APEXIFICATION FOLLOWED BY DIRECT COMPOSITE VENEER ON ELLIS CLASS IV FRACTURE: A CASE REPORT

Effendi Halim, Yoanita Dwiaidina, W. Hadriyanto, Pribadi Santosa, Ema Mulyawati, Yulita Kristanti
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Abstract

Introduction: Traumatized immature permanent teeth can cause pulp necrosis, leading to imperfect root formation, and thus resulting an open apex. The apical opening of the immature teeth is mostly large and thus may lead to difficulties in performing a root filling. In such cases, apexification is mandatory before doing root canal treatment. The aim of this case report was to inform that apexification and direct veneer was suitable to treat Ellis class IV fracture with necrotic pulpCase Report: 21-year-old female came to the Dental Conservation Clinic RSGM Prof. Soedomo Faculty of Dentistry UGM with chief complaint of right central incisive maxilla fracture and tooth discoloration. Radiographic examination showed an open apex of tooth 11 with a diffuse apical radiolucent area. Root canal treatment and apexification were carried out using circumferential technique and Mineral Trioxide Aggregate (MTA). Vertical warm obturation was performed, followed by intra coronal bleaching in the next visit. Final restoration was carried out using direct composite veneer. Post treatment radiographic showed a 1 mm diameter of radiolucent area at the apex in a good healing process.Conclusion: Apexification using MTA can be used to treat an open apex tooth. 1Student of Specialist Programme in Conservative Dentistry, Dentistry Faculty, Gadjah Mada University 2Department of Conservative Dentistry, Dentistry Faculty, Gadjah Mada University
Ellis iv级骨折根尖固定术后直接复合贴面1例
未成熟恒牙外伤可引起牙髓坏死,导致牙根形成不完善,从而导致牙尖打开。未成熟牙齿的顶端开口大多很大,因此可能导致进行牙根充填的困难。在这种情况下,根管治疗前必须进行根尖矫正。本病例报告的目的是为了说明根尖矫治和直接贴面治疗Ellis IV级骨折伴牙髓坏死的合适方法。病例报告:21岁女性,以右中尖上颌骨骨折和牙齿变色为主诉来到RSGM牙科保护诊所。x线检查显示11号牙顶端开放,顶端弥漫透光区。根管治疗和根尖化采用环向技术和三氧化二矿骨料(MTA)。进行垂直温封闭,随后在下一次就诊时进行冠状内漂白。最后采用直接复合贴面进行修复。治疗后的x线片显示顶端有直径1mm的透光区,愈合良好。结论:MTA根尖修复术可用于治疗尖牙开放性。1 Gadjah Mada大学牙科学院保守性牙科专业课程学生2 Gadjah Mada大学牙科学院保守性牙科学系
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