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KOMPLIKASI POST ODONTEKTOMI Kelompok 2  Jumat, 13 Maret 2015

Seminar Wajib

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KOMPLIKASI

POST ODONTEKTOMI

Kelompok 2

 Jumat, 13 Maret 2015

7/23/2019 Seminar Wajib

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A. Pe!em"u#a Luka

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Pe!em"u#a Luka Po$t O%otektom& M&''u pertama

o Se'era $etela# '&'& keluar %ar& $oket, %ara# aka me'&$&%ara# aka me'&$& %aera# ter$e"ut (akt&)a$& *a+tor&tr&$&k%a ek$tr&$&k

o A!ama -"r& aka mea'kap $el %ara# mera# %akemu%&a aka meutup pem"ulu# %ara# !a' ru$ak

o

Pem"etuka e%ala %ara# %&mula& 2/ $ampa& / am%e'a $um"ata %a %&lata$& pem"ulu# %ara# pa%a ar&'a l&'amet per&o%otal !a' ter$&$a, %&&kut& %e'am&'ra$& leuko$&t %a pem"etuka lap&$a -"r&

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M&''u pertama $etela# pe+a"uta e%ala %ara#

mem"etuk kera'ka $eaktu m&'ra$& $el$el &ama$&

Ep&tel pa%a p&''&ra luka tum"u# atau "erprol&*era$& keata$ permukaa luka

Akumula$& o$teokla$ $epaa' pu+ak tula' al)eolar akamere$op$& tula'

Kemu%&a tera%& a'&o'ee$&$ pa%a $&$a ar&'a

per&o%otal

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 M&''u ke%ua

M&''u ke%ua pe!em"u#a luka tera%& *a$e -"ropla$&a,pem"etuka pem"ulu# %ara# "aru ma$uk ke %alam e%ala %ara#, $erta pe'&$&a $oket ole# ar&'a'raula$&

O$teo&% meuu ke %aera# luka, o$teokla$ mere$op$& tula'kort&kal pa%a $oket '&'&

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4. Kompl&ka$& Po$t O%otektom&

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1 Pe%ara#a

a$e 6a$kuler a$e Platelet a$e Koa'ula$&

 Ter%&r& %ar& 3*a$e

6a$oko$tr&k$& arter& %a

)ea

7etr&k$&arter&

tera%&!akekakua platelet

%a pem"ulu#%ara#

Pem"ulu#

%ara#ter$um"at

 mem"ata$&

%aera# !a'tera%&

per%ara#a%e'a a%a!a"atua *aktorek$tr&$&k %a

&tr&$&k

a$e lauta

a$e-"r&ol&t&k

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Pe!e"a" Per%ara#a

Meka&$ 4&ok&m&a&

4lot 8lot t&%ak %apatter"etuk9pe+a#

a"ormal&ta$ eleme %ara#atau $&$tem )a$kular !a'

me'#am"atpem"etuka e%ela

%ara#

Pa%a pe%er&ta:Kela&a %ara#, 'a''ua

#epar %ll

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2 Pem"e'kaka

Ko'e$t&O"$truk$&L&m*at&k

Permea"&l&ta$Kap&ler

"ertam"a#

pe&'kata tekaa

#&%ro$tat&k &tra)a$kular

+a&ra tu"u# !a'"era$al %ar& pla$ma

%ara# %a #a$&lmeta"ol&$me !a'ma$uk ke %alam

$alura l&m*e aka

tert&m"u

E%ema

perem"e$a +a&rapla$ma ke %alam rua'

&ter$t&t&um

8a&ra pla$ma &&aka me'&$& pa%a$ela$ela ar&'a&kat lo''ar %aro''a "a%a

prote& pla$makeluar kap&ler

tekaa o$mot&k kolo&%%ara# meuru %a$e"al&k!a tekaa

o$mot&+ +a&ra&ter$t&t&um "ertam"a#.

mak& "a!ak +a&ra

!a' me&''alkakap&ler

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3 ;raula$& 4erle"&#a

4&la luka +ukup lua$ ,%alam, %a %&"&arka ter"uka pe!em"u#a aka "er'atu' pa%a kemampua tep&luka $al&' kotrak$& %a m&'ra$& ep&tel ke ara# te'a#luka   pro$e$ -"ropla$&a "erala teru$   ar&'a'raula$& "erle"&#a mak& meumpuk

Pro$e$ kotrak$& tep& luka aka "erala teru$, %ameep&t ar&'a 'raula$& $e#&''a tera%& 'rauloma.Pe!em"u#a $emak& ter'a''u karea ep&tel t&%ak%apat m&'ra$& a&k meutup 'raula$& !a' "erle"&#

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/ Dry socket 

Nama La&:

• Al)eolar o$te&t&$

• Localized alveolitis

•  Alveolitis sicca dolorosa• Localized osteitis

• Postoperative osteitis

• Localized acute osteomyelitis

• Fibrinolytic alveolitis

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<< Ter"uka!a %&%&' $oket%&$e"a"ka a%a!a gangguanpembentukan bekuan darah

ormal !a' tera%& pa%a ta#approl&*era$& %ar& ar&'a 'raula$&%a pem"etuka ar&'a

o$teo&% $e#&''a me!e"a"katera%&!a &*ek$&.

<< Et&olo'& : pe&'kata akt&)&ta$

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Pe&'kata -"r&ol&$&$ "&$akarea :

1. Aa$te$& %e'a )a$oko$tr&ktor"erle"&#a

2. O"ato"ata $&$tem&k

3. 4akter& !a' me'#a$&lka ra$a!er&, "au mulut, %a ra$a t&%akeak

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&"r&ol&$&$ ter"a'& 2 :

1. Fibrinolisis tanpa keterlibatan bakteri

Keru$aka "ekua %ara# ole# me%&ator !a'keluar $elama &ama$&

2. Fibrinolisis dengan keterlibatan bakteri

Treponema denticola Actinomyces viscosus

Streptococcus mutans

4e"erapa "akter& !a' me$ekre$& p&ro'e

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;am"ara kl&&$ %r!$o+ketmu+ul pa%a hari ke 3-4 $etela#

%&lakuka pe+a"uta '&'&

$oket '&'& terl&#at kosong %e'a

hilangnya blood clot $e"a'&a atau$eluru#!a, %&peu#& debris

permukaan tulang soket terpaparRasa nyeri !a' %&ra$aka umum!a

pa%a t&'kat $e%a'para#, "er%e!ut,%a $er&' me!e"ar $ampa& ke tel&'a

Mulut mem&l&k& bau yang tidak enak

(halitosis) %a pa$&e $er&'me'elu#ka adanya gangguanpengecapan

demam ringan %a infamasi margingingia %& $ek&tar $oket "eka$pe+a"uta

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Pato-$&olo'&...

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aktor 7e$&ko

 Trauma pa%a $aat pe+a"uta=$&a

 Je&$ Kelam&

Pe''uaa kotra$ep$&

Ke"&a$aa merokok

;&'& !a' %&+a"ut

Pe''uaa ae$te$& lokal

Oral >!'&ee !a' "uruk

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Pe+e'a#a

Pe+a"uta '&'& pa%a aktu !a'tepat

 Tek&k pe+a"uta !a' tepat

Ster&l&$a$& alat !a' "a&kAe$te$& !a' +ukup pa%a pa$&e

Pe''uaa at&"&ot&k

Pe''uaa klor#ek$&%&

Pe''uaa $al&e &$oto&k

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 Tatalak$aa

&"r&ol&$&$ keterl&"ata "akter& :1. Me'&r&'a$& $oket %e'a laruta $al&e utuk

mem"er$&#ka $&$a ar&'a ekrot&k pa%a $oket "eka$pe+a"uta.

2. Meletakka al)o'!l pa%a $oket "eka$ pe+a"uta '&'&.

3. Ka$a %&'at& $et&ap #ar& utuk 3? #ar& ke %epa.Pe''at&a ka$a $e"a&k!a %&&r&'a$& terle"&# %a#ulu%e'a laruta $al&e

/. 4&la ra$a $ak&t pa$&e tela# "erkura', ka$a %apat%&lepa$.

5. Setela# ka$a %&lepa$, pa$&e %&&$truk$&ka mea'ake"er$&#a ro''a mulut %a pem"er&a o"at NSAIDaal'e$&k, "&la pa$&e t&%ak kotra&%&ka$& %alamr&a!at me%&$.

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&"r&ol&$&$ tapa keterl&"ata"akter&:

De'a mere$epka mult&)&tam& !a'

%apat me&'katka &mu&ta$ %a %a!ata#a tu"u# pa$&e $epert& )&tam& +.6&tam& + %apat mea'a %a me&'katka$&$tem &mu tu"u#, )&tam& + u'a $uatu

"ete' perta#aa tu"u# !a' mem&l&k&tu'a$ me'#ala'& $erta memu$a#ka)&ru$ %a "akter& !a' mem"a#a!akatu"u#

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5 Pare$te$&

<< $e$a$& a"ormal ra$a tertu$uk maupuke$emuta !a' merupaka $ala# $atu ma&*e$ta$&kl&&$ ak&"at a%a!a peru"a#a $e$a$& pa%a$&$tem $ara* per&*er.

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;eala Kl&&$

• @p&$ a% ee%le$, l&m"$ *all&'a$leep atau ke$emuta

• !er& (%&$e$te$&a  &ka pare$te$&

&te$• Mat& ra$a  $e$a$& %ar& ra$a

ke"a$, "erat, atau %&'& pa%a

"a'&a !a' terkea

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Kla$&-ka$& (Se%%o, 1B/3

1. Neuroprak$&a

2. Ak$ootme$&$

3. Neurotme$&$

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 Tatalak$aa

Apa"&la $etela# 1 ta#u t&%ak #&la' makakela&a $e$a$& ter$e"ut kemu'k&ameetap. 4e"erapa t&%aka %apat%&lakuka utuk memper+epat pro$e$

pe!em"u#a +e%era $ara* a%ala# 

1. Pem&ata

2.  Terap& paa$

3. Elektroterap&

/. Pe''uaa o"ato"ata eurotrop&k

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? Tr&$mu$

<< 'a''ua mem"uka mulutole# karea $pa$me ototototma$t&kator&

Et&olo'&

 Trauma, pa%a otot %a atau TMJ

 Pro$e$ kera%a'a %a &*ek$& >ematoma %a -"ro$&$

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 Tatalak$aa

 Ter'atu' pe!e"a" J&ka a%a &*ek$&  pem"er&a at&"&ot&k broad-spectrum 

%&"er&ka.

 Terap& tam"a#a la& !a' %apat %&"er&ka mel&put&:

◦ Terap& paa$. 8oto#!a: kompre$ paa$ %&letakka pa%aek$traoral utuk k&rak&ra 20 me&t $et&ap am $ampa& 'ealamere%a.

◦ P&ata lem"ut pa%a area temporomandibular joint .

◦ Pem"er&a o"at aal'e$&k, at&&ama$&, %a relak$a otot(muscle relaxant 

◦ &$&oterap& $elama 35 me&t $et&ap 3/ am  lat&#a "ukatutup mulut

◦ Pem"er&a $e%at&* ("romaCepam: 1,53 m', %ua kal& $e#ar&,utuk me'atur $tre$ !a' memperpara# per$&$te$& tr&$mu$!a' me!e"a"ka pe&'kata $pa$me pa%a %aera# ter$e"ut.

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I*ek$&

Pe!e"a":Pe''uaa &$trume %a mater&al %&$po$a"le

!a' ter&*ek$& $elama pro$e%ur "e%a#.

Su"$trat $ept&k %& maa pro$e%ur "e%a# %&lakuka.

Keru$aka $u"$trat tula' !a' %&$e"a"ka ole#pe!ak&t pa%a $&$tem $keletal (+oto#:o$teoporo$&$, %a ra%&oterap& pa%a %aera# ra#a'%a *a$&al.

Pe!ak&tpe!ak&t $&$tem&k !a' me!e"a"ka

pe&'kata keretaa terkea &*ek$& (+oto#:leukem&a, a'raulo$&to$&$, %em&k&a pulape!ak&tpe!ak&t !a' terap&!a me!"a"ka&muo$upre$&.

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 Tatalak$aa

=&)er$al Pre+aut&oAt&"&ot&k pro-lak$&$

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>ematoma

Per%ara#a kap&ler !a'"erkepaa'a. Ma$aper%ara#a terakumula$& %&

%alam ar&'a.

Dapat tera%& pa%a1. Su"muko$al

2. Su"per&o$teal3. Itramu$kular/. a$&al

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 Tatalak$aa

kompre$ %&'& pa%a %aera#ek$traoral $elama 2/ ampertama

terap& paa$ utuk mem"uat%aera# ter$e"ut mere%a %e'ale"&# +epat.

at&"&ot&k

 me+e'a# $upura$&%ar& #ematoma

aal'e$&k   pain-relief .

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8. I$truk$& Po$t Opera$&

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1. Me''&'&t ka$a $ter&l $elama 1 am $etela# opera$&

<< ter"etuk u$ta"le +lot

<< +lot terlepa$  pe!em"u#a le"&#lama

<< +lot terlepa$  pe!em"u#a le"&# lama

2. T&%ak kumurkumur $elama

kura' le"&# 2/ am $etela# opera$&

3. T&%ak me'#&$ap#&$ap %aera#luka

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5. T&%ak Merokok

<< 6a$o%&lata$&  per%ara#a $emak& lama

/. T&%ak maka %a m&um #a'at$elama kura' le"&# 2/ am $etela#

opera$&

!ikotin

 %&ameter pem"ulu# %ara#me'e+&l ok$&'e ke %aera# luka"arbon monoksida  "erkompet&$&%e'a ok$&'e , $e#&''a ar&'a lukakekura'a ok$&'e.Ok$&'e %&"utu#ka utuk pem"etukakola'e, kap&lerkap&ler "aru, %aper"a&ka ep&tel

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?. Mea'a O>

<< me+e'a# &*ek$& po$t opera$&

. Kompre$ %&'& pa%a aa#

Kompre$ 30 me&t  e$ "atu %alamkatu' pla$t&k  me'ata$&pem"e'kaka>ar& "er&kut!a  kompre$ a&r #a'at  memperla+ar al&ra %ara#memper+epat pro$e$ pe!em"u#a

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. Mem&um o"at $e$ua&re$ep<< me+e'a# re$&$te$& "akter&

ter#a%ap at&"&ot&k, me'ata$&kompl&ka$& po$t opera$&

<< >ar& pertama  %e"r&%emet

luka<< >ar& ketuu#  a'kat a#&ta

B. Kotrol

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LAPO7AN KAS=S

Pa$&e lak&lak& u$&a 2 ta#u%ata' &'& me+a"ut '&'&"elaka' "aa# kaa karea

me''a''u $aat maka. ;&'&"elaka' "aa# kaa $er&'ter$el&p makaa. Saat && pa$&e

mera$aka $ak&t, pera# m&umo",at pe'#&la' ra$a $ak&t.

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oto Kl&&$

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oto Paoram&k

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Kotrol I (#ar& ke1

S : %apat "uka mulut, p&p& tera$a $e%&k&t '&lu $aat %&ra"a,luka %&$u%ut mulut kaa, t&%ak "e'kak

O : E.O t&%ak a%a pem"e'kaka, luka %&$u%ut mulut kaa  I.O kemera#a $ek&tar luka, luka "elum meutup, a#&ta ma$&# a%a

A : A'ular +#e&l&t&$

P : $pool&' "eta%&e

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Kotrol II (#ar& ke?

 S : %apat "uka mulut, $e%&k&t !er&

 O : E.O t&%ak a%a kela&a

  I.O kemera#a $ek&tar luka, luka "elum meutup, a#&ta $u%a# lepa$

  A :

  P : &$truk$& !a&tu me!&kat '&'& $epert& "&a$a, tetapme''uaka o"at kumur

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Kotrol III (#ar& ke

 S : $u%a# mera$a !ama $aat %&paka&"&+ara,maka %a m&um O : E.O t&%ak a%a kela&a  I.O t&%ak a%a kemera#a, tr&$mu$ t&%aka%a, a#&ta $u%a# lepa$  A :   P : $pool&' "eta%&e %a O>I

 

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#$R%&'"'%