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"Endodontic instruments such as file or reamer has potential risk to breakage during cleaning and shaping procedure especially in curved canals. In this case the instrument was fractured because it was forced into the dentin walls to gain deeper penetration, and its removal result in breakage. In this case report removal of the instrument fragment in root canal with conventional technique was failed. So it was decided to continue the treatment, with the consideration that there is no complain within one month observation."

"Latar Belakang: Karies gigi merupakan masalah kesehatan yang dialami setengah populasi penduduk dunia (3,58 milyar jiwa) dan penyakit gigi dengan prevalensi terbesar di Indonesia. Insidensi karies mencapai pulpa juga selalu meningkat setiap tahunnya. Perawatan saluran akar merupakan tindakan kuratif yang dilakukan untuk mengatasi hal tersebut. Menurut studi di berbagai negara, tingkat kegagalan PSA dapat mencapai 30% dengan melibatkan banyak faktor. Saat terjadi kegagalan, tindakan yang paling diutamakan untuk dilakukan adalah perawatan saluran akar ulang untuk mempertahankan gigi asli dari pasien. Oleh karena itu, perlu dilakukan penelitian mengenai prevalensi PSA ulang di RSKGM FKG UI dengan mengidentifikasi dan mengevaluasi penyebab kegagalan PSA dan faktor-faktor yang mempengaruhi hal tersebut untuk mencegah hal tersebut terjadi lagi di masa yang akan datang. Tujuan: Mengetahui prevalensi perawatan saluran akar ulang di Rumah Sakit Khusus Gigi dan Mulut Fakultas Kedokteran Gigi Universitas Indonesia periode 2019-2021. Metode: Penelitian merupakan penelitian deskriptif dan analitik komparatif yang bersifat retrospektif menggunakan data sekunder rekam medis pasien konservasi di RSKGM FKG UI. Hasil: Dari 3503 pasien PSA di RSKGM FKG UI periode Januari 2019-Juli 2021, 181 pasien dengan kegagalan PSA memilih untuk PSA ulang dan 20 pasien lainnya dilakukan ekstraksi. Melalui analisis komparatif, terdapat perbedaan secara statistik antara etiologi kegagalan PSA dengan status penyakit periapeks pada pasien, tidak ditemukan perbedaan antara sosiodemografi, elemen gigi dan diagnosis periapeks pasien pada perawatan PSA ulang dan ekstraksi, dan terdapat perbedaan secara statistik antara etiologi kegagalan PSA dengan perawatan yang dipilih (PSA ulang dan ekstraksi). Kesimpulan: Prevalensi PSA ulang di RSKGM FKG UI adalah 5,1%. Penyebab kegagalan PSA yang paling banyak ditemukan adalah pengisian saluran akar yang kurang. Diagnosis penyakit periapeks pasca PSA, paling banyak ditemukan adalah abses periapikal. Berdasarkan sosiodemografis, pasien paling banyak didominasi oleh jenis kelamin perempuan dan kelompok usia yang paling banyak ditemukan adalah kelompok usia 50-59 tahun. PSA ulang paling banyak terjadi pada gigi molar mandibula. PSA yang inadekuat memiliki pengaruh yang signifikan terhadap penyakit periapeks, proporsi tertinggi etiologi kegagalan PSA pada tindakan PSA ulang adalah PSA inadekuat dan proporsi tertinggi etiologi kegagalan PSA pada tindakan ekstraksi adalah restorasi inadekuat

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Background: Dental caries is a serious health problem experienced by half of the world’s population (3.58 billion people) and an oral disease with the highest prevalence in Indonesia. The incidence of pulpitis is also increasing every year. Root canal treatment is taken to cure the disease. According to studies in various countries, endodontic treatment failure rate can reach to 30% involving many factors. When endodontic treatment failure occurs, the most applied action to be taken is endodontic retreatment to preserve patient’s teeth. Therefore, it is necessary to conduct a research on the prevalence of endodontic retreatment at RSKGM FKG UI by discovering the causes of the failure and other factors that contributed to the failure to prevent it from happening in the future. Objectives: This study aims to determine the prevalence of endodontic retreatment at RSKGM FKG UI for the period of 2019-2021. Methods: Retrospective descriptive and comparative analytical study is done using secondary data found in patient’s medical record. Results: There were 3503 endodontic patients at RSKGM FKG UI for the period of January 2019-July 2021, 181 patients with endodontic failure chose to be treated with endodontic retreatment and another 20 patients underwent extraction. Through comparative analysis, there were statistical differences between the etiology of endodontic failure and periapical disease. No differences found between the sociodemographic and the tooth, periapical diagnoses of patients with the choices of treatment between endodontic retreatment and extraction, and there were statistical differences between the etiology of endodontic failure and the choice of treatment. Conclusion: The prevalence of endodontic retreatment at RSKGM FKG UI is 5.1%. The most common etiology of endodontic failure is underobturation. Periapical abscess is the most found diagnosis of post endodontic treatment. Based on sociodemographics, most patients are female and the age group that commonly found was 50-59 years old age group. Endodontic retreatment mostly treated on mandibular molars. the biggest proportion of etiology of failure on endodontic retreatment treatment choice is an inadequate endodontic treatment while the highest proportion of etiology of failure on extraction is inadequate restoration"

"The longevity of a tooth is based not on the pulp, but on the health of the attachment apparatus. Mikroorganism and their toxic products can passed out into the periapical tissue and generates lesions of endodontic origin. The rationale of root canal treatment now is based on biologic principles. Healing will occurr if biomecanical preparation, cleaning and shaping were properly excecuted and the root canal system is hermetically sealed in three dimension."

"Latar Belakang: Preparasi saluran akar dengan instrumen putar NiTi dapat menyebabkan crack pada dinding saluran akar.Tujuan: Menganalisa dan membandingkan efek penggunaan instrumen putar NiTi single-file gerakan resiprokal dan kontinyu terhadap terbentuknya crack pada dinding saluran akar. Metode: Tigapuluh dua sampel saluran akar tunggal dipilih secara acak dan dibagi menjadi dua grup (n=16) sesuai dengan instrumen yang digunakan untuk preparasi saluran akar, yaitu instrumen putar NiTi gerakan resiprokal dan gerakan kontinyu. Micro-CT digunakan untuk mengevaluasi crack  sebelum dan setelah preparasi saluran akar. Analisis statistik menggunakan Continuity correction. Hasil: Tidak terdapat perbedaan bermakna antara preparasi saluran akar menggunakan instrumen putar NiTi gerakan resiprokal dan gerakan kontinyu (p>0,05). Crack yang terbentuk ditemukan pada bagian sepertiga apikal saluran akar dengan tipe incomplete crack. Simpulan: Preparasi saluran akar menggunakan instrumen putar NiTi single-file dengan gerakan resiprokal dan kontinyu dapat menyebabkan terbentuknya crack pada dinding saluran akar.

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Background: Root canal preparation with NiTi rotary instrument has the potential to induce cracks in the root canal wall. Objective: To analyze and compare the effects of single-file NiTi rotary continuous and reciprocating instruments in the propagation of cracks in the root canal wall. Methods: Thirty two single root canal samples were randomly assigned into two groups (n=16 per group) according to the system used for root canal preparation : reciprocating instruments and rotary continuous instruments. The samples were scanned through high-resolution micro-computed tomographic imaging to evaluate cracks before and after root canal preparation. The comparison between two groups was analysed statistically using Continuity correction. Results: There was no significant difference in the number of cracks between reciprocating group and rotary continuous group (p> 0.05). Cracks that occured was found in the apical third of the root canal, with incomplete cracks. Conclusion: Root canal preparation with single-file NiTi rotary continuous and reciprocating instruments can induce dentinal cracks in the root canal wall."

"Instrumentasi saluran akar masih meninggalkan area tidak terpreparasi. Insrumen osilasi diklaim dapat membersihkan dinding saluran akar secara optimal.Tujuan: Membandingkan luas dinding sepertiga apeks saluran akar yang tidak terpreparasi antara instrumen osilasi Reciproc® dan WaveOne®.Metode: Tiga puluh dua saluran akar premolar mandibula diisi tinta cina kemudian dibagi menjadi dua kelompok berjumlah sama (n=16): Reciproc® dan WaveOne®. Luas dinding yang tertutup tinta cina dianalisis dengan Adobe Photoshop CS5.Hasil: Kelompok II mempreparasi lebih banyak dinding tetapi tidak berbeda bermakna dengan kelompok I (p=0,265).Kesimpulan: Reciproc® dan WaveOne® tetap meninggalkan area tidak terpreparasi di sepertiga apeks saluran akar.

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Thirty five percents area of root canal wall was left uninstrumented after instrumentation. Oscillation instrument was claimed able to clean whole area of root canal walls.Objective: to compare uninstrumented area of root canal at the apical third after instrumented by oscillation instrument.Methods: Thirty two human mandibular premolar root canals were dyed with china ink and were divided equally into Reciproc® and WaveOne® group. The area was analyzed using Adobe Photoshop CS5.Results: WaveOne® showed a better result than Reciproc®, but not statistically significant (p=0,265).Conclusion: The Reciproc® and WaveOne® showed no difference in cleaning the root canal."

"Preparasi saluran akar menghasilkan ekstrusi debri, memicu respons inflamasi di periapeks. Tujuan: Mengamati perbedaan jumlah ekstrusi debri ke periapeks pada saluran akar yang dipreparasi menggunakan gerakan rotasi kontinyu dan resiprokal. Metode: Tigapuluh dua gigi premolar secara acak dibagi dalam dua kelompok. Kelompok 1 dipreparasi menggunakan gerakan rotasi kontiyu. Kelompok 2 menggunakan gerakan resiprokal. Penimbangan tabung penampung debri dilakukan dua kali, yaitu sebelum dan setelah preparasi. Perbedaan berat tabung tersebut dianggap sebagai berat debri terekstrusi. Hasil: Tidak terdapat perbedaan bermakna antara kelompok 1 dan 2 (p=0,844) Kesimpulan: Perbedaan gerakan preparasi saluran akar menggunakan rotasi kontinyu maupun resiprokal tidak memengaruhi jumlah ekstrusi debri ke periapeks.

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Root canal preparation produces debris extrusion, lead to inflammation in periapical tissue.

Objective: Assess the differences of periapically extruded debris amount after preparation using continous rotation and reciprocating motion.

Method: Thirty two premolars in a receptor tube were randomly divided into 2 groups. Group 1 was prepared using continuous rotation, Group 2 using reciprocating motion. Amount of the extruded debris was obtained by the receptor tube weight differences before and after preparation.

Results: The difference between groups were not statistically significant (p = 0,844).

Conclusion: Continuous rotation and reciprocating motion have no influence in the amount of periapically extruded debris."

"Latar Belakang: Penelitian mengenai pengaruh pelebaran korona saluran akar terhadap tingkat ketepatan apex locator hanya sedikit. Tujuan: Membandingkan ketepatan lokasi foramen apikalis pada dua tipe apex locator dan menilai pengaruh pelebaran koronal saluran akar. Metode: Panjang kerja 16 gigi premolar satu mandibula diukur secara visual, menggunakan dua jenis apex locator saat sebelum dan setelah dilakukan pelebaran korona saluran akar. Hasil: Berbeda bermakna ketepatan pada tiap jenis apex locator setelah dilakukan pelebaran korona, namun tidak berbeda bermakna pada keduanya setelah pelebaran koronal saluran akar. Kesimpulan: pelebaran korona saluran akar meningkatkan ketepatan apex locator mengukur lokasi foramen apikalis.

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Background: Only a few studies on the effect of coronal preflaring to the accuracy of apex locator.

Objective: To compare the accuracy of two types of apex locators and evaluate the influence of coronal preflaring in them.

Method: working length of sixteen first mandibular bicuspids were measured visually, using two types apex locator at before and after coronal preflaring.

Result: statistically significant of two type apex locators at before and after coronal preflaring, no statistically significant at both types after coronal preflaring.

Conclusion: coronal preflaring will increase the accuracy of apex locator in locating the apical foramen."

"ABSTRAKLatar belakang: Salah satu sifat ideal suatu siler saluran akar adalah memiliki kemampuan penutupan yang baik terutama pada sepertiga apeks. Tujuan: Untuk mengevaluasi perbandingan kebocoran antara pengisian saluran akar dengan siler polidimetilsiloksan SP dan siler bioceramic SB . Metode: Tiga puluh enam gigi premolar rahang bawah, dibagi dua kelompok dan diisi dengan teknik kon tunggal menggunakan siler polidimetilsiloksan pada kelompok pertama, dan siler bioceramic pada kelompok ke-dua. Selanjutnya gigi diinkubasi 37?C, selama 24 jam , kemudian dilapisi dengan dua lapis cat kuku kecuali pada 2 mm dari apeks, dan direndam dalam tinta india 7 X 24 jam . Sampel didekalsifikasi, didehidrasi dan dibuat transparan sesuai dengan metode Robertson. Kedalaman penetrasi zat tinta dievaluasi dengan mikroskop stereo. Skor 0 untuk tidak bocor, skor 1 untuk penetrasi zat tinta le; 0,5 mm, skor 2 untuk penetrasi 0,51 ndash; 1 mm, dan skor 3 untuk penetrasi > 1 mm. Hasil: Distribusi proporsi kebocoran terbesar pada kelompok SP terdapat pada skor 2 44.4 , sedangkan pada kelompok SB terdapat pada skor 1 55.6 . Kesimpulan: Tingkat kebocoran pengisian saluran akar dengan siler bioceramic tidak berbeda dengan siler polidimetilsiloksan.

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ABSTRACTBackground One of the ideal properties of a root canal sealer is to have a good sealing ability, especially at the apical third of the root. Objective To evaluate the comparison of the apical leakage between obturation using bioceramic sealer SB and polydimethylsiloxane sealer SP . Methods Thirty six mandibular premolars were equally divided into two groups and was obturated with single cone technique. The sealer used for Group I and Group II were SP and SB respectively. After obturation, the samples were incubated 37 C, 24 h , sealed with two coats of nail polish except for 2 mm from the apex, immersed in the Indian ink for 7 days, decalcified, dehydrated and made transparent according to Robertson technique. Dye penetration were evaluated under stereomicroscope. Samples with no dye penetration were given score 0, le 0,5 mm dye penetration were given score 1, 0,051 ndash 1 mm were given score 2, and 1 mm were given score 3. Result The largest proportion distribution in SP group was at the score 2 44.4 , and in group SB was at the score 1 55.6 . Conclusion Bioceramic sealer showed similar apical leakage to polydimethylsiloxane sealer."

"Residu Ca(OH)2 dapat mengganggu hermetisitas obturasi saluran akar. Tujuan penelitian ini adalah untuk menganalisis tiga metode pembersihan residu Ca(OH)2. Metode. Tigapuluh premolar bawah dipeparasi dengan ProTaper sampai F3, kemudian diberi medikamen Ca(OH)2 dan disimpan selama 7 hari. Setelah itu, sampel dibagi tiga sama banyak. Residu Ca(OH)2 di Kelompok I dibersihkan dengan irigan gabungan NaOCl-EDTA, kelompok II dengan CanalBrush, dan Kelompok III dengan file NiTi. Sampel kemudian dibelah arah buko-lingual dan residu diperiksa dengan mikroskopstereo dan program Axiocam. Hasil. Pembersihan paling baik adalah pada kelompok II, disusul oleh kelompok III, dan kelompok I, walaupun secara statistik tidak berbeda signifikan (p <0,05). Kesimpulan. Ketiga metode menghasilkan efek pembersihan residu Ca(OH)2 yang tidak berbeda.

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The residu of Ca(OH)2 will hamper the hermeticity of root canal obturation. The aim of this study was to analyze the effectiveness of the methods of its removal. Methods. Root canal preparation was performed on 30 lower premolar using Proaper system. The Ca(OH)2 paste was put on the root canal for 7 days. The samples were then divided equally into three groups. The residu of Ca(OH)2 in group I, II, and III were removed by combined irrigant of NaOCl-EDTA, Canal Brush, and NiTi file respectively. After bisected bucco-lingually, the residu was assessed under stereomicroscope (12x magnification) and AxioCam. Results. Substantially, the most effective method was group II, followed by group III and I, but statistically no significance difference (p < 0.05). Conclusion. The canal brush is the best methods in removing Ca(OH)2 residu, although the difference is statistically not significant."

"Latar Belakang: Preparasi saluran akar gigi menghasilkan smear layer saat bersentuhan dengan dinding saluran akar yang berpotensi menyebabkan kegagalan perawatan. Bentuk penampang file mempengaruhi pembentukan smear layer. Penelitian ini membandingkan kuantitas smear layer pada dinding saluran akar sepertiga apikal yang dipreparasi menggunakan file berpenampang melintang segitiga dan segi empat. Metode: 32 sampel gigi premolar rahang bawah dibagi ke dalam dua kelompok perlakuan yang dipreparasi dengan file berpenampang segitiga (One Curve®, n = 16) dan segi empat (Hyflex EDM®, n = 16). Setelah preparasi, saluran akar diirigasi menggunakan kombinasi larutan NaOCl 2,5% dan EDTA 17%. Smear layer pada dinding saluran akar sepertiga apikal diamati menggunakan scanning electron microscope (SEM) dan dikuantifikasi menurut sistem skoring Foschi. Hasil: Uji Mann- Whitney menunjukkan perbedaan bermakna secara statistik antara preparasi saluran akar menggunakan kedua instrumen dengan skor smear layer. Kelompok yang dipreparasi dengan file berpenampang segitiga menghasilkan skor smear layer lebih rendah dibanding kelompok yang dipreparasi dengan file berpenampang segi empat. Kesimpulan: Preparasi saluran akar menggunakan file berpenampang segitiga dan segi empat dengan irigasi kombinasi NaOCl 2,5% dan EDTA 17% tetap menghasilkan smear layer pada daerah sepertiga apikal, namun preparasi dengan file berpenampang segitiga menunjukkan kuantitas smear layer yang lebih sedikit dibandingkan file berpenampang segi empat.

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Background: Root canal preparation produces smear layer when in contact with its wall, which potentially causing treatment failures. Cross-section shape of file influences smear layer production. This experiment compares smear layer quantity at apical third of root canal walls prepared using files with triangular and rectangular cross-section.

Methods: Thirty-two premolar samples taken from mandibles were divided into two groups whose root canals were prepared using file with triangular (One Curve®, n = 16) and rectangular (Hyflex EDM®, n = 16) cross-section. After preparation, root canals were irrigated with combination of NaOCl 2,5% and EDTA 17% solutions. Smear layer in apical third of root canal walls were then observed using scanning electron microscope (SEM) dan quantified according to Foschi scoring system.

Results: Mann- Whitney test shows significant difference between root canal preparation using both instruments and produced smear layer score. Group prepared with triangular file produced lower smear layer score compared to those which prepared with rectangular file.

Conclusions: Root canal preparation using files with triangular and rectangular cross-section, followed by combined NaOCl 2,5% and EDTA 17% irrigation still produces smear layer in apical third area. However, preparation with triangular file shows less smear layer quantity compared to rectangular file."