Perawatan Estetik Kompleks Empat Gigi Anterior Maksila dengan Resorpsi Eksternal

Permasalahan estetik merupakan salah satu hal penting dalam perawatan kedokteran gigi restoratif dan harus sejalan dengan penampilan yang alami serta harmonis berdasarkan prinsip-prinsip estetik. Untuk menginformasikan perawatan restorasi estetik komplek dari empat gigi anterior maksila. Laki-laki berusia 17 tahun datang dengan fraktur insisal karena kecelakaan. Empat tahun yang lalu, gigi tersebut telah dirawat endodontik dan direstorasi dengan mahkota jaket namun tujuh hari yang lalu, mahkota lepas. Pemeriksaan klinis menunjukkan bahwa gigi 11 fraktur horizontal pada sepertiga mahkota. Gigi 21 ditumpat dengan komposit tetapi memiliki anatomi dan warna yang buruk. Terdapat diastema di antara gigi insisivus kiri atas. Semua gigi normal terhadap perkusi, palpasi dan probing periodontal. Radiograf periapikal menunjukkan adanya resorpsi apikal pada gigi 11 dengan radiolusensi apikal dengan diameter 3-4 mm. Setelah pemeriksaan, perawatan yang dilakukan pada gigi 11 adalah retreatment dan apeksifikasi menggunakan MTA, pemasangan pasak komposit indirek dan mahkota jaket PFM. Gigi 21 dan diastema di antara gigi insisivus maksila kiri direstorasi dengan komposit. Gigi 22 juga direstorasi dengan resin komposit untuk mendapatkan lebar ideal. Kontrol 1 bulan menunjukkan gigi asimptomatik, terlihat adanya regenerasi jaringan periapikal dan gigi berfungsi normal. Perawatan keempat gigi anterior maksila dengan mempertimbangkan kondisi estetik dan konservasi sisa jaringan keras gigi menunjukkan keberhasilan sehingga gigi dapat berfungsi normal. ABSTRACT: Aesthetic Treatment of Four Maxillary Anterior Teeth with External Resorption. Esthetic aspect has become increasingly important in the modern restorative dentistry and synonymous with a natural, harmonious appearance based on esthetic principles. This case report aimed to inform the esthetically complex restorative treatment of four maxillary anterior teeth. A 17-year-old male had a fractured incisor following a traumatic incident. Four years earlier, the tooth was treated endodontically and restored with a crown. Seven days ago, the crown fell off. A clinical examination revealed that tooth 11 was horizontally fractured on the mid-third of the crown. Tooth 21 had been previously restored using composite, but it had a bad contour and color. There was also a diastema between left maxillary incisors. All teeth responded normally to percussion and palpation and had normal periodontal probing. A periapical radiograph showed apical resorption at teeth 11 with an apical rarefaction 3-4 mm in diameter. After complete examination and esthetic analysis, several treatments were undertaken. Tooth 11 was retreated using MTA to facilitate the apexification followed by indirect, customized composite post and porcelain-fused-to-metal crown. Tooth 21 and the diastema between the left maxillary incisors were closed using composite resin. Tooth 22 was also restored using composite resin to get the ideal width of the tooth. After 2 weeks, the treated teeth were asymptomatic, radiographic examination demonstrated apparent regeneration of periapicular tissue, and the teeth functioned normally. The teeth were successfully treated by endodontic therapy and restoration with crown and composite resin to restore esthetic problems.