi ini, mempertahankan sisa struktur gigi yang ada dan tampilan estetik baik. Laporan kasus ini bertujuan menginformasikan restorasi direk resin komposit teknik preparasi onlei dengan parallel  self threading dowel dan penguat  fiber pada molar pertama kiri mandibula pasca perawatan saluran akar. Seorang pasien perempuan berusia 20 tahun datang ke RSGM dengan keluhan ingin menambalkan gigi geraham besar bawah kiri. Pasien pernah merasakan sakit spontan beberapa kali kurang lebih 6 bulan yang lalu dan sekarang tidak pernah merasa sakit lagi. Pada gambaran radiograf terdapat radiolusen pada oklusal hingga pulpa dan radiolusen pada furkasi. Dari pemeriksaan klinis diperoleh diagnosa karies profunda dengan nekrosis pulpa disertai lesi furkasi. Perawatan  gigi tersebut adalah perawatan saluran akar teknik preparasi crown down, dilanjutkan preparasi onlei dan pemasangan pasak parallel self threading pada akar distal disertai penguat fiber di sepertiga oklusal kemudian direstorasi dengan resin komposit secara direk. Kesimpulan  gigi pasca perawatan saluran akar dapat direstorasi menggunakan resin komposit secara direk dengan hasil yang baik.ABSTRACT: Direct resin composite onlay preparation on endodontically treated teeth. The tooth after root canal treatment is more fragile than vital teeth due to loss of structural integrity of the tooth as a result of the preparation of access or caries. This is a major consideration for determining the quality of the restoration on the tooth after root canal treatment. Direct composite restorations is one of the alternative designs to do the restoration after root canal treatment. Advantages of this restoration is remind the existing tooth structure and good aesthetic appearance. This case report aims to inform the direct composite resin restorations onlay  preparation techniques with parallel self-threading dowel and reinforcing fiber on the left mandibular first molar after root canal treatment. A 20-year-old female patient came to the hospital and complaints her left  mandibular  molar. Pain spontaneously several times about 6 months ago and now never feel pain again. On radiographs are radiolucent on occlusal to the pulp and radiolucent on furcation. Clinical examination diagnoses obtained from deep caries with pulp necrosis accompanied furcation lesions. The dental care is the treatment of root canal preparation techniques crown down, followed onlay preparation and installation of self-threading parallel pegs on the distal root with fiber amplifier in a third occlusal then restored with direct composite resin. Conclusion tooth after root canal treatment can be restored with direct composite resin with good results.
One visit root canal treatment using rotary instrument followed by semi-direct technique composite restoration Lika Yodasari; Diatri Nari Ratih
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 3, No 2 (2017)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/mkgk.54468

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One visit root canal treatment is non-surgical conservative treatment of irreversible pulp disease or pulp necrosis. Treatment includes cleaning and shaping, sterilization, and obturation of root canal performed in one visit. The aim of this case report is to evaluate the success of one visit root canal treatment using rotary instrument followed by semi-direct composite restoration. A 23 year-old patient presented into dental hospital Faculty of Dentistry UGM to obtain treatment of leaking composite filling on his mandibular right molar that previously had been treated 1 year ago. The tooth was asymptomatic. Radiograph showed a cavity reaches the pulp and there was no periapical lesions, clinical examination showed necrosis. Patient was treated with one visit root canal treatment using rotary instrument followed by semi-direct technique of composite restoration. Five months after treatment the patient had no complaints. Radiographic examination showed no periapical lesions. One visit root canal treatment using rotary instrument followed by semiindirect technique composite restoration may be an effective treatment option when performed with case selection, proper diagnosis, aseptic work, as well as the appropriate operator’s knowledge and skills
Pasak customized fiber dengan mahkota jaket komposit pada gigi fraktur Ellis kelas III Dyah Tri Kusumawati; Diatri Nari Ratih
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 5, No 2 (2019)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/mkgk.65720

Abstract

Gigi fraktur Ellis kelas III merupakan kasus fraktur mahkota dengan terbukanya pulpa. Fraktur mahkota yang luas dengan pulpa terbuka mengakibatkan terjadinya nekrosis pulpa sehingga memerlukan perawatan saluran akar. Laporan kasus ini bertujuan untuk mengevaluasi perawatan gigi fraktur Ellis kelas III dengan perawatan saluran akar dan restorasi pasak customized fiber reinforced composite (FRC) disertai mahkota jaket resin komposit. Pasien wanita, 17 tahun datang ke Klinik Konservasi FKG UGM untuk merawat gigi depan kanan atas yang patah 3 tahun lalu. Diagnosis gigi 11 Fraktur Ellis kelas III dengan nekrosis pulpa disertai lesi periapikal. Pasien dirawat dengan perawatan saluran akar multi kunjungan (meliputi pembersihan dan pembentukan, sterilisasi serta pengisian saluran akar), kemudian gigi direstorasi dengan restorasi pasak customized FRC disertai mahkota jaket resin komposit. Kesimpulan dari hasil evaluasi klinis dan radiografis saat kontrol tidak ada keluhan dan pasien merasa puas.
Root Canal Retreatment Followed By Root-End Resection and Direct Veneer Restoration Using Resin Composite of Maxillary Right Central Incisor Diatri Nari Ratih
Majalah Kedokteran Gigi Indonesia Vol 19, No 1 (2012): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (944.265 KB) | DOI: 10.22146/majkedgiind.15679

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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.
Pemasangan Implan Endodontik sebagai Stabilisator Pasca Apikoektomi Gigi Premolar Dua Kanan Bawah Andreas Edwin; Wignyo Hadriyanto; Diatri Nari Ratih
Majalah Kedokteran Gigi Indonesia Vol 17, No 1 (2010): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2169.178 KB) | DOI: 10.22146/majkedgiind.15980

Abstract

Latar Belakang: Gigi yang tidak didukung akar yang cukup panjang akan kesulitan menahan beban kunyah dan akan terjadi kegoyahan. Implan endodontik dapat digunakan sebagai alternatif stabilisator pada gigi dengan panjang akar yang tidak memadai. Tujuan: untuk memberikan informasi mengenai perawatan gigi premolar kedua bawah kanan yang mengalami perforasi eksternal dan harus menjalani perawatan apikoektomi dengan menggunakan MOl sebagai stabilisator endodontik. Kasus: seorang wanita, 23 tahun, datang dalam keadaan gigi sakit sebelah belakang kanan bawah. Beberapa tahun yang lalu pasien menjalani operasi pengambilan gigi supernumerary pada area tersebut. Beberapa bulan setelah operasi pasien mengeluhkan adanya rasa nyeri. Gambaran radiograf tampak ada area radiolusen bagian mesial gigi 46 dan di bagian distal gigi 45. Hal ini diperkirakan karena tindakan iatrogenik operasi pengambilan gigi supernumerary. Gigi 45 dirawat dengan prosedur apikoektomi dilanjutkan dengan bedah pemasangan implan endodontik sebagai stabilisator. Manajemen kasus: dilakukan bedah apikoektomi, bersamaan dengan bedah apikoektomi dilakukan pemasangan implan endodontik. Material implan yang digunakan adalah Mini Oental lmplant berukuran 1,8 mm panjang 15 mm. Bagian akar yang berbatasan dengan implan ditutup dengan MTA sebagai penutup tepi. Kesimpulan: pemasangan implan endodontik pada gigi 45 telah di evaluasi selama 45 hari sejak prosedur bedah dilakukan menunjukkan pasien tidak mengalami keluhan dan secara klinis tidak ada kelainan pada gigi 45 tersebut. Gigi siap direstorasi dengan mahkota jembatan porselen fusi metal.