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Single visit root canal treatment of a third lower molar with curved canal and Class II disto-occlusal caries: Case report Tsanie, Maria Latifa; Junaidi, Achmad; Kristanti, Yulita; Nugraheni, Tunjung; Untara, Tri Endra; Santosa, Pribadi; Enggardipta, Raras Ajeng
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 37, No 1 (2025): April 2025
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v37i1.58361

ABSTRACTIntroduction: Root canal treatment (RCT) of mandibular third molars is often considered challenging due to anatomical variability, limited accessibility, and difficulty achieving proper isolation. As a result, extraction is frequently chosen. This case report outlines a successful single-visit RCT on a right mandibular third molar with a curved canal and Class II disto-occlusal caries. Case Report: A 30-year-old female presented with a large cavity on her right lower molar and requested a restorative treatment. Three weeks earlier, devitalization and temporary restoration had been performed by another dentist. Clinical examination revealed no periapical lesion, and percussion testing was negative. Radiographic analysis showed a slight curvature in the distal canal. A pre-curved K-File and the One Curve System were used for instrumentation. The canal was obturated in a single visit, followed by restoration using direct composite and short fiber-reinforced composite. Matrix and PTFE tape were utilized for proper adaptation in the distal area. Conclusion: With accurate diagnosis, understanding of anatomical complexity, and appropriate technique, single-visit RCT on mandibular third molars is achievable. This case supports the viability of conservative treatment for necrotic third molars with asymptomatic apical periodontitis, avoiding unnecessary extraction.Keywords single visit, root canal treatment, third lower molar, curved canal, composite restoration. ABSTRAKPendahuluan: Perawatan saluran akar (RCT) pada molar ketiga mandibula menantang karena variasi konfigurasi saluran, kesulitan akses ke area posterior, dan tantangan dalam isolasi. Akibatnya, pencabutan sering menjadi pilihan. Laporan kasus ini mendeskripsikan protokol RCT kunjungan tunggal pada molar ketiga kanan mandibula dengan saluran melengkung dan karies disto-oklusal kelas II. Laporan Kasus: Seorang wanita 30 tahun datang dengan kavitas besar pada molar ketiga kanan bawah dan menginginkan perawatan tanpa pencabutan. Tiga minggu sebelumnya, dokter lain telah melakukan devitalisasi dan restorasi sementara. Pemeriksaan klinis menunjukkan tidak ada lesi periapikal dan uji perkusi negatif. Radiograf menunjukkan kelengkungan ringan pada saluran distal. RCT dilakukan menggunakan K-file pra-lengkung dengan sistem One Curve. Obturasi dilakukan dalam satu kunjungan, diikuti restorasi komposit langsung yang diperkuat dengan komposit serat pendek. Area distal direstorasi menggunakan matriks dan pita PTFE. Simpulan: RCT kunjungan tunggal pada molar ketiga mandibula dengan pulpa nekrotik dan periodontitis apikal asimptomatik dapat berhasil dilakukan dengan diagnosis akurat dan teknik yang tepat. Pendekatan konservatif ini menunjukkan bahwa pencabutan bukan satu-satunya pilihan.Kata kunci sekali kunjungan, perawatan saluran akar, molar ketiga, saluran melengkung, restorasi komposit.

Diversity and habitat preference of orchirds in R. Soerjo Forest Park, East Java, Indonesia Rohmah, Laila Ainur; Elyasa, Ayu Tya; Nugraheni, Tunjung; Pratama, Bella Pratiwi Kurnia; Sakna, Bariznaba’us
Genbinesia Journal of Biology Vol. 3 No. 1 (2023): November 2023
Publisher : Generasi Biologi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55655/genbinesia.v3i1.50

The diversity and habitat preferences of orchids in the natural tourist attraction area of R. Soerjo Forest Park (TAHURA) are not yet completely known. Lack of information and the activities of tourist visitors increase the risk of natural orchid habitat degradation. The aim of this research is to determine the diversity and habitat preferences of orchids in R. Soerjo Forest Park. The research design used a line transect method for orchid diversity data and a purposive sampling method with a plot measuring 10 × 10m for habitat preference analysis or environmental data. The research results show that there are 37 species of orchids in the natural tourist attraction area of R. Soerjo Forest Park, which is divided into 25 epiphytic orchids and 12 terrestrial orchids. The results of the Shannon-Wienner analysis show that the orchid diversity index value is 2.46, which is show a medium level of diversity. Dominant orchids grow at an altitude of 1,400–1,600 m.a.s.l. The most dominant orchid species are Nervilia punctata (558), Appendicula angustifolia (296), and A. elegans (130), with an evenness value of 0,32, 0,17, and 0,07. The dominance of N. punctata is influenced by the root shape, which is modified as a tuberous type. The results of redundancy analysis (RDA) show that the environmental variables that most influence the distribution of orchids are air temperature, soil pH levels, light intensity, and elevation.

Endodontic Care for Patients with Polycythemia: Clinical Considerations and Case Analysis Nugroho, Dian Lestari Putri; Nugraheni, Tunjung; Imandini, Aldila; Rinastiti, Margareta
Majalah Kedokteran Gigi Indonesia Vol 10, No 3 (2024): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.91425

Polycythemia is a myeloproliferative neoplasm characterized by uncontrolled proliferation of red blood cells due to mutations in early hematopoietic cells, often linked to Janus kinase 2 (JAK2) gene mutations. Polycythemia vera (PV), the primary form of the disease, leads to increased blood viscosity and stasis, raising the risk of thrombotic events such as stroke and myocardial infarction. Secondary polycythemia results from hypoxic conditions, stimulating erythropoietin production. Diagnosis is confirmed through hemoglobin and hematocrit levels, with treatment aimed at reducing thrombosis and hemorrhage risks. Low-risk patients are treated with aspirin and phlebotomy, while high-risk cases may require cytoreductive therapies like hydroxyurea.In our case, a patient presented with necrosis and horizontal bone loss in tooth 36, complicated by polycythemia. Due to the increased risk of bleeding and inflammation, the decision was made to prioritize endodontic treatment, avoiding periodontal surgery. The patient, considered low-risk for PV complications due to the absence of thrombosis history, was managed conservatively. Preoperative coordination with hematologists was essential to optimize hematologic parameters and minimize potential risks.The goal of endodontic treatment was to disinfect and seal the root canal, reducing inflammation in the surrounding periodontal tissues and preventing reinfection. This approach allowed for effective management of the patient's oral condition while minimizing systemic risks. This case highlights the importance of a multidisciplinary approach in managing dental treatment for patients with polycythemia, ensuring both local and systemic complications are effectively addressed.

Effect of 35% sodium ascorbate combined with 0.4% surfactant on resin tag length in composite restorations following intracoronal bleaching Arlini, Rakhmalita; Nugraheni, Tunjung; Mulyawati, Ema
Majalah Kedokteran Gigi Indonesia Vol 11, No 1 (2025): April
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.94170

The application of 35% hydrogen peroxide in intracoronal bleaching generates free radicals that shorten resin tags and weaken the bond strength of composite resin restorations. Although 35% sodium ascorbate can neutralize free radical residues, its molecular instability limits its effectiveness. The addition of surfactants may enhance both the penetration ability and stability of sodium ascorbate. This study aimed to investigate the effect of adding 0.4% surfactant to 35% sodium ascorbate on the length of resin tags in composite resin restorations following intracoronal bleaching. Thirty mandibular premolars were prepared with standardized Class I cavities measuring 2.7 mm in diameter and 6 mm in depth. A 35% hydrogen peroxide gel was applied to the cavities for five consecutive days. After bleaching, the samples were randomly assigned to three groups of ten teeth each. The first group was stored in an incubator for seven days before undergoing composite resin restoration. The second group received an application of 35% sodium ascorbate, which was then rinsed off before immediate composite restoration. The third group received an application of 35% sodium ascorbate combined with 0.4% surfactant, followed by rinsing and immediate composite restoration. Histological preparations were made using hematoxylin-eosin staining and observed under a light microscope at 400× magnification. Resin tag lengths were measured using the Image Raster application. The one-way ANOVA test revealed a statistically significant difference among the groups (p = 0.000). Post-hoc LSD analysis showed that resin tag lengths in the third group were significantly greater than those in both the first and second groups (p = 0.000 for both comparisons). These results indicate that the combination of 35% sodium ascorbate with 0.4% surfactant significantly increases resin tag length and may enhance the bonding performance of composite restorations following intracoronal bleaching.

The effect of sodium ascorbate application and intracoronal bleaching on the shear bond strength of composite resin Wijaya, Rama Insan Kusuma; Nugraheni, Tunjung; Untara, Tri Endra
Majalah Kedokteran Gigi Indonesia Vol 11, No 3 (2025): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.107996

An increase in the frequency of 35% hydrogen peroxide (HP) application during intracoronal bleaching leads to a higher accumulation of free radical residues, which can negatively affect the bonding of composite resin. The removal of these free radicals can be facilitated by the application of 35% sodium ascorbate (SA) combined with 0.4% surfactant. An additional frequency of SA application is required to counteract the increased free radical residues. This study aimed to evaluate the effect of the frequency of 35% SA combined with 0.4% surfactant and different intracoronal bleaching frequencies on the shear bond strength of composite resin. Forty-eight premolar teeth were divided into two main groups of 24 specimens each. Group I received two applications of 0.01 mL HP 35%, while Group II received three applications. After each bleaching session, the specimens were stored in a closed tube for five days per session, then washed and dried. Each group was further divided into three subgroups. Subgroup A was left untreated for seven days; Subgroup B received two applications of 35% sodium ascorbate combined with 0.4% surfactant; and Subgroup C received three applications. All specimens were restored with composite resin and immersed in pH 7 artificial saliva in an incubator for seven days. Shear bond strength was tested using a Universal Testing Machine at a crosshead speed of 0.5 mm/min. Two-way ANOVA revealed a significant effect of sodium ascorbate application frequency and different intracoronal bleaching frequencies on composite resin shear bond strength (p < 0.01). The results indicate that the shear bond strength of composite resin subjected to three applications of 35% sodium ascorbate combined with 0.4% surfactant is statistically comparable to those obtained with two applications of the same formulation.

The effect of sodium ascorbate application and intracoronal bleaching on the shear bond strength of composite resin Wijaya, Rama Insan Kusuma; Nugraheni, Tunjung; Untara, Tri Endra
Majalah Kedokteran Gigi Indonesia Vol 11, No 3 (2025): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.107996

An increase in the frequency of 35% hydrogen peroxide (HP) application during intracoronal bleaching leads to a higher accumulation of free radical residues, which can negatively affect the bonding of composite resin. The removal of these free radicals can be facilitated by the application of 35% sodium ascorbate (SA) combined with 0.4% surfactant. An additional frequency of SA application is required to counteract the increased free radical residues. This study aimed to evaluate the effect of the frequency of 35% SA combined with 0.4% surfactant and different intracoronal bleaching frequencies on the shear bond strength of composite resin. Forty-eight premolar teeth were divided into two main groups of 24 specimens each. Group I received two applications of 0.01 mL HP 35%, while Group II received three applications. After each bleaching session, the specimens were stored in a closed tube for five days per session, then washed and dried. Each group was further divided into three subgroups. Subgroup A was left untreated for seven days; Subgroup B received two applications of 35% sodium ascorbate combined with 0.4% surfactant; and Subgroup C received three applications. All specimens were restored with composite resin and immersed in pH 7 artificial saliva in an incubator for seven days. Shear bond strength was tested using a Universal Testing Machine at a crosshead speed of 0.5 mm/min. Two-way ANOVA revealed a significant effect of sodium ascorbate application frequency and different intracoronal bleaching frequencies on composite resin shear bond strength (p < 0.01). The results indicate that the shear bond strength of composite resin subjected to three applications of 35% sodium ascorbate combined with 0.4% surfactant is statistically comparable to those obtained with two applications of the same formulation.

Hemisection of the upper right first molar with a grade-2 furcation lesion: case report Ristyawati, Agatha; Chrysandra, Yustika; Untara, Tri Endra; Nugraheni, Tunjung; Enggardipta, Raras Ajeng
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 37, No 3 (2025): Desember 2025
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v37i3.58368

Introduction: Hemisection is the separation procedure of multiple root teeth from the crown to the furcation and removing one damaged root with periodontium abnormalities, followed by a fixed denture treatment for retaining partially damaged posterior teeth. This case report aims to demonstrate the clinical management of a maxillary first molar with grade-2 furcation involvement using a multidisciplinary approach consisting of endodontic treatment, surgical hemisection, and prosthodontic rehabilitation, and to highlight hemisection as a conservative tooth-preserving treatment option compared with extraction and implant therapy. Case report: A female patient, 56 years old, visited the Dental Conservation Clinic of Prof. Soedomo RSGM with discomfort in the right upper molars when chewing. Based on the dental and radiograph examination, the diagnosis was pulp necrosis with asymptomatic apical periodontitis. Beginning with root canal treatment, the damaged mesial root of tooth 16 was hemisected; triangular flap was prepared in the buccal region of the maxillary right first molar; the tooth was divided mesial-distally; mesial root was removed; socket was debrided; the flap was sutured with interrupted technique and the surgical wound was closed. A modified ridge lap pontics denture design was discussed with the Prosthodontia specialist. Conclusion: A root canal-treated abutment tooth followed by hemisection was confirmed to be a better treatment choice in this case over extraction, with the goal of retaining the tooth with the damaged root in the mouth and restoring dental function.Hemiseksi gigi molar pertama kanan atas dengan lesi furkasi derajat-2: laporan kasusPendahuluan: Hemiseksi adalah prosedur pemisahan beberapa akar gigi dari mahkota sampai ke furkasi dan pencabutan satu akar yang rusak dengan kelainan periodontal, dilanjutkan dengan perawatan fixed bridge untuk mempertahankan gigi. Laporan kasus ini bertujuan untuk menunjukkan pengelolaan klinis gigi molar pertama rahang atas dengan keterlibatan furkasi derajat 2 menggunakan pendekatan multidisiplin yang meliputi perawatan endodontik, hemiseksion bedah, dan rehabilitasi prostodontik, serta menyoroti hemiseksion sebagai opsi perawatan konservatif yang mempertahankan gigi dibandingkan dengan ekstraksi dan terapi implan. Laporan kasus: Seorang pasien wanita, 56 tahun, datang ke Klinik Konservasi Gigi RSGM Prof. Soedomo dengan keluhan rasa tidak nyaman pada gigi geraham kanan atas saat mengunyah. Diagnosis berdasarkan pemeriksaan gigi dan radiografi adalah nekrosis pulpa dengan periodontitis apikal asimptomatik. Dilakukan perawatan saluran akar, hemiseksi akar mesial gigi 16 yang mengalami kerusakan dilakukan pada kunjungan berikutnya, insisi dengan triangular flap dilakukan pada daerah bukal gigi molar pertama kanan atas, gigi diseparasi mesial dan distal, akar mesial diekstraksi, debridemen soket mesial, flap dijahit dengan teknik interrupted. Desain fixed bridge berupa modified ridge lap pontics yang telah didiskusikan dengan spesialis Prostodonsia. Kesimpulan: Perawatan saluran akar gigi penyangga yang diikuti dengan hemiseksi dipastikan menjadi pilihan perawatan yang lebih baik dalam kasus ini daripada pencabutan gigi dengan tujuan mempertahankan gigi dengan salah satu akar yang rusak di dalam mulut dan mengembalikan fungsi gigi.

The effect of sodium ascorbate 35% combination of surfactant 0,4% application frequency and different intracoronal bleaching on composite resin microleakage: an experimental study Elitasari, Denti; Nugraheni, Tunjung; Untara, Tri Endra
Jurnal Kedokteran Gigi Universitas Padjadjaran Vol 38, No 1 (2026): April 2026
Publisher : Fakultas Kedokteran Gigi Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkg.v28i1.61901

Introduction: Bleaching with hydrogen peroxide produces free radicals in dentin which can interfere with the penetration of adhesive materials and the polymerization process of composite resin, thereby increasing the occurrence of microleakage. In cases of severe discoloration, bleaching can be repeated more than once to maximize the color change. Repeated bleaching will increase free radical residues, so more antioxidants are needed. The purpose of this study was to examine the effect of the frequency of application of sodium ascorbate 35% combined with surfactant 0,4% at different intra coronal bleaching frequencies on microleakage of composite resin. Methods: The research sample consisted of 30 premolars prepared with class I cavities with a diameter of 3 mm and a depth of 6 mm. The samples were divided into 2 groups, group I was bleached twice while group II was bleached three times, after bleaching each group was divided into 3 subgroups, group A was incubated for 7 days then filled with composite resin, group B was applied with sodium ascorbate 35% combined with surfactant 0,4% twice then filled with composite resin, group C was applied with sodium ascorbate 35% combined with surfactant 0,4% three times then filled with composite resin. All samples were observed for microleakage using a scanning electron microscope (SEM). Results: The results of the two-way ANOVA test showed that there was a significant effect of the frequency of sodium ascorbate application and the frequency of bleaching on microleakage with a value of p=0.001 (p<0.05) and there was an interaction between the frequency of sodium ascorbate 35% combined with 0,4% surfactant application and the frequency of bleaching on microleakage of composite resin. Conclusion: The frequency of application of sodium ascorbate 35% combined with surfactant 0,4% and different intracoronal bleaching has an effect on the level of composite resin microleakage.Efek frekuensi aplikasi sodium askorbat 35% kombinasi surfaktan 0,4% dan bleaching intrakoronal yang berbeda terhadap kebocoran mikro resin komposit: studi eksperimenPendahuluan: Bleaching dengan hidrogen peroksida menghasilkan radikal bebas pada dentin yang dapat mengganggu penetrasi bahan adhesif dan proses polimerisasi resin komposit sehingga meningkatkan terjadinya kebocoran mikro. Pada kasus perubahan warna yang berat, bleaching dapat diulang sebanyak lebih dari satu kali untuk memaksimalkan perubahan warna. Bleaching yang dilakukan secara berulang akan meningkatkan residu radikal bebas, sehingga dibutuhkan antioksidan yang lebih banyak. Tujuan penelitian ini untuk menguji pengaruh frekuensi aplikasi sodium askorbat 35% kombinasi surfaktan 0,4% pada frekuensi bleaching intrakoronal yang berbeda terhadap kebocoran mikro resin komposit. Metode: Sampel penelitian berupa 30 premolar yang di preparasi kavitas kelas I dengan diameter 3 mm kedalaman 6 mm. Sampel dibagi menjadi 2 kelompok, kelompok I dilakukan bleaching dua kali sedangkan kelompok II dilakukan bleaching tiga kali, pasca dilakukan bleaching, masing-masing kelompok dibagi menjadi 3 sub kelompok yaitu kelompok A di inkubasi selama 7 hari kemudian di tumpat resin komposit, kelompok B diaplikasi sodium askorbat 35% kombinasi surfaktan 0,4% dua kali kemudian di tumpat resin komposit, kelompok C diaplikasi sodium askorbat 35% kombinasi surfaktan 0,4% tiga kali kemudian di tumpat resin komposit. Seluruh sampel dilakukan pengamatan kebocoran mikro dengan menggunakan scanning electron microscope (SEM). Hasil: Hasil uji ANAVA dua jalur menunjukkan bahwa terdapat pengaruh yang signifikan frekuensi aplikasi sodium askorbat dan frekuensi bleaching terhadap kebocoran mikro dengan nilai p=0,001 (p<0,05) dan terdapat interaksi antara frekuensi aplikasi sodium askorbat 35% kombinasi surfaktan 0,4% dan frekuensi bleaching terhadap kebocoran mikro resin komposit. Simpulan: Frekuensi aplikasi sodium askorbat 35% kombinasi surfaktan 0,4% dan bleaching intrakoronal yang berbeda berpengaruh terhadap tingkat kebocoran mikro resin komposit.

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