Publication: Aşırı kron harabiyeti ve sınıf 2 derece A furkasyon defekti bulunan alt molar dişin multidisipliner tedavisi: Bir olgu sunumu
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Date
2022-10-19
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Abstract
AMAÇ: Hemiseksiyon, sıklıkla aşırı kron harabiyeti, periodontal hastalık veya kök kırığı bulunan çok köklü dişlerin
iki parçaya ayrılması işlemi olarak tanımlanır. Dental oklüzyonun devamlılığının sağlanması, tedavi işlemlerinin
kısa sürmesi ve maliyetinin düşük olması gibi nedenlerle günümüzde tercih edilen bir tedavi yöntemidir. Bu
işlemi takiben, tek kron veya köprü protetik restorasyonu ile estetik ve fonksiyon sağlanmış olur. Bu olgu
raporunda, çürük nedeniyle aşırı kron harabiyeti ve sınıf 2 derece A furkasyon defekti bulunan sağ alt 2. molar
dişin multidisipliner tedavisi sunulmuştur.
OLGU SUNUMU: 50 yaşındaki, kronik böbrek yetmezliği hikayesi olan erkek hastanın ağız içi klinik ve radyografik
muayenesinde; 6 ay önce endodontik tedavisi tamamlanmış olan #46 numaralı dişinde sekonder çürüğe bağlı
aşırı kron harabiyeti ve sınıf 2 derece A furkasyon defekti tespit edildi. Düzenli diyalize giren hastanın doktorundan
alınan konsültasyona göre tedavileri planlandı. Her hafta bir seans olmak üzere 4 seans başlangıç periodontal
tedavi yapıldı. Takiben lokal anestezi altında flep operasyonu yapıldı. Tam kalınlık flep kaldırıldıktan sonra
granülasyon dokuları degranüle edildi. Ardından elmas frezler ile dişin kronuna ve köklerine furkasyon hizasından
hemiseksiyon işlemi uygulandı. Dişin kron kenarı ile alveol kreti tepesi arasında biyolojik mesafeyi oluşturabilmek
için osteoktomi ve osteoplasti işlemi yapıldı. Flep 3-0 ipek sütur kullanılarak kapatıldı. Operasyon sonrası hastaya
parasetamol içerikli analjezik antienflamatuar (2x1, 5 gün), amoksisilin içerikli antibiyotik (2x1, 1 hafta) ve
klorheksidin içerikli gargara (2x1, 1 hafta) reçete edildi. Dikişler 1 hafta sonra alındı. Postoperatif 6. haftada
iyileşmenin sorunsuz olduğu gözlemlendi. Premolar formundaki dişlere prefabrik post uygulaması yapıldı. Dişler
basamaklı preparasyonun ardından metal destekli porselen kronlarla restore edildi ve okluzyon ideal koşullara göre
düzenlendi. Operasyon sonrası 6. ay klinik ve radyografik incelemede periodontal dokuların sağlıklı olduğu gözlendi.
SONUÇ: Aşırı kron harabiyeti ve sınıf 2 derece A furkasyon defekti bulunan alt molar dişin tedavisinde,
hemiseksiyonu takiben metal destekli protetik restorasyonun kısa dönem takiple başarılı bir tedavi seçeneği
olduğu görüldü.
AIM: Hemisection is defined as separating multi-rooted teeth into two parts, with excessive crown destruction, periodontal disease or root fracture. It is a preferred method due to ensuring the continuity of occlusion, short treatment procedures and low cost. In this case report, multidisciplinary treatment of the right lower 2nd molar tooth with excessive crown destruction due to caries and class 2 grade A furcation defect is presented. CASE REPORT: In the oral clinical and radiographic examination of a 50-year-old male patient with a history of chronic renal failure; excessive crown destruction due to secondary caries and class 2 grade A furcation defect were detected in tooth #46. Non-surgical periodontal treatment was performed for 4 sessions, one session per week. Subsequently, flap operation was performed under local anesthesia. After the full thickness flap was removed, tissues were degranulated. Hemisection was applied to the crown and roots of the tooth from the furcation level with diamond burs. In order to create the biological width between the crown edge and alveolar crest, osteoctomy and osteoplasty were performed. The flap was closed using 3-0 silk sutures. Patient was prescribed paracetamol-containing analgesic anti-inflammatory (2x1, 5 days), amoxicillin-containing antibiotics (2x1, 1 week) and chlorhexidine-containing mouthwash (2x1, 1 week) postoperatively. Sutures were removed after 1 week. It was observed that the recovery was uneventful at 6 weeks post-op. Prefabricated post was applied to teeth in premolar form. Teeth were restored with metal supported porcelain crowns after preparation and occlusion was adjusted according to ideal conditions. In the 6th month postoperatively, clinical and radiographic examination revealed that the periodontal tissues were healthy. CONCLUSION: In the treatment of mandibular molar tooth with excessive crown destruction and class 2 degree A furcation defect, metal-supported prosthetic restoration following hemisection was found to be a successful treatment option with short-term follow-up.
AIM: Hemisection is defined as separating multi-rooted teeth into two parts, with excessive crown destruction, periodontal disease or root fracture. It is a preferred method due to ensuring the continuity of occlusion, short treatment procedures and low cost. In this case report, multidisciplinary treatment of the right lower 2nd molar tooth with excessive crown destruction due to caries and class 2 grade A furcation defect is presented. CASE REPORT: In the oral clinical and radiographic examination of a 50-year-old male patient with a history of chronic renal failure; excessive crown destruction due to secondary caries and class 2 grade A furcation defect were detected in tooth #46. Non-surgical periodontal treatment was performed for 4 sessions, one session per week. Subsequently, flap operation was performed under local anesthesia. After the full thickness flap was removed, tissues were degranulated. Hemisection was applied to the crown and roots of the tooth from the furcation level with diamond burs. In order to create the biological width between the crown edge and alveolar crest, osteoctomy and osteoplasty were performed. The flap was closed using 3-0 silk sutures. Patient was prescribed paracetamol-containing analgesic anti-inflammatory (2x1, 5 days), amoxicillin-containing antibiotics (2x1, 1 week) and chlorhexidine-containing mouthwash (2x1, 1 week) postoperatively. Sutures were removed after 1 week. It was observed that the recovery was uneventful at 6 weeks post-op. Prefabricated post was applied to teeth in premolar form. Teeth were restored with metal supported porcelain crowns after preparation and occlusion was adjusted according to ideal conditions. In the 6th month postoperatively, clinical and radiographic examination revealed that the periodontal tissues were healthy. CONCLUSION: In the treatment of mandibular molar tooth with excessive crown destruction and class 2 degree A furcation defect, metal-supported prosthetic restoration following hemisection was found to be a successful treatment option with short-term follow-up.
Description
Keywords
Cerrahi prosedür, Dental kron, Diş, Furkasyon defektleri, Molar, Dental crown, Furcation defects, Surgical prosedüre, Tooth
Citation
BABALI S., KIRMACI S., ÇANAKÇI M., ŞANIVAR ABBASGHOLIZADEH Z., GÜNGÖRMEK H. S., \"Aşırı Kron Harabiyeti ve Sınıf 2 Derece A Furkasyon Defekti Bulunan Alt Molar Dişin Multidisipliner
Tedavisi: Bir Olgu Sunumu\", Türk Dişhekimleri Birliği 26. Uluslararası Dişhekimliği Kongresi, İstanbul, Türkiye, 8 - 11 Eylül 2022, cilt.11, ss.243-244