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Apeksifikasi pada Gigi Insisivus Kanan Maksila dengan Mineral Trioxide Aggregate Widiadnyani, Ni Kadek Eka; Mulyawati, Ema
Majalah Kedokteran Gigi Indonesia Vol 20, No 2 (2013)
Publisher : Majalah Kedokteran Gigi Indonesia

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Trauma pada gigi permanen imatur non vital dengan apikal terbuka sering terjadi dan melibatkan kurang lebih 30% populasi anak. Mineral trioxide aggregate (MTA) adalah bahan pilihan terbaik yang dipakai sebagai bahan apeksifikasi untuk pembentukan apikal barrier dan penyembuhan pada gigi imatur. Tujuan laporan kasus adalah untuk melaporkan keberhasilan penutupan apikal dengan menggunakan MTA pada gigi permanen insisivus non vital dengan apikal terbuka yang diakibatkan trauma. Pasien perempuan 18 tahun dengan keluhan gigi depan atas kanan patah dan berubah warna. Kejadian trauma sejak 6 tahun yang lalu karena jatuh dari sepeda. Pemeriksaan klinis, gigi non vital dengan fraktur Ellis klas IV disertai apikal terbuka dan diskolorasi oleh karena trauma. Periapikal radiografis menunjukkan apikal masih terbuka dengan saluran akar yang besar serta terdapat radiolusensi periapikal. Apeksifikasi dilakukan dengan MTA dilanjutkandengan Â pemasangan pasak pita fiber, pembuatan inti dan restorasi mahkota jaket porselin fusi metal. Simpulan hasil perawatan menunjukkan bahwa apeksifikasi dengan MTA dapat mempersingkat waktu kunjungan dengan pembentukan barier apikal yang merangsang penyembuhan dan dapat langsung dilanjutkan dengan restorasi akhir.ABSTRACT: Apexification With Mineral Trioxide Aggregate In Right Maxillary Incisor. Traumatic injury in non-vital immature permanent teeth with open apex is common, and it comprises approximately 30% of the pediatric population. Mineral trioxide aggregate (MTA) is the best material to be used as an ingredient for apexification procedure for apical calcific barrier formation and healing. The aim of the present case study is to overview the successful closure of root apex in pulpless permanent incisors with wide open apices as a consequence of trauma using MTA. The examination was conducted to an 18 year-old female patient who complained about her broken and discolored right upper front teeth. The traumatic injury of her teeth had happened since 6 years ago after she fell from bike. On clinical examination, she suffered from non-vital teeth with fracture Ellis class IV, apex open and discoloration accompanied by trauma. Periapical radiographic evaluation showed that root formation with wide open apices with root canal was large and indicated a periapical radiolucency. Therefore, apexification with MTA was performed followed by ribbon fiber-reinforced, core making and restoration of full crown porcelain fusion metal. From the treatment, it can be concluded that the time visit for apexification treatment using MTA is shortened, and MTA can heal and stimulate apical barrier formation immediately after final restoration.

Perawatan Saluran Akar Satu Kunjungan Pada Pulpa Nekrosis Disertai Restorasi Mahkota Jaket Porselin Fusi Metal dengan Pasak Fiber Reinforced Composit (Kasus Gigi Insisivus Sentralis Kanan Maksila) Triharsa, Surya; Mulyawati, Ema
Majalah Kedokteran Gigi Indonesia Vol 20, No 1 (2013)
Publisher : Majalah Kedokteran Gigi Indonesia

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Perawatan saluran akar satu kunjungan dapat memperkecil resiko adanya kontaminasi bakteri serta mengurangi jumlah kunjungan. Restorasi gigi insisvus sentralis maksila setelah perawatan saluran akar harus mempertimbangkan sisa jaringan keras gigi yang masih ada. Tujuan laporan kasus ini adalah untuk menginformasikan hasil perawatan saluran akar satu kunjungan dengan restorasi mahkota jaket porselin fusi metal dengan pasak Fiber Reinforced Composit (FRC) pada gigi insisivus sentralis kanan maksila. Pasien perempuan 32 tahun datang ke klinik konservasi Gigi RSGM Prof Soedomo FKG UGM ingin merawat gigi depan atas dengan tumpatan yang telah berubah warna. Berdasarkan pemeriksaan subjektif, objektif dan radiografis diperoleh diagnosis pulpa nekrosis. Selanjutnya dilakukan perawatan saluran akar satu kunjungan, dan restorasi mahkota jaket porselin dengan pasakÂ FRC. Hasil evaluasi klinis saat kontrol tidak ada keluhan rasa sakit gigi dan gigi bisa berfungsi dengan normal.Â ABSTRACT: One Visit Root Canal Treatment On Necrosis Pulp Followed by Fused Porcelain Metal Jacket Crown with Fiber Reinforced Composit (A Case on Right Maxillary Central Incisivus Teeth). One visit root canal treatment is more beneficial to reduce the risk of bacteria and also shorten the time during the treatment in restoring maxillary incisor, considering the on rest of hard tissue. The objective of this case report is to inform the result of restoration teeth 11 to necrotic pulp after one visit root canal treatment. A 32 year-old female came to RSGM Prof Soedomo FKG UGM to have a treatment on her maxillary central teeth restoration for tooth whose color has changed. After an objective and radiograph examination, it was diagnosed that she suffered from necrotic pulp. The treatment chosen was a one visit root canal treatment followed by porcelain fused to metal jacket crown with fiber post reinforced composit. Based on the clinical evaluation, there was no more pain after the treatment, and the aesthetic aspect was also achieved. The patient was satisfied.

Restorasi mahkota jaket porselen fusi metal dan customed dowel pasca perawatan saluran akar satu kunjungan Arisanti, Teleseptiserngi Dian; Mulyawati, Ema
MKGK (Majalah Kedokteran Gigi Klinik) (Clinical Dental Journal) UGM Vol 2, No 1 (2016)
Publisher : Fakultas Kedokteran Gigi, Universitas Gadjah Mada

Porcelain fuse to metal restoration and customed dowel post one visit endodontic treatment. Esthetic of anterior teeth has an important role to build self-confidence. Common esthetic problem on anterior teeth is caries, causing damage to the crown and discoloration. The aim of the case report is to report a porcelain fuse to metal restoration and custom dowel post one visit endodontic treatment in the left central maxillary incisor. A 25-years-old male patient came to seek care of his discolorized left central maxillary incisor. The diagnosis has been established as followed, pulp necrosis with discoloration on left central maxillary incisor. Method : In this case, we have undergone the one visit endodontics treatment followed by porcelain-fused-to-metal crown restoration and custom dowel of the left central maxillary incisor. Result: Three months evaluation post treatment, the patient had no pain during chewing, traumatic occlusion, nor periodontal tissue issue. Conclusion: The restoration on anterior teeth and endodontic treatment can reestablished the function of the teeth moreover esthetic, increasing self-confidence

Root Canal Treatment of the Maxillary Second Molar with an Unusual Morphology: A Case Report Desire Octarina, Lia; Endra Untara, Tri; Mulyawati, Ema
Journal of Dentistry Indonesia Vol. 27, No. 2
Publisher : UI Scholars Hub

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Four rooted maxillary second molar is a rare condition. A research of 1,200 maxillary second molars found only 0.4% of the sample with this condition. In a tooth with two palatal roots, one of them is the normal palatal root, while the other is a supernumerary structure which can be found mesiolingually (radix mesiolingualis) or distolingually (radix distolingualis). Objective: to describes a successful root canal treatment of a maxillary second molar with radix mesiolingualis. Final restoration using a short fiber-reinforced composite as the bottom structure under the onlay composite direct restoration. Case report: A 39-year old female patient complained of pain continuously for the past two weeks in her right maxillary second molar (tooth #17). Clinical examination revealed a deep mesioocclusal caries lesion and presence of extra cusps on the palatal surface of the crown. Conclusion: Crown with extra cusps relatively larger compared to a normal crown. It could be indicated the additional palatal roots. Those variations could be identified by clinical and radiographic examination, while more accurate assessment with CBCT imaging. The right material was required to support function and strengthen the tooth after root canal treatment.

Retrieval of broken file and retreatment of previously treated mandibular left second molar Paramastri, Sukma; Fitriningtyas, Kurnia; Santosa, Pribadi; Mulyawati, Ema; Rinastiti, Margareta; Kristanti, Yulita
Majalah Kedokteran Gigi Indonesia Vol 9, No 3 (2023): December
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.83545

Broken files in the root canal system which are not removed may interfere with thorough cleaning of the root canals. As a result, they cannot be hermetically obturated. This imperfect cleaning can leave necrotic tissue which can potentially cause failure in root canal treatment. The purpose of this paper is to describe the management of retrieval of broken files and re-treating root canals in previously treated mandibular left second molars. The retrieval of the broken file used conventional techniques combined with a Satelec ultrasonic scaler to remove the files from the root canal. It was operated under an endodontic microscope, and after retreatment of the root canal, the tooth was restored with final restoration of endocrown. Retrieval of fractured files using conventional techniques combined with Satelec ultrasonic scaler and the root canal re-treatment followed by final endocrown restoration could restore all four tooth functions properly.

Effect of sodium thiosulfate irrigation on push-out bond strength of root canal obturation material Panjiswastiawan, Leonardo Radito; Mulyawati, Ema; Kristanti, Yulita
Majalah Kedokteran Gigi Indonesia Vol 10, No 1 (2024): April
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.85125

Sodium hypochlorite is used as irrigation solution during root canal preparation because of its antibacterial effect. However, it degrades dentinal collagen and generates oxygen free layer on dentin surfaces that might prevent penetration of sealer. Sodium thiosulfate is an antioxidant and has been reported to neutralize that side effect. The objective of this study was to determine the effect of concentration and application time of sodium thiosulfate irrigation on push-out bond strength of root canal obturation material. This study used extracted human mandibular premolars single root post extraction. The root canals were prepared using crown down technique up to file F3. The samples were divided into four groups. Groups IA and IB were irrigated with sodium thiosulfate 5% for 3 and 5 minutes, while Groups IIA and IIB were irrigated with sodium thiosulfate 10% for 3 and 5 minutes. The control group was irrigated with saline for 3 and 5 minutes. The root canals were obturated with epoxy resin sealer and gutta percha, and were incubated for 7 days. Samples were horizontally sectioned into 2 mm thickness in apical third and were tested with push-out technique using universal testing machine. The adherence failure of samples was observed using stereo microscope. Data were analyzed with two-way ANOVA. There was a significant effect between concentration of sodium thiosulfate on push-out bond strength (p < 0.05), but application time showed the same effect (p > 0.05). The application of antioxidant resulted in an increase in the push-out bond strength of root canal obturation material, with 10% sodium thiosulfate demonstrating the highest push-out bond strength.

The Effect Of Final Irrigation Materials And Techniques On The Cleanliness Of The Smear Layer In The Apical Third Of The Root Canal Maranantan, Helga Anindyastika; Ratih, Diatri Nari; Mulyawati, Ema
Odonto : Dental Journal Vol 12, No 1 (2025): April 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.1.44-53

17% EDTA is a chelating agent used to clean the smear layer. Novel silver citrate (NSC) is a new material with the same use, while 0.2% chitosan nanoparticles are a material that has been widely studied. The agitation technique influences smear layer cleanliness by optimizing the penetration of irrigation material. Agitation techniques are sonic and ultrasonic agitation techniques; each has its advantages and disadvantages. The research objective is to evaluate the effect of final irrigation materials, agitation techniques, and a combination of both on the cleanliness of the smear layer in the apical third of the root canal.Forty-five premolars were prepared with a rotary instrument. Samples then randomly divided into 3 experimental groups (n=15). Group 1 used 17% EDTA, group 2 used NSC, and group 3 used 0.2% nanoparticle chitosan. Each group was divided into three subgroups (n=5) with subgroup A using manual agitation technique, subgroup B sonic agitation, and subgroup C ultrasonic agitation. The samples were sectioned and then examined under SEM with 5000x magnification to evaluate the cleanliness of the smear layer. The results from SEM were scored and then analyzed using Chi-Square test (IBM SPSS Statistics 29.0.1.0).Final irrigation agents of 17% EDTA, NSC, and 0.2% chitosan nanoparticles resulted in the same cleanliness of the smear layer (p˃0.05). The ultrasonic agitation technique showed better cleanliness of the smear layer than the sonic agitation and manual agitation techniques (p˂0.05). The final irrigation material combined with agitation techniques resulted in the same cleanliness of the smear layer (p˃0.05).

The Effect Of Final Irrigation Materials And Techniques On The Cleanliness Of The Smear Layer In The Apical Third Of The Root Canal Maranantan, Helga Anindyastika; Ratih, Diatri Nari; Mulyawati, Ema
Odonto : Dental Journal Vol 12, No 1 (2025): April 2025
Publisher : Faculty of Dentistry, Universitas Islam Sultan Agung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30659/odj.12.1.44-53

17% EDTA is a chelating agent used to clean the smear layer. Novel silver citrate (NSC) is a new material with the same use, while 0.2% chitosan nanoparticles are a material that has been widely studied. The agitation technique influences smear layer cleanliness by optimizing the penetration of irrigation material. Agitation techniques are sonic and ultrasonic agitation techniques; each has its advantages and disadvantages. The research objective is to evaluate the effect of final irrigation materials, agitation techniques, and a combination of both on the cleanliness of the smear layer in the apical third of the root canal.Forty-five premolars were prepared with a rotary instrument. Samples then randomly divided into 3 experimental groups (n=15). Group 1 used 17% EDTA, group 2 used NSC, and group 3 used 0.2% nanoparticle chitosan. Each group was divided into three subgroups (n=5) with subgroup A using manual agitation technique, subgroup B sonic agitation, and subgroup C ultrasonic agitation. The samples were sectioned and then examined under SEM with 5000x magnification to evaluate the cleanliness of the smear layer. The results from SEM were scored and then analyzed using Chi-Square test (IBM SPSS Statistics 29.0.1.0).Final irrigation agents of 17% EDTA, NSC, and 0.2% chitosan nanoparticles resulted in the same cleanliness of the smear layer (p˃0.05). The ultrasonic agitation technique showed better cleanliness of the smear layer than the sonic agitation and manual agitation techniques (p˂0.05). The final irrigation material combined with agitation techniques resulted in the same cleanliness of the smear layer (p˃0.05).

Fiber reinforced direct composite for endodontic treated tooth in one year follow-up Satrio, Fajar; Mulyawati, Ema; Rinastiti, Margareta
Majalah Kedokteran Gigi Indonesia Vol 11, No 2 (2025): August
Publisher : Faculty of Dentistry, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/majkedgiind.91558

After root canal treatment, tooth will be more fragile due to loss of tooth structure integrity as a result of the caries process, access preparation, reduced water, and or tooth fracture. This is the main consideration for determining the material and restoration technique for endodontic treated tooth (ETT). Fiber reinforcement direct composite can maintain the remaining tooth structure and increase fracture resistance. This case report aims to evaluate the 1-year follow-up of fiber reinforcement direct composite in molar tooth after root canal treatment. The first case was a 28-year-old man, who came to RSGM to maintain his left lower right molar which had been filled for about 10 years. On the radiograph, there was a radiopaque filling to the pulp and apical radiolucency. The results of clinical examination obtained previously initiated therapy, asymptomatic apical periodontitis. The second case, a 27-year-old woman, complained pain on biting in the lower left molar for a week. On the radiograph, there was a radiopaque filling at the occlusal side, a non-hermetic obturation material in the root canals, and apical radiolucency. From the clinical examination, previously treated, symptomatic apical periodontitis was obtained. One-visit endodontic treatment was given followed by a direct restoration with composite resin, short-fiber filler, and fiber ribbond. The endodontic treated tooth restored with fiber reinforcement direct composite obtained good results after 1 year follow-up.

Apicoectomy and root canal treatment of a maxillary right central incisor with discoloration, class IV ellis fracture, and radicular cyst Elitasari, Denti; Wijaya, Meliana Ganda; Kristanti, Yulita; 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.91793

In cases of pulp necrosis, infection products can spread into the periapical tissues, triggering an inflammatory response that stimulates the proliferation of the epithelial cell rests of Malassez. As the epithelial mass enlarges, the central cells—farther from the nutritional supply, undergo necrosis, leading to fluid accumulation. The cyst continues to expand due to cyst wall proliferation and increased hydrostatic pressure in the lumen. This pressure causes the accumulated fluid to spread and compress the epithelial lining of the fibrous capsule. This report presents the successful management of a radicular cyst in the maxillary anterior region through apicoectomy. The patient, who sustained a traumatic injury and fractured the tooth at the age of 10, later experienced pain and gingival swelling. Clinical examination revealed a Class IV Ellis fracture and discoloration of tooth 11. Radiographic evaluation showed a well-defined, rounded radiolucency approximately 20 mm in diameter in the periapical region of teeth 11 and 12, extending toward tooth 13. The treatment plan included disinfection and healing enhancement (DHE), root canal therapy, apicoectomy, and intracoronal bleaching. Apicoectomy proved to be a reliable treatment with a favorable prognosis for anterior teeth.

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