<p>Protesa obturator definitif resin akrilik pada pasien systemic lupus erythematosus (SLE) pasca maksilektomi</p><p>Acrylic resin definitive obturator prosthesis in systemic lupus erythematosus (SLE) patients post-maxillectomy</p>

• Main Authors: Pramudya Aditama (Author), Erwan Sugiatno (Author), Murti Indrastuti (Author), Endang Wahyuningtyas (Author)
• Format: Book
• Published: Fakultas Kedokteran Gigi Universitas Padjadjaran, 2020-11-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.

Summary

ABSTRAK Pendahuluan: Systemic lupus erythematosus (SLE) merupakan inflamasi kronis yang dapat melibatkan sistem saraf, membran mukosa, dan organ lain dalam tubuh. Avascular bone necrosis (AVN) merupakan gejala yang muncul pada penderita SLE. Maksilektomi dilakukan pada tulang maksila yang mengalami AVN. Penutupan celah pasca maksilektomi tersebut dilakukan dengan cara  menggunakan protesa maksilofasial intraoral yaitu obturator. Tujuan laporan kasus ini mengkaji rehabilitasi prostetik menggunakan protesa obturator definitif resin akrilik pada penderita SLE pasca maksilektomi. Laporan kasus: Seorang wanita berusia 21 tahun datang ke Poli Gigi dan Mulut RSUP Dr. Sardjito dengan keluhan bau mulut, hilangnya gusi pada langit-langit, dan kegoyahan gigi rahang atas. Pasien didiagnosis SLE sejak lebih dari 1 tahun yang lalu. Pada pemeriksaan intraoral, selain lesi pada mukosa palatum, ditemukan juga nekrosis pada tulang palatum, kehilangan gigi 14, 15, 16, dan 25, serta kegoyahan derajat 3 pada seluruh gigi rahang atas yang tersisa. Pasien dirawat dengan obat Myfortic (2 x 180 mg/hari) dan Fluconazole (1x150 mg/hari) kemudian dirujuk ke Poli Bedah Mulut untuk dilakukan maksilektomi, dilanjutkan dengan pembuatan protesa obturator oleh tim prostodonti. Pasien dibuatkan obturator pasca bedah untuk menutup celah palatum pasca maksilektomi. Pencetakan menggunakan bahan hydrocolloid irreversible sebelum operasi untuk pembuatan obturator pasca bedah. Insersi obturator menunjukkan celah palatum tertutup rapat oleh plat akrilik. Retensi didapatkan menggunakan kawat stainless pada titanium wire mesh pengganti tulang maksila. Tidak ada keluhan saat kontrol, penelanan baik. Tiga bulan pasca pemakaian obturator pasca bedah dilakukan pemasangan obturator definitif resin akrilik rahang atas. Pemeriksaan klinis menunjukkan suara sengau berkurang, estetis, dan pengunyahan baik. Simpulan: Protesa obturator definitif resin akrilik pada pasien SLE pasca maksilektomi dapat mengembalikan fungsi estetik, mengurangi suara sengau (mengembalikan fungsi bicara), mengembalikan fungsi penelanan, dan pengunyahan. Kata kunci: Maksilektomi, obturator definitif resin akrilik, systemic lupus erythematosus.   ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is a chronic inflammation that involves the nervous system, mucous membranes, and other organs. Avascular bone necrosis (AVN) is a symptom that appears in people with SLE. Maxillectomy is performed on the maxillary bone affected with AVN. The post-maxillectomy gap closure was performed using an intraoral maxillofacial prosthesis, namely an obturator. This case report was aimed to examine the prosthetic rehabilitation using Acrylic resin definitive obturator prosthesis in SLE patients post-maxillectomy. Case report: A 21-years-old woman came to Dr Sardjito Oral Clinic with complaints of bad breath, palatogingival loss, and loose maxillary teeth. The patients was diagnosed with SLE for more than one year prior. The intraoral examination result showed that apart from the palatal mucosa lesions, there was also found necrosis of the palate bone, loss of teeth 14, 15, 16, and 25, and grade 3 loose of all of the remaining maxillary teeth. The patient was treated with Myfortic® (2 x 180 mg/day) and Fluconazole® (1 x 150 mg/day), then referred to the Oral Surgery Clinic for maxillectomy, followed the fabrication of obturator prostheses by the prosthodontist team. The patient was assigned a postoperative obturator to close the palate gap after maxillectomy. An imprint was carried out using an irreversible hydrocolloid material before surgery for the manufacture of a post-surgical obturator. The obturator insertion shows that the palate gap was tightly closed by an acrylic plate. Retention was obtained using the stainless wire on titanium wire mesh instead of the maxillary bone-the patients presented no complaints during control and had adequate ingestion. Three months after wearing a postoperative obturator, the acrylic resin definitive obturator prosthesis was then installed. Clinical examination showed reduced nasal sound, and better aesthetical and mastication aspect. Conclusion: Acrylic resin definitive obturator prosthesis in post-maxillectomy SLE patients can restore aesthetic function, reduce nasal sound (restore speech function), restore swallowing and mastication function. Keywords: Maxillectomy, acrylic resin definitive obturator prosthesis, systemic lupus erythematosus.

Item Description

0854-6002
2549-6514
10.24198/jkg.v32i2.28175