Pigmentasi Gingiva

shape image

Pigmentasi Gingiva

 

  • DEFINISI

    • Pigmentasi adalah perubahan warna mukosa rongga mulut atau gingiva karena berbagai macam lesi dan kondisi tertentu
  • Warna (faktor)

    → ketebalan epitel dan keratinisasi, vaskularisasi, dan pigmentasi.

  • DISTRIBUSI

    • Distribusi (org kulit hitam) : gingiva 60%, palatum keras 61%, membran mukosa 22%, dan lidah 15%.

    https://s3-us-west-2.amazonaws.com/secure.notion-static.com/597118d2-f5ce-4904-962e-34bc8cfb1e03/Untitled.png

  • SKOR

    https://s3-us-west-2.amazonaws.com/secure.notion-static.com/8f4fa184-a920-4474-82ef-282b6fdfe306/Untitled.png

    Fig 1. Classification according to extent of brownish or black pigmentation in labial gingiva of anterior teeth: 0, no pigmentation; 1, solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units; and 2, formation of continuous ribbon extending from neighboring solitary units

    • Skor 1

      satu atau dua unit soliter dari pigmentasi yang ditemukan pada papila gingiva tanpa terbentuknya pita yang tersambung antara tiap unit soliter.

    • Skor 2

      terdapat lebih dari 3 unit pigmentasi pada papila gingiva, tanpa terbentuk pita yang tersambung.

    • Skor 3

      satu atau lebih pita pigmentasi.

    • Skor 4

      sebuah pita yang terlihat menyambung daerah pigmentasi, termasuk seluruh daerah diantara kaninus kiri dan kaninus kanan.

  • MACAM

    • Fisiologis
      • Genetik
      • Pigmen melanin
    • Patologis
      • Masuknya bahan metal
      • Penyakit
  • ETIOLOGI

    • Exogenous

      • Superficial mucosal staining

        lidah ada papila→ kotor

      • Black hairy tongue

        papila filiformis panjang berlebih, stain rokok

      • Foreign bodies

        • amalgam tattoo,
        • graphite tattoo (gigit pensil)
      • Heavy metal salts

        di tambang logam

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/d146c726-f881-42f4-9bbc-cf32a681a1a5/Untitled.png

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/52570921-0e62-490b-94d8-9eddd22ab626/Untitled.png

      https://s3-us-west-2.amazonaws.com/secure.notion-static.com/47040f78-0873-4906-a2f0-4a83b51d4f6e/Untitled.png

    • Endogenous

      • Developmental:

        • Ras,

        • peutz-jeghers syn

          • Gastrointestinal disease
          • Pigmentasi mukosa, kulit.

          https://s3-us-west-2.amazonaws.com/secure.notion-static.com/a2cd2eb2-9732-47a1-b9c4-27007113f8e5/Untitled.png

      • Acquired:

        • endocrine,
        • drug,
        • chronic irritant,
        • melanotic macule,
        • HIV

        https://s3-us-west-2.amazonaws.com/secure.notion-static.com/ce8635e8-d545-4d66-b1f3-4059ae4719ec/Untitled.png

        melanotic macule

      • Neoplastic

        malignant melanoma

      • Sistemik

        • Addison’s disease

          • Disfungsi adrenal (ginjal)
          • Hitam kebiruan sampai coklat

          https://s3-us-west-2.amazonaws.com/secure.notion-static.com/84267e91-8b71-492f-89c2-9191f0d9f094/Untitled.png

        • Albright Syndrome

          • Fibrous dysplasia (sendi diganti fibrous)
          • Melanotic skin pigmentation

          https://s3-us-west-2.amazonaws.com/secure.notion-static.com/5986788e-6b35-4a72-8830-63a83d3bb605/Untitled.png

  • PATOGENESIS

    • Hiperpigmentasi gingiva disebabkan oleh deposisi melanin yang berlebih pada lapisan basal dan suprabasal epithelium, melanin ini diproduksi oleh melanosit
    • Jumlah dan ukuran granula melanin → derajat pigmentasi
    • Melanocytic Stimulating Hormone (MSH) increases the skin pigmentation by stimulating the dispersion of melanin granules in melanocytes, thus causing darkening of the skin. Secretion of thishormone is stimulated by MSH stimulating factor.
    • Glucocorticoids have an inhibiting effect on MSH, when there is adrenal insufficiency, there is reduced glucocorticoids secretion increase in MSH increase melanin pigmentation

    https://s3-us-west-2.amazonaws.com/secure.notion-static.com/c30b644f-e63f-40f8-a023-f353a10711c4/Untitled.png

  • HPA

    https://s3-us-west-2.amazonaws.com/secure.notion-static.com/3a430072-d92d-4684-b88f-d7be18acc007/Untitled.png

  • PERAWATAN

    • BEDAH
      • Scalpel (gingivectomy, free gingival graft, scrapping)
      • Bur high speed
      • Electrosurgery
      • Laser (CO2, NdYAG, Diode)
      • Cryosurgery
    • NONBEDAH
      • bahan kimia (fenol 90%)
    • Harus diperhatikan
      • Warna kulit subjek
      • Kondisi sistemik
      • Kondisi periodontal
      • Ketebalan gingiva
  • PROGNOSIS

    • Post terapi

      Rasa sakit minimal

    • Hasil

      Memuaskan

    • Kemungkinan

      Repigmentasi

Post a Comment

© Copyright 2019 DENTSIVE: materi dan soal kedokteran gigi

Form WhatsApp

This order requires the WhatsApp application.

Order now