CHARACTERISTIC OF AMELOBLASTOMA IN ORAL AND MAXILLOFACIAL SURGERY AT HASAN SADIKIN HOSPITAL : 2 YEARS RETROSPECTIVE STUDY

ABSTRACTBackground: Ameloblastoma is the most common odontogenic tumor. Ameloblastoma is a borderline tumor because it is a benign but locally aggressive tumor with a high recurrence rate if the excision is not complete. The principle of treatment for ameloblastoma is excision all the tumor. This article aimed to conduct a retrospective study to analyze the characteristics of ameloblastoma in patients at Oral and Maxillofacial Surgery Hasan Sadikin Hospital Oral Surgery between the period of January 2018-December 2019Method: This is a retrospective study with 37 patients diagnosed with ameloblastoma during 2018-2019. We took data from each patient such as gender, age, radiological features, histopathological diagnosis of the location of ameloblastoma, management, defects, reconstruction. Result: A total of 22 patients were diagnosed with plexiform ameloblastoma, 12 cases of follicular ameloblastoma, 3 cases of mixed plexiform and follicular ameloblastoma. 31 patients were treated radically, while 6 patients were treated conservatively. Radical treatment is more often used to reduce recurrence rates, whereas conservative measures are indicated in children and adolescents, as well as adult patients with unilocular ameloblastoma types. Conclusion: The most characteristic of ameloblastoma is plexiform ameloblastoma in the mandible. Ameloblastoma is usually performed radically and reconstructed with an AO plate

Orbital cellulitis as a complication of odontogenic infection

Orbital cellulitis is uncommon sequelae of the spread of odontogenic infection to adjacent maxillary sinuses or to distant sites such as the orbits. Once it happened, the spread of such infection can be of serious complication such as complete blindness or even more serious and life threatening situations as cavernous sinus thrombosis, intra-cranial abscess, or even death. This paper aimed to expose the guideline treatment of orbital cellulitis as a complication of odontogenic infection. It reported one case of orbital cellulitis in the emergency unit of Hasan Sadikin hospital Bandung, with complaints of pain, swelling at cheek and periorbital region, and the history of toothache. The treatment include incision drainage, extraction of tooth, and parenteral administration of antibiotic and analgesic. Odontogenic infections are derived from dental infection and can potentially spread rapidly to be ascending infection like orbital cellulitis. Odontogenic infection and orbital cellulitis should be adequately treated with incision drainage, extraction of tooth and parenteral administration of antibiotic, steroid and analgesic. Without immediate treatment, odontogenic infection can lead to ascending infection. Orbital cellulitis due to spreading of odontogenic infection is a rare case. In this case report, the patient had a significantimprovement due to immediate and proper treatment

Osteomyelitis kronis supuratif mandibula sebagai komplikasi sekunder impaksi gigi molar tiga

Chronic osteomyelitis suppurative the mandible as a complication secondary impaction of the mandibular third molars. Impacted third molars is a common thing and become a common reason patients seek dental treatment. Complications of impacted teeth is the most frequently occurring infection oromaksilofasial particularly acute infection. Suppurative osteomyelitis of the mandible due to secondary complications of impacted molars wisdom is rare. The aim of this case report describe treatment  of chronic suppurative osteomyelitis is caused secondary complications of impacted third molars. A female patient reported a history of recurrent toothache previous six months in the region of the right mandible and develop into extra-oral fistula since the last three months. Swelling that does not improve to make the patient come to the oral surgeon poly rs Hasan Sadikin. Preoperative panoramic radiographs showed mesioangular impacted third molars right mandible with deep caries and periapical radiolucent area of the mesial root of the tooth. From the results of clinical examination and radiographic findings made the diagnosis of chronic osteomyelitis of the mandible. Sequesterectomy and extraction of mandibular right second molar and all third molars upper and lower jaw. Sinus passages excised and closure. Histopathological examination conducted on tissues resected. Sekuesterektomi, fistulektomi and causa tooth extraction is a definitive method for treating chronic osteomyelitis with a satisfactory clinical outcome after surger

<p>Etiopatogenesis dan terapi kasus multipel sialolithiasis kelenjar submandibula</p><p>Etiopathogenesis and treatment of multiple cases of submandibular gland sialolithiasis</p>

Pendahuluan: Sialolithiasis adalah penyakit umum kelenjar saliva. Gejalanya termasuk pembengkakan kelenjar yang terlibat, terutama selama makan, dan nyeri tekan, yang mungkin mereda tetapi dapat kambuh kembali. Sialolith terjadi terutama di kelenjar submandibula (80-90%) dan pada tingkat yang lebih rendah di kelenjar parotid (5-20%). Sialolith bisa tunggal atau jamak. Multipel sialolith di kelenjar submandibula jarang terjadi. Tujuh puluh dari delapan puluh persen kasus memiliki sialolith tunggal, hanya sekitar 5% pasien yang memiliki tiga atau lebih sialolith. Faktor etiopatogenesis terkait dengan pembentukan sialolith adalah obstruksi, penurunan laju aliran saliva, dehidrasi, infeksi kelenjar saliva, dan terganggunya kelarutan kristaloid. Tujuan penulisan laporan kasus ini untuk menjelaskan etiopatogenesis dan terapi kasus multipel sialolithiasis kelenjar submandibula. Laporan kasus: Seorang wanita 24 tahun datang dengan pembengkakkan dan nyeri pada submandibula kanan. Radiografi panoramik menunjukkan massa radiopak terdefinisi dengan baik dalam submandibula kanan. Interpretasi ultrasonografi menunjukkan massa tak homogen hypoechoic dengan kalsifikasi ganda. Pengangkatan kelenjar submandibula dilakukan dengan pendekatan ekstraoral. Laporan kasus ini menunjukkan Gambaran sebanyak sembilan sialolith di kelenjar submandibula, yang dihilangkan dengan pendekatan ekstraoral. Simpulan: Etiopatogenesis dari pembentukan multipel sialolithiasis pada duktus kelenjar, yaitu faktor mekanis, inflamasi, kimiawi, dan infeksi. Diperkirakan bahwa alkalin serta saliva kental yang mengandung banyak sel mukus, memiliki persentase kalsium fosfat lebih tinggi seperti pada kelenjar saliva submandibula yang mendukung pembentukan sialolith. Pengangkatan kelenjar submandibula beserta sialolith dilakukan sebagai standar baku perawatan dan dapat menghindari kekambuhan. Pasien kontrol kembali satu minggu pasca operasi dengan kondisi baik dan dijadwalkan untuk pemeriksaan radiografis ulang enam bulan kemudian untuk memastikan tidak terjadinya pembentukan sialolith baru di saluran kelenjar saliva. Kata kunci: Multipel, sialolithiasis, kelenjar submandibula.   ABSTRACT Introduction: Sialolithiasis is a common disease of the salivary glands. Symptoms include the glands inflammation, especially during eating, and tenderness, which may subside but may recur. Sialoliths occur mainly in the submandibular glands (80-90%) and to a lesser extent in the parotid glands (5-20%). Sialolith can be singular or plural. Multiple sialoliths in the submandibular gland rarely occur. Seventy out of eighty per cent of cases have a single sialolith. Only about 5% of patients have three or more sialoliths. The etiopathogenetic factors associated with sialolith formation are obstruction, decreasing salivary flow rate, dehydration, salivary gland infection, and impaired crystalloid solubility. The purpose of this case report was to describe the etiopathogenesis and treatment of multiple cases of submandibular gland sialolithiasis. Case report: A 24-year-old woman presented with inflammation and pain in the right submandibular. Panoramic radiograph shows a well-defined radiopaque mass in the right submandibular. Ultrasound interpretation revealed a hypoechoic homogeneous mass with multiple calcifications. Removal of the submandibular gland was carried out with an extraoral approach. This case report showed the appearance of as many as nine sialoliths in the sub-mandibular gland, removed by an extraoral approach. Conclusion: Etiopathogenesis of the formation of multiple sialolithiasis in the glandular duct are mechanical, inflammatory, chemical, and infectious factors. It is thought that alkaline and thick saliva, which contains many mucus cells, has a higher percentage of calcium phosphate than in the submandibular salivary glands, which support the formation of sialoliths. Submandibular gland removal along with the sialoliths is performed as the treatment standard, which can avoid recurrence. The control visit is carried out one week postoperatively in good condition, and the patient is scheduled for another radiographic examination six months after to ensure that no new sialoliths occurred in the salivary gland. Keywords: Multiple, sialolithiasis, submandibular gland

Characteristics of oral squamous cell carcinoma at Oral and Maxillofacial Surgery Department of Hasan Sadikin Hospital

Background: Oral cancer is a malignancy on the lip or oral cavity. Because 90% of cancers in the oral cavity area histologically originated in the squamous cells, they are traditionally defined as oral squamous cell carcinoma (OSCC). OSCC is the 17th most common type of cancer worldwide, based on the International Agency for Research on Cancer (IARC). Purpose: This study was conducted to analyze the characteristic features of oral squamous cell carcinoma in patients who came to the Oral and Maxillofacial Surgery Department of Hasan Sadikin Hospital from 2016-to 2020. Methods: This research is a retrospective observational study by taking patients' medical records at the Oral and Maxillofacial Surgery Department of Hasan Sadikin Hospital from 2016 - to 2020 and data from histopathological examination results as confirmation. Results: During 2016 - 2020, there were 124 patients with OSCC, with several male patients (50.8%) more than the female patient (49.2%) and more common in the age group over 50 years. There was an increasing total of patients per year: 13 patients in 2016; 14 patients in 2017; 22 patients in 2018, 31 patients in 2019, and 44 patients in 2020. The tumours were located on the tongue (58.1%), buccal mucosa (33.1%), gingiva (7.3%), lip (0.8%) and palate (0.8%). Most histopathologic examinations were well-differentiated (53.8%), moderately differentiated (33.6%), and poorly differentiated (12.6%) squamous cell carcinoma. Conclusion: Over the last 5 years, the number of oral squamous cell carcinoma patients in the Oral and Maxillofacial Surgery Department of Dr Hasan Sadikin hospital has increased. It is more common in men, with an age range above 50. The major histopathology result was well-differentiated squamous cell carcinoma, most of which were located on the tongue

Congenital double lip pits

Introduction : Lip pits are unusual congenital anomalies affecting the lip, first described by DeMurquay in 1845. Lip pits can encounter aesthetic problem thus the patient ask for surgical overcome. Case Report : A 4-year-old girl patient came with double lower lip pits that present since birth with bilateral cleft lip and palate. The pits made a mucous accumulation occurs during mealtimes and crying, and felt aesthethic discomfort. The surgery was performed by simple excision combined with split-lip advancement technique under general anaesthesia and the excised pits was then analized for histopatological structures. The patient has no aesthetic defect after surgery. Discussion : Congenital lip pits are developmental anomalies that occur as an isolated defect or either in association with other developmental disturbances. It happens due to notching of lip at an early stage of development with fixation of tissues of the base of the notch or from a failure of complete union of embryonic lateral sulci of the lip. Lip pits can be shallow or deep, and may be associated with accessory salivary glands. The treatment is usually surgical excision with removal of entire fistulous tract. Conclusion : Surgical removal of lip pits is commonly for cosmetic purpose. It must be treated wisely because lips are essential part of someones face

Characteristics of Cervical Necrotizing Fasciitis (CNF) Patient in Oral and Maxillofacial Surgery Department Rsup Dr Hasan Sadikin: 2 Years Retrospective Study

Cervical necrotizing fasciitis (CNF) is a life-threatening bacterial infection that runs aggressively in the subcutaneous tissue and fascia in the head and neck area with clinical presentation of extensive necrotic tissue that develops from infection of the teeth or gingiva and other supporting tissues accompanied by an endosteal or periosteal infection of the jaw. This research aims to obtain information about characteristic patients with cervical necrotizing fasciitis (CNF). This study is an observational study with a retrospective descriptive approach. Based on medical record data, the research was conducted at Hasan Sadikin General Hospital (RSHS) Bandung from March 2019 – March 2021. The data collected include age, gender, onset, nutritional status, region, clinical diagnosis, microbiology, antibiotic sensitivity resistance, length of stay, and source focal infection. In this study, 23 medical records were obtained. The most frequent characteristics of the subjects were elderly aged more than 50 years (47.8%) and males (61%). The most frequent locations were the submandible area (100%), and the most frequent source of focal infection was from mandibular posterior teeth (60.46%). From the onset to the symptoms frequently 7-14 days with the nutritional status, most patients were malnourished (58%). Regarding microbiology gram negative dominantly (66,6%), with the most bacterial that worsening the spread of CNF being Acinobacter Baumanii (26.0%), Tigecycline becomes antibiotic most sensitive (43,47%), Cefazoline is the most resistance (73.91%). Most patients were treated by surgery necrotomy debridement (95, 6 %), and most improved (76 %). The ability to diagnose quickly and take aggressive action is needed to treat patients with Cervical Necrotizing Fasciitis (CNF) because of its high progression

A rare case of massif Adenomatoid Odontogenic Tumor in the anterior region of mandible: Mimicking as dentigerous cyst

Background. Adenomatoid Odontogenic Tumor (AOT) is a rare tumor of epithelial origin. AOT appears in three clinico-topographic variants: follicular, extrafollicular and peripheral. The AOT was predominantly found in the upper jaw, and rarely found in mandible, especially at anterior mandible. AOT is a tumor of odontogenic epithelium having duct like structures, which may be partly cystic, and in some cases the solid lesion may be present only as masses in the wall of a large cyst. The surgical management of this lesion would be enucleation along with removal of associated impacted tooth. The prognosis for both of them is good and recurrences are very rare after complete removal of the lesion. Purpose. It is important to define final diagnose for AOT due to mimicking with DC in clinically and radiographically finding. Biopsy is still obviously necessary to the final diagnosis. Case. 15-year-old female patients reported with chief complain of swelling in anterior mandible. The swelling beginning 4 years ago, gradually progressed, with no history pain, discharge and patient is complaint about loss of sensation around anterior mandible. Aspiration revealed straw colored fluid thinking in the way of DC. The provisional diagnosis of DC was given due to clinical presentation and radiographic imaging. But the biopsy examination showed AOT due to duct-like epithelial cells was being found. Discussion. The case report illustrates characteristic clinical and radiographic features of follicular variant of AOT mimicking a DC at unusual site that is anterior mandible. AOT is thought to arise from odontogenic epithelium and associated with the impacted tooth. Rightfully AOT is a perfect imitator of DC radiographically as well as histopathologically. It usually clinically misdiagnosed as DC as both have a unilocular, well-defined radiolucency surrounding the crown of an impacted tooth. The mass was enucleated, involved teeth were extracted, and titanium plates are used to avoid pathologist fracture. The patient had uneventful postoperative recovery. Follow up of a year has not shown any evidence of recurrence. Conclusion. Follicular type of OAT could confuse us with DC if the support examination just only clinicaly finding and radiographic examination. This case could not be definitively diagnosed on clinical and radiographic features alone. Biopsy was obviously necessary to the final diagnosis

Compound Odontoma in young girl

Introduction. Odontomas are the most common type of odontogenic tumors and generally they are asymptomatic. These tumors are formed from enamel and dentin, and can have variable amounts of cement and pulp tissues. According to radiographic, microscopic, and clinical features, two types of odontomas are recognized: Complex and compound odontomas. Complex odontomas occur mostly in the posterior part of the mandible and compound odontomas in the anterior maxilla. Case Report. A young girl patient, 9 years old came to Department of Oral and Maxillofacial Surgery with a slow growing and asymptomatic swelling in her left posterior mandible for 5 years in his history taking. The panoramic radiograph show  a radioopacity and radiolucent lesion at the lower second molar region, with well-corticated limits. An insisional biopsi   confirmed  as compound odontoma. The surgery  performed with simple enucleation and curettage under general anaesthesia. Discussion. Compound odontomas are usually located in the anterior maxilla, over the crowns of unerupted teeth, or between the roots of erupted teeth. In this case report, Compound odontomas are found in the posterior mandible. Conclusion. Compound odontomas in the posterior mandible is a rare. The treatment of odontomas depends on the size of the lesion. The early diagnosis, the treatment of choice is conservative surgical enucleation and curettage and prognosis is excellent