Perawatan endodontik pada gigi molar kedua mandibula dengan konfigurasi saluran akar berbentuk-C  Endodontic treatment of mandibular second molar with a C-shaped root canal configuration

Aya Amida; Rahmi Alma Farah Adang

doi:10.24198/jkg.v32i2.18032

Perawatan endodontik pada gigi molar kedua mandibula dengan konfigurasi saluran akar berbentuk-C
Endodontic treatment of mandibular second molar with a C-shaped root canal configuration

Aya Amida, Rahmi Alma Farah Adang

Abstract

ABSTRAK

Pendahuluan: Keberhasilan perawatan endodontik membutuhkan pengetahuan yang tepat mengenai berbagai morfologi sistem saluran akar. Variasi sistem saluran akar tidak selalu terjadi dalam variasi jumlah saluran, melainkan juga dalam konfigurasi bentuk. Salah satu variasi anatomi yang paling penting adalah konfigurasi berbentuk-C dan banyak ditemukan pada gigi molar kedua mandibula. Tujuan laporan kasus ini mempresentasikan perawatan endodontik pada gigi molar kedua mandibula dengan konfiguraasi saluran akar berbentuk-C. Laporan kasus: Pasien wanita berusia 21 tahun datang ke Klinik Konservasi Gigi RSGM UNPAD dengan keluhan gigi geraham belakang kiri bawah yang berlubang dan sakit berdenyut spontan sejak dua hari yang lalu.Preparasi akses kavitas memperlihatkan kamar pulpa yang dalam dan luas ke bukal berbentuk C. Hasil interpretasi CBCT memperlihatkan kavitas berbentuk C dengan orifis saluran akar di mesio lingual yang terhubung dengan isthmus ke orifis saluran akar distal. Perawatan endodontik pada konfigurasi sistem saluran akar berbentuk C kategori II (C2) dengan diagnosis pulpitis ireversibel simtomatik dapat dilakukan dengan optimal dengan mempertimbangkan anatomi eksternal dan internal gigi. Preparasi biomekanis yang intensif dengan teknik instrumentasi circumferential filing, serta penggunaan kombinasi irigan NaOCl 5,25% dan EDTA 17% yang diaktivasi dapat meningkatkan efektivitas debridemen saluran akar. Teknik obturasi kondensasi vertikal termoplastis dapat mengisi iregularitas saluran akar, serta menutup konfigurasi sistem saluran akar. Simpulan: Perawatan endodontik pada gigi molar kedua mandibula dengan konfigurasi saluran akar berbentuk-C berhasil dilakukan dengan baik, diawali penentuan diagnosis yang tepat serta identifikasi dini terhadap variasi saluran akar dan pemeriksaan diagnostik tambahan CBCT yang memfasilitasi preparasi biomekanis dan pengisian sistem saluran akar.

Kata kunci: Anatomi akar, konfigurasi bentuk-C, konfigurasi saluran akar, molar kedua mandibula, perawatan endodontik

ABSTRACT

Introduction: Successful endodontic treatment requires proper knowledge of various morphologies of the root canal system. The canal system variation does not always occur in the number of canals, but also the shape configuration. One of the essential anatomical variations is the C-shaped configuration which is found in many mandibular second molars. This case report was aimed to present endodontic treatment of mandibular second molar with a C-shaped root canal configuration. Case report: A 21-year-old female patient came to the Conservative Dentistry Clinic of Universitas Padjadjaran Dental Hospital with a complaint of cavities and spontaneous pulsating pain since two days prior. CBCT interpretation shows a C-shaped cavity with a root canal orifice in the mesiolingual connection with an isthmus to the distal root canal orifice. Endodontic treatment of a C-shaped root canal system configuration with category II (C2), with a diagnosis of symptomatic irreversible pulpitis, can be performed optimally by considering the external and internal tooth anatomy. Intensive biomechanical preparation using the circumferential filing instrumentation techniques, and the use of a combination of activated 5.25% NaOCl and 17% EDTA irrigation can increase the effectiveness of root canal debridement. Thermoplastic vertical condensation obturation technique can fill the irregularities of the root canal, as well as sealing the root canal system configuration. Conclusion: Endodontic treatment of mandibular second molar with a C-shaped root canal configuration was successfully performed, initiated with determination of the correct diagnosis and early identification of root canal variations and additional diagnostic CBCT tests which facilitates the biomechanical preparation and root canal system filling.

Keywords: Root anatomy, C-shape configuration, root canal configuration, mandibular second molar, endodontic treatment.

Keywords

Anatomi akar; konfigurasi bentuk-C; konfigurasi saluran akar; molar kedua mandibula; perawatan endodontik

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References

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DOI: https://doi.org/10.24198/jkg.v32i2.18032