INFEKSI BAKTERI NON SPESIFIK

 

• Gingivitis

• Introduction

• Workshop 1989 categorised periodontitis as:

• 1993 categorised :

  • Adult
  • Early onset periodontitis

• 1996 determined insufficient new evidence to change the classification

• 1999 reclassified under the category of Necrotizing Periodontal Disease (NPD) as:

  • Chronic
  • Aggressive (localized and generalised)
  • Necrotising
  • Manifestation of systemic disease

• Caton, 2018

• Definisi

• KLASIFIKASI

• Gejala

• Epidemiologi

  Prevalence di negara berkembang dengan gizi buruk sangat tinggi

  • Namun sudah mulai berkurang sejak abad 20

  • Young adult between 15 and 30 Y.O

  • Preceded by chronic gingivitis

  • Begins with ulceration and necrosis in the col area

    col - a craterlike area of the interproximal oral mucosa joining the lingual and buccal interdental papillae

    

• More susceptible :

• Clinical Finding

• Distingushing characteristic :

• Etiopathogenesis

• Laboratory

• Management

  • Supportive care

  • Relief of pain

  • Definitive treatment

  • 2 phases :

    • Acute
    • Maintenance phase treatment

  • Definitive treatment:

    • Debridement
    • Chlorhexidine digluconate
    • Hydrogen peroxide
    • Antibiotic : gram-negative anaerobes
    • Metronidazole

  • Maintenance :

    SRP and Root Planing

  • NOMA :

    • agrresive treatment : nutrition supplementation
    • Antibiotic
    • Tissues debridement
    • Plastic surgery

• Simpulan by me

  • NUG

    di interdental papila

    trench mouth

    fetid odor, metallic taste

    tx: CHX

  • NUP

    → di seluruh papila, margin, attached ggv, ada LOA

    ada yg HIV non HIV

    klo HIV: linear gingival erythema

  • NUS

    → sampe mukosa, expose tulang

    gambaran pseudomembran putih kekuningan bekas nekrosis

  • NOMA / Cancrum oris

    → perforasi kulit

    gangren

    krn malnutrisi

Blood Diseases

Blood diseases associated with periodontal disease:

• LEUKEMIA

• Etiologi

  • Tidak diketahu pasti
  • Faktor genetic dan lingkungan
  • Infeksi virus
  • Kemoterapi
  • Radiasi
  • M>L

• Clinical findings

  • Fatigue, mud lelah, dyspnea
  • Joint pain
  • Splenomegaly,hepatomegaly, limfadenopati,infiltrasi sel ganas pada organ
  • Infeksi
  • 65 % gingival bleeding, petechiae, ecchymosis
  • Enlargement, ulceration, oral infection

• Management

  • Kemoterapi
  • Supportive→ nutrisi, tranfusi
  • Antibiotic
  • Kemoradiasi
  • Transplants

• NEUTROPENIA

  • Kelainan darah = jumlah netrofil dalam sirkulasi darah < 1500 cell per mikroliter

  • Severe neutropenia = netrofil < 200 cell per microlitre = agranulosit

  • Etiologi

    Penyebab tidak diketahui pasti

    • Congenital = genetik
    • Acquired = pasca infeksi, transplants tulang, radioterapi, defisiensi nutrisi, drugs

    Imunocompromis

    • Penurunan netrofil disebabkan oleh penurunan produksi atau peningkatan kerusakan netrofil
    • Benign ethnic neutropenia
    • Def. B12, copper dan folat akibat malabsorbsi dapat menghambat prod. Netrofil

    Infeksi : bakteri,virus

    • Penyakit autoimun

• Clinical findings

  • Peny. Periodontal

  • Premature loss teeth

  • Enamel hypoplsia, caries, delayed eruption

  • Pre pubertal periodontitis

    

• Management

  • Peningkatan OH = munurunkan infeksi
  • Antiseptic : chlorhexidine
  • Antibiotic : tetracycline
  • Pemberian GCSF granulocyte colony-stimulating factor = sitokin pertumbuhan dan diff. Netrofil