LABIAL FRENECTOMY-CASE REPORT (FKG UNMAS)

LABIAL FRENECTOMY ALONE OR IN COMBINATION WITH A FREE GINGIVAL AUTOGRAFT

 

HISTORY

Frena, which are triangle-shaped folds found in the maxillary and mandibular alveolar mucosa, are located between the central incisors and canine premolar area. Frena may be long and thin, or short and broad. Labial frenum attachments have been described as mucosal, gingival, papillary, and papilla penetrating (Placek et al. 1974a & b). Insertion points of the frena may become a problem when the gingival margin is involved (Corn 1964). This may be the result of an unusually high insertion of the frenum or marginal recession of the gingiva. High frenal insertion can distend and pull the marginal gingiva or papilla away from the tooth when the lip is stretched. This condition may be conducive to plaque accumulation and inhibit proper oral hygiene. Aberrant frena can be treated by frenectomy or frenotomy procedures. The terms frenectomy and frenotomy signify operations that differ in degree of surgical approach.

Frenectomy is a complete removal of the frenum, including its attachment to the underlying bone, and may be required for correction of abnormal diastema between maxillary central incisors (Friedman 1957). Frenotomy is the incision and relocation of the frenal attachment. Abnormal frenal attachments occur most often on the facial surface between the maxillary and mandibular central incisors and in the canine and premolar areas (Whinston 1956). High frenal attachments on the lingual surface are less common. Orthodontic closure of diastema without excision of the associated frena are clinically associated with relapse separation of the teeth (Edwards 1977). A frenectomy is a simple surgical procedure that can be performed separately (that is, for orthodontic reasons) or in conjunction with a free gingival graft (that is, to treat a gingival

recession, increase the amount of attached gingival, or deepen the vestibule).

 

INDICATIONS

• Eliminate tension on the gingival margin (frenum-pull concomitant with or without gingival recession)

• Facilitate orthodontic treatment

• Facilitate home care

 

ARMAMENTARIUM

This includes the basic kit plus a mosquito hemostat.

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CRUSTED AND CRACKED LIP-CASE REPORT (FKG UI)

“Crusted and Cracked Lip”

Scenario Description
Dewi, a 49 years old, came to RSGM FKGUI with complain of sore in her mouth and its
surrounding. The patient could not eat because of the sore. She said that just before she feels
the mouth sore, she had a cold and drank Sanaflu with antibiotic that she didn’t remember. It
was her first time to suffer this kind of disease. Right now, she feels a bit of fever and
malaise. The patient also said that she had a family history of Diabetes Mellitus. Physical
examination revealed easily bleed ulcerative and vesicle lesion inside the mouth, on the lip
and circum oral. On the lip, there was lesion that covered with blackish red crust.

Her daughter, Cinta, 24 years old, complains of dry and cracked lips since 2 months ago. The
patient said that it happended since she wore a new lip balm. The condition gets worse when
she had extra work from her office, so that she had to work overtime until late at night.
Patient was disturbed by her appearance, but she still could eat normally. Physical
examination showed lip lesion such as dryness, desquamative lesion and a little bit
erythematous. The patient did not have any systemic disease history, but she was smoking
and she did not like to eat vegertables.

Keywords
1. Dewi, female, 49 years old
a. Sore in the mouth and its surrounding
b. Could not eat
c. Had a cold and drank Sanaflu with antibiotic
d. First time to suffer
e. Fever and malaise
f. Family history of Diabetes Mellitus
g. Easily bleed ulcerative and vesicle lesion inside the mouth, on the lip and circum
oral
h. Lesion that covered with blackish red crust on the lip
2. Cinta, female, 24 years old
a. Dry and cracked lip since 2 months ago (since wore a new lip balm)
b. Worse when she work over time
c. Disturbed by her appearance
d. Could eat normally
e. Desquamative and a little bit erythematous lesion
f. Smoking
g. Didn’t like to eat vegetables

Problems
1. What is the relation between the medication that she was taking and her sore mouth?
2. What is the relation between the sore mouth and her fever and malaise? 3. What is the cause of the sore mouth (easily bleed ulcerative and vesicle lesion, also
the blackish red crust which covers lesion)?
4. What is the relation between the lesion and her family history of Diabetes Mellitus?
5. What is the diagnosis of Mrs. Dewi’s oral condition?
6. What is the treatment for Mrs. Dewi?
7. What is the relation between the dry and cracked lips and her lip balm?
8. Why does the lesion get worse when she worked overtime?
9. What is the effect of her smoking habit and not eating vegetables to the lesion?
10. What is the diagnosis of Ms. Cinta’s oral condition?
11. What is the treatment for Ms. Cinta?

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PERIIMPLANTITIS, DIAGNOSA DAN PERAWATAN (FKG UNMAS)

BAB I
PENDAHULUAN
1.1 Latar Belakang
Teknik rehabilitasi gigi berbasis implan/penanaman (implant-based dental) telah hadir untuk menawarkan hasil yang sangat mudah diprediksi, sehingga teknik tersebut menjadi salah satu elemen tambahan yang diikutsertakan dalam berbagai terapi alternatif untuk pasien yang mengalami total atau sebagian edentulous, walaupun telah terjadi beberapa komplikasi seperti yang telah dijelaskan dalam kaitannya dengan jenis pengobatan. Dari komplikasi tersebut, terganggunya pertumbuhan tulang alveolar di sekitar implan mungkin merupakan yang paling menonjol.
Nama penyakit periimplan mengacu pada perubahan inflamasi patologis yang terjadi pada jaringan yang berada disekitar implan. Beberapa penulis menganggap bahwa hal tersebut merupakan komplikasi yang paling umum dalam dental implan.
Dua entitas berikut ini dijelaskan terkait dengan konsep penyakit periimplan:
– Mukositis : manifestasi klinis yang ditandai dengan munculnya perubahan inflamasi yang terbatas pada mukosa periimplan. Jika diobati dengan benar, maka proses tersebut bisa berbalik atau pulih.
– Periimplantitis : manifestasi klinis di mana secara klinis dan radiologis jelas terganggunya tulang pendukung disebabkan karena adanya implan, bersamaan dengan reaksi inflamasi dari mukosa periimplan.
Osseointegrasi didefinisikan sebagai hubungan langsung antara tulang dan implant yang sedang berfungsi, istilah “functioning” menyiratkan bahwa kontak antara tulang dan permukaan implant adalah terjaga saat aktif atau menahan beban. Hal ini juga harus ditekankan ketika mengacu pada periimplantitis. Implan harus “berfungsi”, karena hal ini menyiratkan untuk semua sindrom inflamasi lain yang mengalami gangguan osseointegrasi.
Contoh non-integrasi atau terganggunya osseointegrasi yang tidak bisa dianggap sebagai periimplantitis yaitu proses yang muncul selama periode teoritis osseointegrasi pasif. Biasanya merupakan konsekuensi dari teknik bedah tidak memenuhi standar (pemanasan tulang yang berlebihan) atau kepadatan tulang trabekular yang tidak memadai dalam reseptor.
Periimplantitis apikal yang infeksi periimplannya terletak di daerah apikal implan, juga tidak termasuk dalam kategori penyakit periimplantitis. Hal ini juga mungkin diakibatkan karena adanya kontaminasi implant dengan sandaran epitel Malassez yang tersisa dalam tulang, meskipun ada skala alveolar tepat yang mengikuti ekstraksi/pencabutan gigi yang akan diganti dengan implan.

sumber: perwakilan komisi A psmkgi (2012-2014) FKG UNMAS

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