DISKUSI TATAP MUKA

ODONTEKTOMI 38
ANNISA MONZA
1112014009

http://www.free-powerpoint-templates-design.com
Identitas Pasien

No. Rekam medis : 1709011

Nama : Px. T
Jenis kelamin : Laki-laki
Tempat, tanggal lahir : Indramayu, 11 Agustus 1996
Pekerjaan : Wiraswasta
ANAMNESIS
Seorang laki-laki berusia 23 tahun datang ke RSGM
Yarsi mengeluhkan gigi bungsu sebelah kiri rahang
bawah belum tumbuh dan gusi bagian kanan dan
kiri rahang bawah paling belakang terasa sakit saat
makan. Pasien sudah pernah kedokter gigi sebelum-
nya, pasien menyikat gigi 2x sehari, pasien tidak
mempunyai kebiasaan merokok, dan tidak
mempunyai riwayat penyakit.
KELUHAN UTAMA
Pasien ingin mencabut gigi geraham bawah kiri, geraham atas kanan
dan kiri
RIWAYAT PENYAKIT YANG DIKELUHKAN
Gigi belakang bawah sebelah kiri belum tumbuh, gusi bagian kiri
bawah terkadang terasa nyeri, mengganggu saat makan dan
terasa tidak nyaman saat berkontak dengan gigi lawannya, pasien
tidak memiliki riwayat penyakit sistemik
PEMERIKSAAN KEADAAN UMUM
Kesadaran : Compos Mentis
TD : 120 / 80 mmHg
Nadi : 80x / menit
Respirasi : 18x / menit
PEMERIKSAAN KEADAAN LOKAL: KEBUTUHAN PEMERIKSAAN
Ekstra oral PENUNJANG:
Lokasi :TAK Foto Panoramik
Inspeksi :TAK
Palpasi :TAK HASIL PEMERIKSAAN PENUNJANG:
Perkusi :TAK Radiologi panoramik:
Terdapat gigi 38 impaksi dengan posisi
Intraoral mesioangular, gigi 18 dan 28 impaksi dengan
Lokasi : gigi 38 IMV posisi vertikal
Inspeksi : gigi 38 IMV
Palpasi : TAK DIAGNOSA KERJA:
Perkusi : TAK Impaksi gigi 38 kelas II Posisi B Mesioangular
Mobiliti : TAK
RENCANA TERAPI/TINDAKAN:
Odontektomi gigi 38
 Radiografi
Panoramik

Impaksi Gigi 38 Klas II Posisi B Mesioangular

Intra Oral
• Indikasi • Kontraindikasi
• Gigi impaksi • Gigi tumbuh sempurna dan pasien tidak
• Perikoronitis rekuren mengeluhkan sakit
• Resorpsi eksternal gigi m3 atau • Pasien trismus
m2 yang diduga disebabkan oleh • pasien usia lanjut (diatas 70thn & KU
kondisi gigi molar ketiga buruk)
• Perwatan ortodonti dengan gigi • Penyakit sistemik yang tidak terkontrol
impaksi
Pell & Gregory (1933)

Archer (1975) & Kruger (1984)

KLASIFIKASI IMPKASI PADA
KASUS
• Archer : Mesioangular Mesioangular
• Pell & Gregory : Klas II Posisi B

Klas II Posisi B
  Masker, Gloves, Polibib

ALAT DAN BAHAN Alat standar (pinset, kaca mulut,
excavator, sonde)
 Syringe anestesi
 Larutan anestesi
 disposable syringe
 elevator periosteal
 Handle blade & blade No.15
 Pinset bedah & jaringan
 Straight Handpiece
 Bur tulang bulat & fissure
 luxator & bein
 tampon
 Kuret periapical
 Needle holder
 Jarum jahit dan benang silk
 NaCl
 Povidone iodine
 Cryer
 Tang M3
 hemostat
 bone file
 Duk bolong & duk clamp
 suction
 Prosedur Odontektomi

Mempersilahkan pasien duduk terlentang di Dental Unit, mengukur

tekanan darah pasien sebelum memulai operasi
Melakukan asepsis menggunakan betadine 10% ekstra oral dan intra oral
Anastesi mandibular blok pada gigi 38
Anastesi infiltrasi di daerah bukal regio gigi 38
Tunggu sekitar ± 5 menit, dilakukan pengecekan apakah pasien sudah
teranastesi sempurna apa belum. Jika pasien sudah teranastesi, maka
dilakukan insisi flap dengan metode triangular, insisi menggunakan scalpel
dan blade no. 15
Desain flap

Insisi
 Kemudian flap dibuka dengan rasparatorium
 Dilakukan pembuangan tulang
hingga terlihat bifurkasi dari gigi 38
 Separasi gigi
pengeluaran gigi dibantu dengan bein/cryer
 Penghalusan tulang yang tajam
 flap dikembalikan dan di jahit rapat.
 bersihkan daerah kerja
 operasi selesai
 Instruksi pasien post-op
• Gigit tampon selama 1 jam, setelah itu dibuang
• Jangan makan dan minum yang panas setelah operasi
• Tidak kumur-kumur selama 24 jam
• Minum obat teratur
• Menjaga kebersihan mulut
• Istirahat yang cukup
• Kontrol setelah 1 minggu untuk melepas jahitan
Pasien diberikan obat analgesik, antiinflamasi, antibiotik :
R/ Tab Asam mefenamat 500 mg No X
S3 dd Tab 1
R/ Tab Dexamethasone 0,5 mg No X
S3 dd Tab 1
R/ Tab Clindamycin 500 mg No XV
S3 dd Tab 1
 KOMPLIKASI
• Bleeding
• Dry socket (alveolitis)
• Prolonged anestesi (parestesi)
• Fraktur tulang Alveolar /mandibula
• Bibir atau mukosa terluka/inflamasi akibat tang ekstraksi,
raspatorium dan alat lain yang digunakan
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