Analisis Morfologi Saluran Akar Gigi Insisivus Menggunakan Radiografi Periapikal Teknik Bisektris dan Perubahan Angulasi Horizontal pada Sub Ras Proto dan Deutro-Melayu

Abstract

The incisor has a variation of root canal morphology. Root canal morphology can be assessed using periapical radiography. Periapical radiography with standard angulation often makes the dentist difficult to assess the root canal morphology that is branched off in buccal and lingual directions because in the result of radiograph of the root canal will appear superimposed. Therefore, it is necessary to change horizontal angulation to mesial or distal to help assess the root canal superimposed. Root canal morphology may vary by population. The population in Indonesia consists mainly of the sub-races of Proto and Deutro-Malay. The purpose of this study was to determine the difference of root canal morphology between maxillary and mandibular incisors; between the sub-races of Proto and Deutro-Malay; and between the right and left regions, using twice the radiation projection. This study was an analytical study with cross-sectional method using 55 subjects who come from three previous generations of Proto and Deutro-Malay. On each tooth were performed twice radiations periapical radiography, using standard angulation and altering horizontal angulation toward distal 30º. The results showed that in Proto-Melayu, for maxillary central incisors maxillary teeth were obtained type I (99.1%) and III (0.9%) Vertucci, and maxillary lateral incisors were obtained type I Vertucci (100%). In mandibular central incisors were obtained type I (90%), II (3.6%), III (2.7%) Vertucci and IV Gulabivala (3.6%), and mandibular lateral incisors were obtained type I (87.3 %), II (1.8%), III (7.3%) Vertucci and type IV Gulabivala (3.6%). In Deutro-Malay, maxillary central incisors were obtained 100% Vertucci type I and maxillary lateral incisors were obtained type I (99.1%) and II (0.9%). In mandibular central incisors were obtained type I (85.5%), III (11.8%) Vertucci, IV Gulabivala (1.8%), and other types 1-2-1-2-1 (0.9%), and mandibular lateral incisors were obtained by type I (81.8%) and III (18.2%) Vertucci. The result of chi-square analysis showed there were no significant differences of root canal morphology of maxillary insicors tooth between Proto and Deutro-Malay and between right and left region (p> 0,05), but there were significant differences of root canal morphology between maxillary and mandibular incisors and root canal morphology of the mandibular incisor between Proto and Deutro-Malay (p <0.05). In conclusion that maxillary and mandibular incisors of Proto and Deutro-Malay sub-races have variations in root canal configuration and there were differences found in the mandibular incisors.

Gigi insisivus memiliki variasi morfologi saluran akar. Morfologi saluran akar dapat dinilai dengan menggunakan radiografi periapikal. Radiografi periapikal dengan angulasi standar sering membuat dokter gigi kesulitan untuk menilai morfologi saluran akar yang bercabang ke arah bukal dan lingual karena pada hasil foto tersebut saluran akar akan terlihat berhimpit. Oleh sebab itu perlu dilakukan perubahan angulasi horizontal ke arah mesial atau distal untuk dapat membantu menilai saluran akar yang berhimpit. Morfologi saluran akar dapat bervariasi pada setiap populasi. Populasi di Indonesia sebagian besar terdiri dari sub ras Proto dan Deutro-Melayu. Tujuan penelitian ini adalah untuk mengetahui perbedaan morfologi saluran akar antara gigi insisivus maksila dan mandibula; antara sub ras Proto dan Deutro-Melayu; dan antara regio kanan dan kiri, menggunakan dua kali proyeksi penyinaran. Penelitian ini adalah penelitian analitik dengan metode cross-sectional menggunakan 55 orang subjek yang berasal dari tiga keturunan sebelumnya keturunan dari Proto dan Deutro-Melayu. Pada setiap gigi dilakukan dua kali penyinaran yaitu foto ronsen periapikal dengan menggunakan angulasi standar dan mengubah angulasi horizontal ke arah distal 30º. Hasil penelitian menunjukkan bahwa pada Proto-Melayu, untuk gigi insisivus sentralis maksila diperoleh tipe I (99,1%) dan III (0,9%) Vertucci, dan insisivus lateralis maksila diperoleh tipe I Vertucci (100%). Pada Insisivus sentralis mandibula diperoleh tipe I (90%), II (3,6%), III (2,7%), Vertucci dan IV Gulabivala (3,6%), dan insisivus lateralis mandibula diperoleh tipe I (87,3%), II (1,8%), III (7,3%), Vertucci dan tipe IV Gulabivala (3,6%). Pada Deutro-Melayu, insisivus sentralis maksila diperoleh 100% tipe I Vertucci dan insisivus lateralis maksila tipe (99,1%) dan II (0,9%). Pada insisivus sentralis mandibula diperoleh tipe I (85,5%), III (11,8%) Vertucci, IV Gulabivala (1,8%), dan tipe lain 1-2-1-2-1 (0,9%), dan insisivus lateralis mandibula diperoleh tipe I (81,8%) dan III (18,2%) Vertucci. Hasil analisis chi-square diperoleh tidak dijumpai perbedaan signifikan morfologi saluran akar gigi insisivus maksila antara Proto dan Deutro-Melayu dan antara regio kanan dan kiri (p>0,05), namun ada perbedaan signifikan morfologi saluran akar antara gigi insisivus maksila dan mandibula, dan morfologi saluran akar gigi insisivus mandibula antara Proto dan Deutro-Melayu (p<0,05). Sebagai kesimpulan bahwa gigi insisivus maksila dan mandibula sub ras Proto dan Deutro-Melayu memiliki variasi konfigurasi saluran akar dan ada perbedaan dijumpai pada gigi insisivus mandibula.