Prorosal Seminar Pdgi Tala 17 Nov Fix

PERSATUAN DOKTER GIGI INDONESIA
INDONESIAN DENTAL ASSOCIATION

CABANG TANAH LAUT
Sekretariat : Jl. A. Yani Km. 8.500 ( Apotek Al Humaini ) No. 44 RT. 011 RW.03
Kel. Manarap Lama, Kec. Kertak Hanyar, Kab. Banjar
Kalimantan Selatan, 70654
Telp : +6281349076222, +6282255322005
Email : pengcab.tanahlaut@pdgi.or.id

PROPOSAL SEMINAR
I. PENDAHULUAN
A. LATAR BELAKANG
Perkembangan ilmu kedokteran gigi dewasa ini sangat pesat menuntut seorang
general praktis maupun spesialis untuk meningkatkan mutu keilmuannya. Hal
ini merupakan suatu kewajiban yang harus disadari oleh setiap dokter gigi.
Ketika kita merasa tidak perlu meningkatkan keilmuan, maka dampak secara
signifikan lambat laun akan kita rasakan, karena kedepan permasalahan
maupun kasus gigi tidak akan stagnan, akan tetapi akan berkembang lebih
pesat, ditambah lagi dengan demand dari masyarakat yang akan sebanding
dengan perkembangan dan pengetahuan masyarakat. Ditahun baru ini dengan
semangat baru di dalam keharmonisan persatuan dokter-dokter gigi
dilaksanaknnya update keilmuan sehingga dapat menjawab tuntutan kesehatan
terkini
B. TEMA
Private Course of Endo Resto with drg. Rio Suryontoro, Sp. KG
C. TUJUAN
Memenuhi kebutuhan update ilmu pengetahuan guna peningkatan
profesionalisme bagi profesi dokter gigi serta meningkatkan rasa persaudaraan
dan keakraban di antara para sejawat dokter gigi.
D. TEMPAT
Hotel Best Western JL. A Yani KM 4,5 Banjarmasin.
E. WAKTU
Tanggal : 17 November 2018
Jam : 08.00 – 18.00 WITA
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

II. DATA PENYELENGGARA
Penyelenggara PDGI CABANG TANAH LAUT

Jl. A. Yani Km. 8.500 ( Apotek Al Humaini ) No. 44 RT. 011 RW.03
Alamat Kel. Manarap Lama, Kec. Kertak Hanyar, Kab. Banjar
Lengkap
Website Facebook PDGI Cabang Tanah Laut
Telpon +6281349076222, +6282255322005
Fax -
E-mail pengcab.tanahlaut@pdgi.or.id
Ketua Panitia Nama : drg. Haeran Kurnia 081321617970
Sekretaris Nama : drg. Karina Ika Putri Sukarno 082255322005
Bendahara Nama : drg. Senja Anisa 082251036065
Nama : drg. I. Gandhi Wati 087704477672
Seksi Acara drg. Catri Era Pakarti 085248609231
drg. Destiya 081254035554
Nama : drg. Erlina Dyah W 081349460772

Seksi Danus drg. Rizki Yulita R 082233442087
dan Humas
085750548145
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

Nama : drg. Diana Susanti 08122120406
Seksi Konsumsi drg. Lidya Lovin 085255718617
Nama : drg. Vina 081321617970

Seksi drg. Heriyadi 085232985668
Dokumentasi
III. BENTUK DAN MATERI KEGIATAN

1. Bentuk dan Metoda Kegiatan
No Bentuk Kegiatan
1. Pemaparan Teori
2. Diskusi Panel
3. Hands-On
2. Fasilitas untuk Sponsor

a. Meja dan kursi di depan ruang seminar
b. Waktu untuk presentasi produk 15 menit (sesuai kesepakatan)
c. Pemutaran video iklan produk (sesuai kesepakatan)
3. Narasumber
Pembicara dalam acara ini terdapat Pembicara tumggal, yaitu :
drg. Rio Suryantoro, Sp.KG
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

CURICULUM VITAE
OBJECTIVE
Person with lifetime commitment and dedication to dental science and practice is seeking
challenge in order to deepen and broaden expertise and analytic in the field of dentistry
STRONG POINTS
Good communication skill. Adaptation to dental clinical problem, and incorporates them to create
dental clinical decisions making solutions. Able to learn new technique in dentistry and implement
it in daily clinical practices with good motoric skill. Having good hospitality spirit to serve patients.
PERSONAL DATA AND PHOTO
Date and Place of birth : Magelang/ December 11st , 1986
Nationality : Indonesia
Mariage Status : Married
Blood Type : O
Height / Weight : 180 cm / 79 Kgs
EDUCATION
 TK Al‐Falah Surabaya; Surabaya (1991‐1992)
 SD HANG TUAH 1 SURABAYA; Surabaya (1992‐1998)
 SMP 49 JAKARTA; Jakarta (1998‐2001)
 SMA 14 JAKARTA; Jakarta (2001‐2004)
 Faculty of Dentistry, Universitas Indonesia (FKG UI); GPA 3,77 of 4; Jakarta (2004‐2009),
Sertified as a Cumlaude student with the higest GPA by Universitas Indonesia
 Faculty of Dentistry, Universitas Indonesia (FKG UI) Specialist Educational Program on
Conservative Dentistry; GPA 3,70; Jakarta (2010 – 2012)
INFORMAL EDUCATION AND ACHIEVEMENT PRE UNIVERSITY
No Descriptions Year
1 Lembaga Bahasa & Pendidikan Profesional LIA; successfully completed a 176‐ Q1 2001
hour course in General English: Basic Levels; Jakarta.
hour course in General English: Intermediate Levels; Jakarta.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

hour course in General English: Advanced Levels; Jakarta.
ORGANIZATIONS AND COMMITTEE
1 Coordinator of Security committee in “Celebration Day 2004”; Faculty of Q4 2004
Dentistry, Universitas Indonesia, Jakarta.
2 Member of External Relationship Committee in “Dentistry fair 2005”; Faculty of Q2 2005
Dentistry, Universitas Indonesia, Jakarta.
3 Member of Equipment Committee in “Pengenalan Sistem Akademik Universitas Q2 2005
(PSAU) FKG UI 2005”, Faculty of Dentistry, Universitas Indonesia, Jakarta.
4 Coordinator of Equipment Committee in “SAHARA 2005”; Faculty of Dentistry, Q3 2005
Universitas Indonesia, Jakarta.
5 Project Officer of “Jambore Bakti Sosial 2006”; Bandung, West Java, Indonesia. Q1 2006
6 Member of Supervisor Committee of “Seleksi Penerimaan Mahasiswa Baru Q2 2006
(SPMB) 2006”; Jakarta.
7 Coordinator of Vital Support Committee of “Masa Bimbingan Mahasiswa Baru Q4 2006
Fakultas Kedokteran Gigi Universitas Indonesia tahun 2006”; Faculty of Dentistry,
Universitas Indonesia, Jakarta.
8 Member of Security section of “14th Scientific Meeting & Refresher Course in Q4 2006
Dentistry, Faculty of Dentistry, Universitas Indonesia”; Jakarta Convention Center
9 Member of Steering committee of “Jambore Bakti Sosial 2007”; West Java. Q2 2007
10 Project officer of “Pengenalan Sistem Akademik Universitas Fakultas Kedokteran Q3 2007
Gigi Universitas Indonesia Tahun 2007”; Faculty of Dentistry, Universitas
Indonesia, Jakarta.
11 Member of Steering Committee of “Jambore Bakti Sosial 2008”; west Java. Q2 2008
12 Chief of exhibition committee of “15th Scientific Meeting & Refresher Course in Q3 2009
Dentistry, Faculty of Dentistry, Universitas Indonesia”; Jakarta Convention Center
13 Chief of “Seminar Sehari Penyegaran Keterampilan Dasar Dokter Gigi”; aula FKG Q1 2010
UI, Jakarta
14 Chief of “Sumpah Dokter Gigi dan Penglepasan Spesialis, Magister dan Doktor Q1 2010
FKG‐UI periode April 2010”, Faculty of Dentistry, Universitas Indonesia; Balai
Sidang BNI (Kampus UI Depok)
15 Committee of “Jakarta Great Dentistry – Membangun Sikap Profesional Dalam Q2 2010
Praktik Kedokteran Gigi Sehari‐hari”, PDGI Jakarta Pusat, Auditorium RSPAD
Gatot Subroto, Jakarta.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

OUTLINE OF COURSE AND SEMINAR
No Description Year SKP
1 Seminar Career Days; “Make Up Your Mind for the Future Dentist”; Q4 2005 2
Graha Wisata Kuningan.
2 Direktorat Kemahasiswaan & Hubungan Alumni beserta Badan Q1 2006 ‐
Eksekutif Mahasiswa Universitas Indonesia; “Seminar Karya Tulis
dan Kreativitas Mahasiswa”; Kampus UI, Depok.
3 Kajian Ilmiah Keislaman; “Perkembangan Forensik Dalam Q2 2006 2
Kedokteran Gigi dan Islam”; Auditorium Kampus B Trisakti, Jakarta.
4 The Jakarta International Association of Oral and Maxillofacial Q1 2007 6
Surgeons; “Educational Program: Maxillofacial Trauma”; Jakarta.
5 Faculty of Dentistry, Universitas Indonesia; “Recode Your Change DNA”; Q2 2007 2
Aula Kampus FKG UI, Jakarta.
6 Dentistry Scientific Meeting; “Appropriate Technology Supporting Q2 2007 4
Dental Services”; Ladokgi Jakarta.
7 Jakarta Islamic Scientific Forum; “Hypnodentistry: Application, Ethics, Q4 2007 3
and Islamic Perceptions”; Auditorium Kampus B Trisakti, Jakarta.
8 Lotte Xylitol; “Xylitol and Dental Caries Prevention”; Aula FKG UI, Jakarta Q2 2008 2
9 Dentistry Scientific Meeting 3rd; “Inside Out Report: Indonesian Dentist Q4 2009 5
vs Global Challenge”; Gd. Dikti, senayan, Jakarta.
10 Fakultas Kedokteran GIgi Universitas Indonesia; “Tooth bleaching in Q1 2010 2
daily practice”; aula FKG UI, Jakarta
11 Ikatan Prostodonsia Indonesia; “Advance Prosthetic Seminar”; RSPAD Q2 2010 4
Gatot Subroto, Jakarta.
12 BEM FKG UI; Seminar “4th Denstistry Scientific Meeting – aestethic Q3 2010 5
Dentistry in Clinical Practice”; Menara hijau, Jakarta
13 BEM FKG UI; Hands on “Komposit Kelas IV, Tata laksana Perawatan Q3 2010 3
Dengan Pasak Fiber dan Inti Komposit, dan Teknik Aplikasi Fissure
Sealant ‐ 4th Denstistry Scientific Meeting – aestethic Dentistry in Clinical
Practice”
14 ILUNI FKG UI; “Dental Career Development”; Graha Jala Puspita, Q2 2011 5
14‐15 Mei 2011, Jakarta
15 Sensodyne Round Table Discussion; “Preventing hypersensitivity during Q2 2011 ‐
and post Tooth Bleaching”; Handayani Restaurant
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

16 Kongres IKORGI IX & Seminar ILmiah Nasional; “Recent Adances in Q4 2011 7
Conservative Dentistry”; Held by Indonesian Association of Conservative
Dentistry as a Participant; Surabaya, November 25th‐27th 2011.
17 Seminar and hands on in 8th FDI‐IDA Joint Meeting and Exhibition 2012. Q4 2012 7
November 16th‐18th 2012, Santika Dyandra Convention Centre Medan. as
participant.
18 Complimentary Seminar Pre the 8th FDI‐IDA Joint Meeting and Q4 2012 4

Exhibition 2012. November 16th‐18th 2012, Santika Dyandra Convention
Centre Medan. as participant.
19 Seminar at “the 16th Scientific Meeting and Refresher Course in Q1 2013 7
Dentistry”, Held by faculty of Dentistry, Universitas Indonesia; Jakarta,
February 27 – March 2, 2013 (17 Hours)
20 Participant of Seminar Ilmiah Nasional IKORGI 2013 (SINI 2013) Q4 2013 6+3
“Interprofessional Implementation of Technology, Art, and Science for
Conservative Dentistry”; held by Indonesian Association of Conservative
Dentistry. At Grand Inna Beach Hotel, Denpasar, November 29th‐30th,
2013.
21 Participant of 17th Scientific Meeting and Refresher Course in Dentistry. Q1 2016 6,5
Held by Faculty of Dentistry Universitas Indonesia. At Jakarta, February
24th – 27th, 2016
22 Seminar and Hands on Participant of the International Scientific Q4 2017 9,5 +
Meeting (TINI IV) and IKORGI National Congress IX. Held by Indonesian 3,5
Conservative Dentistry Association. At Shangri‐La Hotel Surabaya,
November 3rd‐5th 2017
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

OUTLINE OF SPECIALIZED COURSE AND SEMINAR
No Description Year SKP
1 Lecture of Simplifying Endodontic Treatment: A safer technique ini Q4 2010 2
orifice opening and root canal reflaring. By Prof. Patrick S. K.Tseng
BDS., MSc. Held by Indonesian Association of Conservative Dentistry as a
Participant; Jakarta, November 25th 2010.
2 Lecture and Workshop Seminar of Advance Technology in Endodontic Q2 2012 2+2
Treatment and Restoration.
By Dr. Nicola M. Grande, DDS, PhD &Dr. Felix Wohrle. Held by
Indonesian Association of Conservative Dentistry as a Participant;
Jakarta, 27 May 2012. at Pullman Jakarta Central Park Hotel.
3 Esthetic Hands‐on Course “Anterior and Posterior Composite Q2 2012 2
Restoration: Achieving Esthetic with Simplicity”
by Dr. Rafael Beolchi, Msc. Held by Indonesian Association of
Conservative Dentistry as a Participant; Jakarta, 31 May 2012
4 Esthetic Hands‐on Course “Re‐inventing Your Dental Practice: Q2 2012 2
Whitening & Marketing” by: Dr. Mary Jean V. Gallindez. Held by
Indonesian Association of Conservative Dentistry as a Participant;
Jakarta, 1 June 2012. at Pullman Jakarta Central Park Hotel.
5 Lecture and Hands on “The New Direct Composite Veneering Q4 2012 5
System
ComponeerTM” by: Dr. Mario Besek. Held by Indonesian
Association of
Conservative Dentistry as a Participant; Jakarta, August 3rd,
2012. at Pullman Jakarta Central Park Hotel.
6 Simplicity in Endodontic “Achievable Goal” by: Prof. Dr. Sergio Q4 2012 2
Kuttler, BS., DDS. Held by Indonesian Association of
Conservative Dentistry as a Participant; Jakarta, September 4th
2012. at Pullman Jakarta Central Park
Hotel.
7 Lecture of Successful Endodontics With Single File Reciprocating Q1 2013 2
System by: Dr. Philippe Guttier. Held by Indonesian Association
of Conservative Dentistry as a Participant; Jakarta, March 23rd,
2013. at
Pullman Jakarta Central Park Hotel.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

8 Lecture of Esthetic and functional rehabilitation of complex Q4 2013
cases with new restorative materials by Dr. Daniel Edelhoff
C.D.T., Dr. Med. Dent., Ph.D. in Dental competence 2013 by
Ivoclar‐vivadent Indonesia;
Jakarta, August 31st, 2013
9 Lecture of Mastering large Composite restorations with modern Q4 2013
materials by Dr. Markus Lenhard. in Dental competence 2013
by Ivoclar‐vivadent Indonesia; Jakarta, August 31st, 2013
10 Lecture of Clinical and Biological Realities in The Endodontic Q4 2013

Technological Explosion by Dr. James L. Gutmann. Held by
Indonesian Association of Conservative Dentistry as a
Participant; Jakarta,
November 21th, 2013 at Pullman Jakarta Central Park Hotel
11 Lecture of A Breakthrough Shaping Technique Using The Latest Q1 2014
Ni‐Ti Instrumentation & Adaptive Motion Technology by Dr.
Gary Glassman, DDS, FRCD (C). Held by Indonesian Association
of Conservative Dentistry as a Participant; Jakarta, January 19th
2014. at Pullman Jakarta Central
Park Hotel
12 Lecture of New Aspects Of Restorative, Esthetic, And Surgical Q2 2014
Dentistry by Dr. Gordon Christensen. Held By Persatuan Dokter
Gigi Indonesia
cabang Jakarta Pusat; Jakarta, April 2nd, 2014. At Le Meridien
Hotel.
13 Lecture and Hands‐on Training of Predictable and achievable in Q4 2014
Posterior Composite Restoration by Prof. Dr. Peet van der
Vyver. Held
by Dentsply Asia Train The Trainer Program. Hongkong, Sept.
19th 2014.
14 Lecture and Hands‐on Training of Anterior Restoration (Class IV
and Veneer) by Dr. Walter Diaz. Held by Dentsply Asia Train The
Trainer
Program. Bangkok, Feb 2nd and 3rd 2015.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

15 Lecture of “Adhesive Dentistry – So You Think You Can Bond? Q1 2015
And New Materials In Restorative Dentistry” by Dr. Marc
Geissberger, DDS., M.A., CPT. Held By Indonesian Association of
Conservative Dentistry.
Jakarta, March 14th 2015.
16 Asia Endo Forum 2015, Key Opinion Leader Discussion, Sharing, and Q2 2015
Training. Grand Hyatt Hotel Nusa Dua Bali, Bali May 25‐29th, 2015.
17 Lecture “Latest Trends in Endodontic: Glide Path Creation with Q2 2015
Proglider, Root Canal Shaping with Protaper Next, and Obturation with
Gutta Core Obturation” by Prof. Dr. Giuseppe Cantator. Held By
Indonesian Association of Conservative Dentistry, Jakarta. June 1st, 2015.
18 Asia Pacific Key Opinion Leaders Scientific Symposium by 3M Heath Q3 2015
Care Academy. Seefeld, Germany. July 6th to July 10th 2015
19 Lecture and Hands‐on of Endodontic Field with mastering Wave‐on Q1 2016
Gold by Dr. Wilhelm Pertot. Held by Dentsply Asia on Train The Trainer
Program. At Jakarta, March 2016.
20 Lecture of Minimally Invasive Tooth Preparation Techniques A to Z by Q1 2016
Dr. Galip Gurel. Held by Ikatan Prosthodonsia Indonesia (Indonesian
Prostodontist Association). At Jakarta, March 24th 2016.
21 Lecture on One Day seminar “Hot Topics In Esthetic Dentistry, Q2 2016
Restorative Dentistry, Dental Ceramic, and Adhesion by Dr. Edward A.
McLaren, DDS, MDC. And Dr. Johan Figuera, DDS. Held by Ikatan
Prosthodonsia Indonesa (Indonesian Prosthodontist Association). At
Jakarta, June 26th 2016.
22 Lecture on “3D Endodontics: Management of Complex Canals” by Prof. Q2 2016
Dr. Gianluca Gambarini. Held by Ikatan Konservasi Gigi Indonesia
(Indonesian Conservative Dentistry Specialist Association). At Jakarta,
July 21th, 2016.
23 Lecture of “Style Italiano Advanced: The Complete Course” by Dr. Q2 2016
Angelo Putignano. Held by Ikatan Konservasi Gigi Indonesia (Indonesian
Conservative Dentistry Association). At Jakarta, July 25th, 2016.
24 Lecture Of “How To Create A High Esthetic Smile with Minimal Invasive Q4 2016
Technique” By. Dr. Yoshitaka Nijitomi, DDS, MS. Held by Ikatan
Konservasi Gigi Indonesia (Indonesian Conservative Dentistry
Association) branch Jakarta Barat. At Jakarta, September 17th‐18th, 2016.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

25 Lecture of “Rationale of root canal preparation: it is about cleaning the Q4 2016
systems” by: Dr. Marino Sutedjo. Held by Ikatan Konservasi Gigi
Indonesia (Indonesian Conservative Dentistry Association) branch of
West Jakarta. At Swiss‐bell Hotel Mangga Besar, October 9th, 2016
26 Lecture of “The Gold Pathway to Success in Root Canal Procedure” By: Q4 2016
Prof. James L. Gutmann. Held by Ikatan Konservasi Gigi Indonesia
(Indonesian Conservative Dentistry association) branch of West Jakarta.
At Midplaza Hotel, November 16th, 2016
27 Lecture of Endodontic Procure on Dentsply Sirona Dental Insight 2017. Q1 2017
By: Prof. Simone Grandini and Dr. Marino Sutedjo. Held by: Ikatan
Association) branch of Central Jakarta. At Intercontinental Jakarta
MidPlaza Hotel, March 4th 2017
28 Lecture of “Advance Science Applied In Daily Dentistry” with multiple Q2 2017

lecturers. Held by: Ikatan Konservasi Gigi Indonesia (Indonesian
Conservative Dentistry Association) branch of Central Jakarta. At
Shangri‐La hotel Jakarta, 20th‐21st may 2017.
29 Lecture of “Root Canal Instrumentation and Outcome of Endodontic Q2 2017
Treatment with CBCT” by: Prof. Francesco Mannocci. Held by Ikatan
Konservasi Gigi (Indonesian Conservative Dentistry Association) branch
of Central Jakarta. At Jakarta, June 6th, 2017.
30 Lecture of “Simplification in Minimal Invasive Root Canal Preparation: Q4 2017
How To Obtain The Best Results in The Easiest Way With 2shape Rotary
System. Held by: Ikatan Konservasi Gigi Indonesia (Indonesian
Conservative Dentistry Association) branch of Central Jakarta. Jakarta,
October 17th, 2017.
31 Lecture and Hands on of “Esthetic dentistry with composite resin: Q4 2017
Mastering the art” by: Dr. Mauriciou Watanabe. Held by Ikatan
Association) branch of Central Jakarta. At Fairmont Hotel, November
26th‐27th 2017.
32 Lecture of “New Innovations in Glide Path Management and Shaping Q1 2018
Canals with Gold Technology” by: Dr. Julian Webber, DDS, MS, DGDP,
FICD. Held by Ikatan Konservasi Gigi Indonesia (Indonesian Conservative
Dentistry Association) branch of Central Jakarta. At Ayana Hotel,
Sudirman, Jakarta, March 11th, 2018
33 Lecture and Hands on of “What Modern Endodontics Are” by: Dr. Moh’d Q2 2018
Hammo., BDS., DESE. Held by Ikatan Konservasi Gigi Indonesia
(Indonesian Conservative Dentistry Association) branch of Central
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

Jakarta. At Hotel Harris Vertu, Jakarta, April 22nd‐23rd, 2018
PRACTICE EXPERIENCE
No Description Year
1 Jakarta Dental Specialist (JADES), Melawai – South January 2010 – September 2010
jakarta
2 D’smiley Dental Clinic, Cipete – South Jakarta February 2011 – May 2011
3 RS. Admira, Pulomas – East Jakarta November 2011 – June 2012
4 Max Dental Centre , Pramuka‐salemba – Centre Jakarta January 2010 – August 2013
5 Positive Dental Clinic, Slipi – West jakarta August 2010 – August 2016
6 All Care Dental Centre – South Jakarta July 2012 – December 2016
7 Estetika Dental – Centre Jakarta May 2014 – December 2016
8 Mayapada Hospital Lebak Bulus – South Jakarta April 2014 – Now
9 Private Practice at Tebet November 2016 ‐ Now
SPEAKER AND MODERATOR
No Description Year
1 Moderator of “Seminar Nasional Holistic Dentistry 2010 – Kondisi Q3 2010
Periodontal yang Harus Diperhatikan Sebelum Memasang Implant”,
PDGI depok, Gd. Graha Jala Puspita, Jakarta
2 Moderator of “Seminar 4th Denstistry Scientific Meeting – aestethic Q3 2010
Dentistry in Clinical Practice”; BEM FKG UI, Menara hijau, Jakarta
3 Moderator of “Seminar Jakarta Islamic Scientific Forum 2010 – Smile Q4 2010
Make Over In Islamic Perception”: Jakarta, 23‐24 Oktober 2010
4 Moderator of “Seminar 5th Dentistry scientific Meeting”; BEM FKG UI Q2 2011
5 Speaker (short lecture) of Kongres IKORGI IX & Seminar ILmiah Nasional; Q4 2011
“Removing Broken Instrument In The Root Canal During Retreatment
Using Bypass Technique: A Case Report”; Surabaya, 25‐27 November
2011
6 Moderator in Dentistry Scientific Meeting (DSM) FKG UI “Iatrogenic Q3 2012
Cases in Dental Practices”; 23‐24 Juni 2012
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

7 Speaker (Hands On) in Dentistry Scientific Meeting (DSM) FKG UI Q3 2012
“Iatrogenic Cases in Dental Practices”; 23‐24 Juni 2012
8 Speaker (Poster) in Dental Courses Forum FOKUS 2012 Faculty Of Q4 2012
Dentistry Universitas Trisakti; “Post Endodontic Restoration Using
Modified Composite Onlay: A case report”; October 11th‐13th, 2012; Balai
Kartini, Jakarta‐Indonesia.
9 Speaker (short lecture) in 8th FDI‐IDA Joint Meeting and Exhibition 2012; Q4 2012
“Post Endodontic Restoration Using Fiber Reinforced Composite Resin: A
Case Report”; November 16th‐18th 2012, Santika Dyandra Convention
Centre Medan
10 Speaker (short lecture) at “the 16th Scientific Meeting and Refresher Q1 2013
Course in Dentistry”; “Post Endodontic Restoration Using Composite
Onlay: A Case Report”; Held by faculty of Dentistry, Universitas
Indonesia; Jakarta, February 27 – March 2, 2013 (17 Hours)
11 Speaker (main lecture and Hands on) of the Dentistry Scientific Q4 2013
Meeting “Clinical Aesthetic Update” – Clinical update of Dentistry
Knowledge (Claustrum); held by Dentistry Study Program – Faculty of
Medicine Universitas Sriwijaya. November 9th, 2013 at Hotel Graha
Sriwijaya, Palembang, South Sumatera.
12 Speaker (main lecture) of Bogor Dentistry 8 “Upgrading Comprehensive Q4 2013
Diagnosis and Clinical in Dental Practice”; Held by Persatuan Dokter Gigi
Indonesia Kota Bogor, October 26‐27th, 2013. At Botani Square Bogor,
Kota Bogor.
13 Speaker (main lecture and Hands on) of the Jakarta Islamic Scientific Q4 2013
Forum 2013 Seminar “Complication in Dentistry”; Held by Jakarta
Islamic Scientific Forum, November 23‐24th, 2013. At Badan Pengkajian
dan Penerapan Teknologi (BPPT), Jakarta.
14 Speaker (short lecture) of Seminar Ilmiah Nasional IKORGI 2013 (SINI Q4 2013
2013) “Interprofessional Implementation of Technology, Art, and
Science for Conservative Dentistry”; held by Indonesian Association of
Conservative Dentistry. At Grand Inna Beach Hotel, Denpasar, November
29th‐30th, 2013.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

15 Speaker (main lecture) of Cilegon Dentistry “theme: Pentingnya Q1 2014
Restorasi Yang Baik Dalam Pemeliharaan Jaringan Periodontal””; held
by Indonesia Dentists Association Branch Cilegon. At Sari Kuring Hotel,
Cilegon, February 15th, 2014.
16 Speaker (main lecture) of East Jakarta Dentistry 2014 “Clinical Q2 2014
Approach on Complication of Posterior Composite Restoration”; held
by Persatuan Dokter Gigi Indonesia (Indonesia Dentists Association)
Branch East Jakarta. At Happy Tooth Family Dental Clinic, Jakarta, May
2014.
17 Speaker (main lecture) and Table Clinic Lecture in 2nd Dental Research Q4 2014
Exhibition and Meeting “Strategic Achievement for Dental Care in
Multidisciplinary Approach”. Organized by Dental School,
Muhammadiyah University of Yogyakarta. September 5th and 6th 2014 At
Royal Ambarukmo Hotel Yogyakarta.
18 Speaker (main lecture) of Pendidikan dan Pelatihan Proffesionalisme Q4 2014
Kedokteran Gigi Berkelanjutan “Upgrading Knowledge in Preventive,
Curative, and Rehabilitation for Patient’s Satisfaction”. Held by
Indonesia Dentists Association Branch Bandar Lampung. At Begadang
Resto Bandar Lampung, September 20th 2014.
19 Speaker (Main lecture) of One Day Restodontic Gathering with theme Q4 2014
“Pre and Post Endodontic Restoration: A Clinical Approach”. Held by
Indonesia Dentists Association Branch Jakarta Timur. At Gran Melia
Hotel, November 16th, 2014.
20 Speaker (Main lecture) and table clinic of Seminar Sehari Ulang Tahun Q1 2015
Ke‐9 RSGM Prof. Soedomo. With theme “Basic Principle in Clinical
Practice”. Held by Rumah Sakit Gigi & Mulut Prof. Soedomo Fakultas
Kedokteran Gigi Universitas Gajah Mada. (PDGI (Indonesia Dentists
Association) Branch Sleman). At RSGM Prof. Soedomo, UGM. Jogjakarta,
January 7th 2015.
21 Speaker (Main Lecture) and Table Clinic of One Day Restodontic Q1 2015
Seminar with Theme “Clinical Case and Supportive Review Of Post
Endodontic Restoration. Held by Faculty of Dentistry, Moestopo
University. Jakarta, March 28, 2015.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

22 Speaker and Hands‐On Instructure on FORIL XI Trisakti 2015 an Q2 2015
International Seminar and Dental Expo, with theme “Management
Proximal Contact of Class II Resin Composite Restoration”. Held by
Faculty of Dentistry, Trisakti University, April 9‐11th 2015. Jakarta.
23 Speaker on Workshop Peningkatan Pelayanan Kesehatan Gigi dan Q2 2015
Mulut. Held by Pusat Kesehatan dan Kedokteran POLRI. Jakarta, April
15th – 17th 2015.
24 Speaker and Hands‐On Instructure on Jambi Dentistry III, with theme Q2 2015
“Management of Proximal Contact of Class II Composite Resin
Restoration”. Held by Persatuan Dokter Gigi Indonesia (Indonesia
Dentists Association) Branch Jambi. Jambi, April 26th, 2015.
25 Speaker and Hands‐On instructure on Karawang Dentistry 2015. Held Q2 2015
by Persatuan Dokter Gigi Indonesia (Indonesia Dentists Association)
Branch Karawang, West Java. May 10th, 2015.
26 Speaker and Hands‐On Instructure on PDGI Kuningan, west Java, with Q2 2015
theme “Creating A Predictable and Achieveable Proximal Contact In
Posterior Teeth”. Held by Persatuan Dokter Gigi Indonesia (Indonesia
Dentists Association) Branch Kuningan, west Java. June 7th, 2015.
27 Speaker and Hands‐on Instructure on Balikpapan Dentistry 2015, East Q2 2015
Borneo. With theme “Profesionalism in Aesthetic Dentistry”. Held by
Indonesia Dentists Association Branch Balikpapan, East Kalimantan
(Borneo). June 13th‐14th, 2015.
(28 Speaker and Hands‐on Instructure on Bandung Barat’s One Day Q3 2015
Seminar “Simplicity: Simple and Applicable Techniques For General
Practitioners”. Held by Persatuan Dokter Gigi Indonesia (Indonesian
Dental Association) Branch Bandung Barat, West Java. August 8th, 2015.
29 Speaker and Hands‐on Instructure on Samarinda Dentistry 2015 Q3 2015
“Improving Advance Skills In Daily Practice”. Held by Persatuan Dokter
Gigi Indonesia (Indonesia Dentists Association) Branch Samarinda, East
Borneo. August 9th 2015.
30 Speaker and Hands‐on Instructure on “Periodontal Update 3”. Held By Q3 2015
Ikatan Periodonsia Indonesia (IPERI) – Indonesian Association of
Periodontist, in Medan, North Sumatera, September 4th‐5th, 2015.
31 Speaker and Hands‐On instructure of Management of Proximal Contact Q3 2015
in Posterior Restoration with Composite Resin and GIC. Held by
Persatuan Dokter Gigi Indonesia (Indonesian Dental Association) Branch
Lampung Tengah. In Bandar Lampung, September 19th, 2015.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

32 Hands‐on Instructure of Achieveable Clieaning and Shaping in Q4 2015
Endodontic Treatment. Held by Persatuan Dokter Gigi Indonesia
(Indonesian Dental Association) Branch Jakarta Barat. On Jakarta,
october 1st, 2015.
33 Hands‐on Instructure of Creating a Predictable and achieaveable Q4 2015
Proximal Contact in Posterior Tooth. Held by Persatuan Dokter Gigi
Indonesia (Indonesian Dental Association) branch Jakarta Pusat. On
Jakarta, October 4th, 2015
34 Hands‐on and Lecture of Endodontic Treatment “From Apical to Q4 2015
Coronal: Clean and Shape, whats Next?”. In Jakata East Dentistry 2015
held by Persatuan Dokter Gigi (Indonesian Dentists Association) Jakarta
Timur. At Jakarta, November 8th 2015.
35 Hands‐on Instructure of Achieveable Clieaning and Shaping in Q4 2015
Endodontic Treatment. Held by Persatuan Dokter Gigi Indonesia
(Indonesian Dental Association) Branch Jakarta Barat. At Jakarta,
November 19st, 2015.
36 Speaker on 17th Scientific Meeting and Refresher Course in Dentistry. Q1 2016
Held by Faculty of Dentistry Universitas Indonesia. At Jakarta, February
24th – 27th, 2016
37 Speaker and Hands‐on Instructor of Aesthetic Post Endo Restoration on Q2 2016
“The Secret Aesthetic”. Held by Persatuan Dokter Gigi Indonesia
(Indonesian Dentist Association) branch Mataram. At Lombok, April 1st
2016.
38 Main Speaker and Hands‐on of Aesthetic Post Endo Restoration on “The Q2 2016
Secret Aesthetic”. Held by Persatuan Dokter Gigi Indonesia (Indonesian
Dentist Association) branch Mataram. At Bali, April 2nd,
2016.
39 Main Speaker and Hands‐on on 4th Tangerang Dentistry with theme “ Q2 2016
Update Your Practice With Current Trend And Applicable Dentistry. Held
by Persatuan Dokter Gigi Indonesia (Indonesian Dentist Association)
branch Tangerang. At Menara Top Food Alam Sutera, April 24th 2016.
40 Speaker On Denspire 4.0 Denspiration “How Passion Create Your Q4 2016
Success”. Held By Faculty of Dentistry, Universitas Indonesia. At Jakarta,
September 17th, 2016.
41 Main Speaker and Hands‐on at PIT‐8 (Pekan Ilmiah Nasional) UNJANI. Q4 2016
“Shaping Basic Science In Dentistry, that we need today!”. Held By.
Faculty of Medicine Universitas Jendral Ahmad Yani. At Bandung,
October 14th‐15th 2016.
42 Main Speaker and Hands‐on at Continuing Profesional Development Q4 2017
Bakti Sosial, seminar, & Hands‐on. Held by Indonesian Dentists
Association (PDGI) branch of South Jakarta. At Jakarta, November 2nd
and 3rd 2017.
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

43 Main Speaker and Hands‐on at Seminar Ilmiah, Hands On, dan Q1 2018
Pelantikan PDGI Pengcab Pontianak dan Pengwil Kalbar Periode 2017‐
2020. Held by Indonesian Dentists Association (PDGI) branch of
Pontianak. At Pontianak, February 24th‐25th 2018.
44 Main Speaker and Hands‐on at West Jakarta Dentistry. Held by Q1 2018
Indonesian Dentists Association (PDGI) branch of Jakarta Barat. At
Jakarta, March 10th‐11th, 2018.
45 Main Speaker and Hands‐on at Pepsodent Dental Expert Centre. Held Q2 2018
by Indonesian Dentists Association (PDGI). At Jakarta, April 26th, 2018.
46 Main Speaker and Hands‐on at The 1st Greaters Lombok Annual Dental Q2 2018
Seminar 2018. Held by Indonesian Dentists Association (PDGI) branch of
Mataram. At Lombok, 27th‐28th, 2018.
47 Main Speaker and Hands‐on at Bali International Dental Symposium. Q2 2018
Held by School of Dentistry Faculty of Medicine Udayana University. At
Bali, May 10th‐12th 2018
ACHIEVEMENT
1 Faculty Of Dentistry, Universitas Indonesia (FKG UI); Best Student with Q1 2010
highest GPA, 3,77 of 4.
2 Kongres IKORGI IX & Seminar Ilmiah Nasional; 2nd Winner of Scientific Q4 2011
Award: Surabaya, 25‐27 November 2011
3 FDI‐IDA Joint Meeting and Exhibition 2012; 1st winner, The Best Of Case Q4 2012
Report Paper
4 Certified Trainer in Endodontics by Dentsply International. Awarded in Q1 2013
Jakarta at February 2013. (1st part with hands‐on mastering Protaper
Universal)
5 Certified Trainer in Posterior Restorative by Dentsply International. Q4 2014
Awarded in Hongkong at September 2014. (1st part with hands‐on
mastering class II restoration with minimal remaining tooth structure)
6 Certified Trainer in Anterior Restorative by Dentsply International. Q1 2015
Awarded in Bangkok at February 2015. (2nd part with hands‐on
mastering class IV and Labial Veneer restoration with composite resin)
7 Certified Trainer in Endodontics by Dentsply International. Awarded in Q1 2016
Jakarta at February 2016. (2nd part with hands‐on mastering WaveOne
Gold)
8 Author of CeritaPasienRio.com; case reports and discussion of operative Q4 2011 –
dentistry dentistry and endodontic delivered in Bahasa Indonesia now
9 Author of SekilasKonservasiGigi.Com; a case report presentation Q1 2015 –
delivered in english version. A conservative dentistry at a glance. now
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

4. Susunan Acara :
WAKTU (WITA) ACARA
1 07.30 – 08.15 Registrasi
2 08.15 – 09.00 Pembukaan oleh MC
Menyanyikan lagu Indonesia Raya dan Mars PDGI
Sambutan Ketua Panitia Seminar
Sambutan Ketua PDGI Cabang Tanah Laut
Sambutan Ketua PDGI Pengwil Kalimantan Selatan
Pembacaan Do’a
8 09.00 – 11.00 Enjoying Basic Endodontic Protocols in Cleaning and

Shaping the Root Canal
9 11.00 – 13.00 Simply Practice of Managing Pre and Post Endodontic

Restoration
10 13.00 – 14.00 ISHOMA
11 14.00 – 16.30 Hands On I

Enjoying Basic Endodontic Protocols in Cleaning and
Shaping the Root Canal
CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

12 16.30 – 18.30 Hands On II
Simply Practice of Managing Pre and Post Endodontic
Restoration
13 18.30 – 19.00 Selesai

IV. PESERTA
a. Kriteria Peserta : dokter gigi

Mahasiswa Kedokteran Gigi
b. Perkiraan Jumlah Peserta :
- Seminar : 100 orang
- Hands-On : 60 orang
c. Cakupan Wilayah Peserta : Semua Dokter Gigi di Wilayah
Kalimantan Selatan dan dari Provinsi lain
V. ANGGARAN
a. Anggaran yang di butuhkan :
NO JENIS PEMBIAYAAN RINCIAN TOTAL
1 Konsumsi Peserta Seminar / 100 orang x Rp Rp 25.000.000,-

Hari I (Full day) 250.000,-
2 Honor pembicara Seminar 1 orang Sponsorship
3 Honor pembicara Hands On 1 orang Sponsorship

CABANG TANAH LAUT
Telp : +6281349076222, +6282255322005

5 Souvenir Pembicara 1 orang x Rp Rp 500.000,-
500.000,-
6 Akomodasi dan Transport 1 orang x Rp Rp 2.000.000,-

pembicara 2.000.000,-
7 Pembuatan spanduk, backdrop, Rp 5.000.000,-

sertifikat,undangan, leaflet, dll
8 Operasional Seminar dan Rp 7.500.000,-

Hands On
TOTAL Rp 40.000.000,-
a. Sumber Anggaran
1. Biaya partisipasi peserta seminar ilmiah
2. Biaya peserta Hands On
3. Sponsorship
4. Usaha lain yang tidak mengikat
Mengetahui Panitia Kegiatan
KETUA PDGI CAB TANAH LAUT KETUA PANITIA
drg. Budi Rukhiyat drg. Haeran Kurnia Husen

NPA. 2105. 14417 NPA. 2105. 12211

Prorosal Seminar Pdgi Tala 17 Nov Fix

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Prorosal Seminar Pdgi Tala 17 Nov Fix

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PERSATUAN DOKTER GIGI INDONESIA

INDONESIAN DENTAL ASSOCIATION

Penyelenggara PDGI CABANG TANAH LAUT

Website Facebook PDGI Cabang Tanah Laut

Telpon +6281349076222, +6282255322005

Ketua Panitia Nama : drg. Haeran Kurnia 081321617970

Sekretaris Nama : drg. Karina Ika Putri Sukarno 082255322005

Bendahara Nama : drg. Senja Anisa 082251036065

Nama : drg. I. Gandhi Wati 087704477672

Seksi Acara drg. Catri Era Pakarti 085248609231

drg. Destiya 081254035554

Nama : drg. Erlina Dyah W 081349460772

Seksi Konsumsi drg. Lidya Lovin 085255718617

Nama : drg. Vina 081321617970

III. BENTUK DAN MATERI KEGIATAN

2. Fasilitas untuk Sponsor

18 Complimentary Seminar Pre the 8th FDI‐IDA Joint Meeting and Q4 2012 4

10 Lecture of Clinical and Biological Realities in The Endodontic Q4 2013

28 Lecture of “Advance Science Applied In Daily Dentistry” with multiple Q2 2017

No Descriptions Year

WAKTU (WITA) ACARA

1 07.30 – 08.15 Registrasi

2 08.15 – 09.00 Pembukaan oleh MC

Menyanyikan lagu Indonesia Raya dan Mars PDGI

Sambutan Ketua Panitia Seminar

Sambutan Ketua PDGI Cabang Tanah Laut

Sambutan Ketua PDGI Pengwil Kalimantan Selatan

8 09.00 – 11.00 Enjoying Basic Endodontic Protocols in Cleaning and

9 11.00 – 13.00 Simply Practice of Managing Pre and Post Endodontic

10 13.00 – 14.00 ISHOMA

11 14.00 – 16.30 Hands On I

13 18.30 – 19.00 Selesai

a. Kriteria Peserta : dokter gigi

NO JENIS PEMBIAYAAN RINCIAN TOTAL

1 Konsumsi Peserta Seminar / 100 orang x Rp Rp 25.000.000,-

2 Honor pembicara Seminar 1 orang Sponsorship

3 Honor pembicara Hands On 1 orang Sponsorship

6 Akomodasi dan Transport 1 orang x Rp Rp 2.000.000,-

7 Pembuatan spanduk, backdrop, Rp 5.000.000,-

8 Operasional Seminar dan Rp 7.500.000,-

Mengetahui Panitia Kegiatan

KETUA PDGI CAB TANAH LAUT KETUA PANITIA

drg. Budi Rukhiyat drg. Haeran Kurnia Husen

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