Pigmentasi Gingiv

 

• 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%.

  

• SKOR

  

  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
  • Skor 2
  • Skor 3
  • Skor 4

• 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

    

    

    

  • Endogenous

    • Developmental:

      • Ras,

      • peutz-jeghers syn

        • Gastrointestinal disease
        • Pigmentasi mukosa, kulit.

        

    • Acquired:

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

      

      melanotic macule

    • Neoplastic

      malignant melanoma

    • Sistemik

      • Addison’s disease

        • Disfungsi adrenal (ginjal)
        • Hitam kebiruan sampai coklat

        

      • Albright Syndrome

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

        

• 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

  

• HPA

  

• PERAWATAN

  • BEDAH
  • NONBEDAH
  • Harus diperhatikan

• PROGNOSIS

  • Post terapi
  • Hasil
  • Kemungkinan