Perawatan Crown Lengthening pada Gigi Anterior Pasca Terjadi Fraktur

Abstract

Fraktur gigi anterior yang parah akibat trauma sering menyisakan sedikit struktur gigi yang menjadi tantangan dokter gigi untuk merestorasi. Retensi yang minimal memungkinkan terjadinya kegagalan restorasi, sehingga kebanyakan dokter akan lebih memilih melakukan pencabutan. Crown lengthening adalah prosedur pembedahan untuk mengekspose mahkota klinis yang tersisa sebagai usaha untuk meningkatkan retensi restorasi. Tujuan laporan kasus ini adalah untuk mengevaluasi hasil restorasi pasca dilakukan crown lengthening. Laporan kasus seorang perempuan usia 20 tahun mengalami fraktur gigi anterior maksila pasca kecelakaan yang dialaminya 2 minggu lalu. Gigi 21 fraktur dengan garis patahan horizontal 1/3 servikal mengenai pulpa. Status periodontal baik dan tidak ditemukan kelainan pada gambaran radiograf. Penatalaksanaan dilakukan scalling dan root planning pada regio gigi 21 sebelum pembedahan. Gingiva dipotong sedalam 2 mm pada seluruh permukaan menggunakan blade nomor 15 dilanjutkan penutupan luka bekas pembedahan dengan periodontal dressing. Perawatan saluran akar dilakukan dan diikuti dengan restorasi pasak fiber serta inti dengan resin komposit. Porcelain fused to metal diinsersikan sebagai restorasi mahkota akhir. Hasil restorasi akhir gigi 21 menunjukkan retensi yang memadai untuk restorasi mahkota porcelain fused to metal. Mahkota yang diinsersi dapat bertahan setelah 6 bulan observasi dan pasien merasa cukup puas dengan hasil perawatan. Kesimpulan dari kasus ini, prosedur crown lengthening dapat menunjang restorasi akhir yang retentif pada kasus fraktur gigi anterior yang kehilangan sebagian besar struktur mahkota.

A case report: Surgical esthetic crown lengthening procedure for gummy smile treatment

“…Crown lengthening is a surgical procedure to provide adequate crown retention and for aesthetic improvement in restorative procedures and in teeth with caries or subgingival fractures; moreover, this surgical procedure can establish accurate bone width and correct gingival asymmetry [6,15,16]. Crown lengthening procedures include a number of techniques including gingivectomy or gingivoplasty, apical flap procedures and may involve reducing bone and promoting tooth eruption with or without fiberotomy [3,17]. In cases with bone sounding of 5 mm or more on the keratinized gingiva, a gingivectomy procedure was chosen [3,6].…”

“…Crown lengthening procedures include a number of techniques including gingivectomy or gingivoplasty, apical flap procedures and may involve reducing bone and promoting tooth eruption with or without fiberotomy [3,17]. In cases with bone sounding of 5 mm or more on the keratinized gingiva, a gingivectomy procedure was chosen [3,6].…”

“…If more will cause inflammation, irritation of the marginal gingiva, patient discomfort, easy bleeding, poor esthetics, and damaged periodontal tissue. From the aspect of dental anatomy, it is necessary to pay attention to the length and shape of the crown root and root ratio, the roots must not be exposed excessively to a maximum of 3 mm from the Cemento Enamel Junction (CEJ), the height of the furcation, smile line (anterior teeth), the presence of interdental space, what is the position of the lips there is muscle hypertonus, lip hypermobility [3,23]. Several studies have shown that the biologic width regenerates on its own after a crown lengthening procedure within 6 months, so the ideal time for restoration placement after crown lengthening surgery is 6 months [6].…”

“…Crown lengthening is a periodontal resection procedure which aims to remove a portion of the supporting periodontal tissue to increase the exposure of the clinical crown of the tooth. This is a common procedure for several indications of restorative treatment [3,4]. The most common cases dentists encounter are short clinical crowns due to caries, erosion, malformations, fractures, attrition, reduction of excess teeth, incomplete eruption, exostosis and genetic variation.…”

“…The most common cases dentists encounter are short clinical crowns due to caries, erosion, malformations, fractures, attrition, reduction of excess teeth, incomplete eruption, exostosis and genetic variation. Short clinical crown lengths should be increased or extended when the carious or fractured tooth margins are subgingival, so that the crown can have retention with the restoration [3,5].…”