Diagnosis
No Rencana Perawatan Departemen
1. Gigi 18, 17, 16, 15, 14, 13, 12, 11, - Scalling dan root planing Periodonsia
21, 22, 23, 24, 25, 26, 27, 28, 38, - Occlusal adjustment
37, 36, 35, 34, 33, 32, 31, 41, 42,
43, 44, 45, 46, 47, 48:
Periodontitis Kronis
2. Gigi 21,22 : pulpitis reversible Tumpatan Klas III Konservasi Gigi
3. Gigi 38, 37, 47, 48 : pulpitis Tumpatan Klas I Konservasi Gigi
reversible
4. Gigi 44: pulpitis reversible Mahkota Selubung PFM Konservasi Gigi
5. Gigi 36, 46: periodontitis apikalis Ekstraksi Bedah Mulut dan
kronis e.c. gangren radix Maksilofasial
6.
Gigi 16 dan dan 26 : supraposisi Occlusal adjustment Prostodonsia
7. Gigi 36, 46 : Gigi hilang post Gigi tiruan tetap (GTT) PFM Prostodonsia
pencabutan 35-36-37 dan 45-46-47
8. Maloklusi klas 1 Angle disertai Ortodonti Cekat Ortodonsia
berdesakan anterior rahang atas
dan bawah
Check list kelengkapan :
Noer Ulfah, drg., Dr. Michael Josef Kridanto Calista Dienar F.S.
Sp.Perio.(K)., M.Kes K., drg., M.Kes., Sp.Pros.(K)