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5/11/2018 Immediate Full Over Denture - slidepdf.com
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IMMEDIATE FULL OVERDENTURE
UPPER AND LOWER ARCH
IN PATIENT WITH
AGGRESIVE PERIODONTITIS
Oleh:
Vincentius Harsono, drg., Sp.Pros., SertKGINike Hendrijantini, drg., MKes, Sp.Pros(K)
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LATAR BELAKANG
Kehilangan gigi merupakan masalah yang paling umum terjadi di masyarakat
Bahkan untuk kehilangan sebuah gigi dapatmenimbulkan permasalahan.
kesulitan pengunyahan pergeseran gigi geligi
permasalahan di bidang estetik
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Permasalahan ini
menjadi lebih besar
pada pasien periodontitis agresif
Karena:
terdapat resorbsi alveolar
kegoyangan gigi
Membuat prostesa gigi sulit
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TUJUAN
Untuk membuka wawasan dalammenentukan alternatif perawatan dalam
merawat pasien periodontitis agresif.
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Laporan Kasus
Jenis kelamin : Laki-laki
Usia : 32 th
Pekerjaan : Karyawan
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ANAMNESIS
Keluhan Utama
ingin dibuatkan gigi tiruan
banyak gigi hilang dan goyang
Kesulitan pengunyahan
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Riwayat Geligi:
sejak kecil sering gusi berdarah dan pembengkakan
Dua tahun lalu gigi mulai goyang dan lepas spontan.
Gigi terakhir tanggal yaitu gigi kiri atas belakang,karena lepas spontan beberapa bulan yang lalu
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Pengalaman dengan Gigi Tiruan
belum pernah memakai gigi tiruan.
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Profil
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Foto intra oral
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Pemeriksaan darah:
Glukosa puasa: 104 mg/dL (60-120)
SGOT: 42 U/L (<38)
SGPT: 63 U/L (<41)
ALP: 154 U/L (73-207)
Bilirubun Total: 0.68 mg/dL (<1.00)
Biliribun Direk: 0.06 mg/dL (<0.25)
Albumin: 4.5 g/dL (3.8-4.4)
Blood Urea Nitrogen: 9.7 mg/dL (10.0-20.0)
Kreatinin: 0.87 mg/dL (<1.25)
Asam Urat: 5.6 mg/dL (3.4-5.7)
Kolesterol Total: 144 mg/dL (100-220)
Trigliserida: 169 mg/dL (<150)
Kolesterol HDL: 34 mg/dL (<150)
Kolesterol LDL: 90 mg/dL (<130)
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Status Lokalis
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Foto intra oral
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Foto Panoramik
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Diagnosis
Gigi hilang: 17,16,15,14,11,21,24,26,27,36
Gangraen radix: 46
Nekrosis totalis: 17
Periodontitis agresif :18,13,12,22,23,25,28,37,35,34,33,32,31,41,42,43,44,45,47
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Rancangan Perawatan
• Rahang Atas:
Immediate full overdenturedisertai immediate ekstraksi – Immediate overdenture pada:
13,12,23 – Immediate ektraksi pada 17,27 – Basis dan anasir gigi akrilik
• Rahang Bawah:
Immediate full overdenture – Immediate overdenture pada:
37,35,32,43,44,45,47 – Basis dan anasir gigi akrilik
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TAHAPAN PEKERJAAN
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Foto intra oral setelah pencabutan gigi danperawatan saluran akar
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Simulasi susunan anterior
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Proses meradir gigi
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Proses immediate dekaputasi dan immediateektraksi
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Insersi gigi tiruan immediate
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Kontrol hari 1
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Proses relining
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Kontrol 1 tahun setelah insersi
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Foto sesaat setelah insersi
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Profil setelah perawatan
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PEMBAHASAN
Semua gigi goyang
Pemeriksaan darah lengkap: tidak adakelainan sistemik.
Pemeriksaan lebih lanjut:
periodontitis agresif
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Gigi tertanam 1/3:
Dipertahankan: endodontik - dekaputasi
Minimalkan kekuatan lateralmencegah kegoyangan gigi
Membuat non-fungsi periodontal ligamen
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Pada kasus ini:
RA: immediate full overdenture disertai
immediate ekstraksiRB: immediate full overdenture
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Keuntungan:
memperbaiki penampilan secara cepat
rasa sakit pencabutan berkurang melindungi luka
memudahkan adaptasi setelah insersi
mempertahankan tinggi gigit
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Gigi 17 dan 27:
Goyang º3
dipertahankan sampai dicabut sesaatsebelum insersi
untuk menjaga tinggi gigit penderita
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Prognosis:
Bergantung kemampuan penderita
melakukan pemeliharaan pasca insersiharus diberi pendidikan tentang
kebersihan
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KESIMPULAN
Immediate full overdenture
dapat menjadi alternatif perawatan
dalam merawat pasien periodontitis agresif
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TERIMA KASIH
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