KPPIKG 2016 The 17th Scientific

Meeting and Refresher Course in Dentistry

Faculty of Dentistry Universitas Indonesia

2016 Faculty of Dentistry Universitas Indonesia

Jakarta, Indonesia Editor : Dr. Yuniardini S. Wimardhani, drg, MSc.Dent

Nadhia Anindhita Harsas, drg, SpPerio

Andini Tri Wijayati,drg

Perpustakaan Nasional RJ, Data Katalog dalam Terbitan (KDT)

Universitas Indonesia. Fakultas Kedokteran Gigi. Pertemuan (ke-17 : 2016 : Jakarta)

KPPIKG 2016 The 17th Scientific Meeting and Refresher Course in Dentistry

Faculty of Dentistry Universitas Indonesia / editor, Yuniardini S. Wimardhani, Nadhia Anin-

dhita Harsas, Andini Tri Wijayati Jakarta: Fakultas Kedokteran Gigi Universitas Indonesia,

2016.

viii, 354 hIm.; 29,7

ISBN 978-979-8182-53-2

1. Kedokteran gigi-Kongres dan konvensi I. Judul II. Yuniardini S. Wimardhani, III. Nadhia Anindhita Harsas. IV.Andini Tri Wijayati

KPPIKG 2016

The 17th Scientific Meeting

and Refresher Course in Dentistry

Content

Welcome Note From the Chairperson of KPPIKG 2016................................................................................... ........ iii Note from the Editors .................... ,……………………………………………………………………………… IV

SECTION ONE: ORIGINAL ARTICLE

1. PREVENTIVE AND SELF CARE TRArNING IN PREGNANT WOMEN TO IMPROVES

KNOWLEDGE, ATTITUDE, AND PRACTICE

Anne Agustina Suwargiani, Netty Suryanti, Asty Samiaty Setiawan………………………………….

1

2. THE EFFECT OF STRAWBERRY ON COLOR CHANGING

OF TOOTH WITH EXTRINSIC STAIN

Ita Astit Karrnawati, Ita Yulita, Rahaju Budiarti……………………………………………………….

9

3. COLOR CHANGES OF MICROHYBRID RESIN COMPOSITE AFTER BLEACHED WITH

HYDROGEN PEROXIDE

Astrid Yudhit, Kholidina Imanda Harahap, Sefty Aryani Harahap……………………………………

15

4. SURFACE HARDNESS OF HIGH COPPER DENTAL AMALGAM AFTER IMMERSED

IN FERMENTED MILK

Kholidina. Harahap, Rusfian, Aflah Triana…………………………………………………………….

19

5. ANTIDACTERIAL EFFECT OF RADISH TUBERS (Raphanus sativus L.) ON F.

nucleatum AND P. gingivalis AS AN ALTERNATIVE MATERIAL FOR ROOT CANAL

MEDICAMENT (in-vitro study)

Cut Nurliza, Trimumi Abidin…………………………………………………………………………..

23

6. POOR ORAL HEALTH IS RELATED TO CARDIOVASCULAR DISEASES

Bramma Kiswanjaya, Trelia Boel, Menik Priminiarti, Hanna.B. Iskandar……………………………. 29

7. INCIDENCE OF PARESTHESIA FOLLOWING THIRD MOLAR MANDIDULAR SURGERY

IN RSGMP FKGUI ON PERIOD JUNE-AUGUST 2015

Egy P Lenggogeni, Vera Julia, Rachmitha Anne………………………………………………………

33

8. CLINICAL EVALUATION OF 20 AMELOBLASTOMA PATIENTS POST PARTIAL

MANDIDULAR RESECTION WITH RECONSTRUCTION PLATE (Research Paper)

Santi Anggraini, Corputty Johan EM, Lilies D. Sulistyani…………………………………………….

39

9. RELATIONSHIP BETWEEN ANGLE'S CLASSIFICATION OF MALOCCLUSION

AND FACIAL PROFILES PATTERN

Rudi S Darwis, Hillda Herawati, Rina Putt; Noer Fadilah, Cindy Anggadini…………………………

47

10. SALIVARY PH AND BACTERIAL COUNT ASSESMENT IN CHILDREN WITH

HIGH CARIES RISK

Riana Wardani, Cucu Zubaedah, Asty Samiaty………………………………………………………..

51

11. EFFECT OF POSITIVE IMAGES "VISIT TO THE DENTIST' TOWARDS ANXIETY

(STUDY OF SALIVARY ALPHA AMYLASE)

Adina Novia, Margaretha Suharsini, Mochamad Fahlevi Rizal………………………………………..

55

12. EFFECTIVENESS OF LIME (CITRUS AUNRANTIFOUA) EXTRACT IN INHIBlTING

DENTAL PLAQUE FORMATION FOR EARLY CHILDHOOD CARIES"

Fajriani, Resky Mustafa………………………………………………………………………………...

59

13. RELATIONSHIP BETWEEN EATING FREQUENCY AND EARLY CHILDHOOD

CARIES (ECC) OCCURANCE IN ENDEMIC AREA OF MALNUTRITION STATUS

Pindobilowo, Febriana Setiawati, Riska Rina Darwita………………………………………………...

63

14 RADIOGRAPHIC POSITION OF MENTAL FORAMEN IN BATAKAND MINANGKABAU

STUDENTS IN FK UNSRI

Putri Elya Lestari, Shanty Chairani, Erwan Naufal…………………………………………………….

67

SECTION TWO: CASE REPORT

1. DELAYED TOOTH REPLANTATION AFTER TRAUMATIC AVULSION: A CASE REPORT

EmmanueUa G. Untoro, Bambang Nursasongko……………………………………………………………….. 71

2. ENDODONTIC TREATMENT ON MAXILLARY THIRD MOLAR WITH LIMITED

MOUTH OPENING

Ridzki Ridhalaksani, Kamizar…………………………………………………………………………………...

77

3. REMOVAL OF METAL POST USING ULTRASONIC DEVICE IN NON-SURGICAL

RETREATMENT PROCEDURE: A CASE REPORT

Dian S. Nasution, Anggraini Margono…………………………………………………………………………..

81

4. ROOT CANAL TREATMENT OF NON VITAL TOOTH WITH DISCOLORATION

AND DIASTEMA USING INDIRECT COMPOSITE VENEER

Syahdini Meriana, Tien Suwartini, Aryadi Subrata……………………………………………………………

87

5. INDIRECT COMPOSITE RESIN RESTORATION IN ENDODONTICALLY TREATED

POSTERIOR TEETH

Melaniwati, Juanita A Gunawan, Ade Prijanti…………………………………………………………………..

91

6. ENDODONTIC TREATMENT FOR ANOMALIES TEETH

Nevi Yanti, Fitri Yunita, TrimumiAbidin……………………………………………………………………….. 95

7. RECURRENT INTRAORAL HERPES: THERAPEUTIC CHALLENGE IN DIFFERENT

IMMUNE STATUS PATIENTS (Report of Two Cases)

Ahmad Ronal, Harum Sasanti…………………………………………………………………………………

103

8. THE COMPLEXITY IN TREATING NECROTIZING ULCERATIVE ORAL LESIONS

IN PEDIATRIC PATIENT WITH ACUTE LEUKEMIA

Ambar Kusuma Astuti, Harum Sasanti Yudhoyono……………………………………………………………..

109

9. PREDISPOSING FACTORS OF RECALCITRANT ORAL LICHEN PLANUS EROSIVE

TYPE (A CASE REPORT)

Fitriany Darwis, Afi Savitri Sarsito……………………………………………………………………………

117

10. NOMA-LIKE ORAL LESIONS INDUCED BY POLICRESULEN IN A PATIENT WITH

MYELOFIBROSIS

Widya Apsari, Harum Sasanti…………………………………………………………………………………

121

11. DENTIST'S ROLE IN IMPROVING ORAL FUNCTION OF PATIENT WITH ACUTE

MYELOID LEUKEMIA

DwiAriani, SitiA. Pradono………………………………………………………………………………………

125

12. ORAL CANDIDIASIS IN HIV+ PATIENT: CHALLENGE IN TEAMWORK

MANAGEMENT

Anzany Tania Dwi Putri, Felicia Paramita………………………………………………………………………

129

13. MALPOSITION OF TEETH PREDISPOSED RECURRENT APHTHOUS STOMATITIS: NEED TO BE OBSERVED Helena Meyyulinar, Siti Alliyah Pradono……………………………………………………………………….

135

14. COMBINATION OF ARCH BAR A D QUICK FIX AS MAXLLLOMANDIBULAR FIXATION

IN THE ANGLE AND SYMPHISIS FRACTURE OF MANDIBLE (CASE REPORT)

Siska Sutedja, Evy Eida Vitria…………………………………………………………………………………...

139

15. ADENOMATOID ODONTOGENIC TUMOR OF THE MANDIBLE MIMICKING DENTIGEROUS

CYST: A CASE REPORT

Fiona Verisqa, Dwi Ariawan…………………………………………………………………………………….

143

16. MANAGEMENT OF SCHWANNOMA OF THE TONGUE (CASE REPORT)

BambangT. Susilo, Vera Julia………………………………………………………………………………….. 147

17. MANAGEMENT OF LOWER LIP MUCOCELES REMOVAL BY CARBON DIOXIDE (CO2)

LASER: CASE REPORT

Fredy Budhi Dharmawan, Rachmitha Anne……………………………………………………………………

149

18. SURGICAL MANAGEMENT OF MANDIBULAR ADENOMATOID ODONTOGENIC TUMOR: REPCRT OF A RARE CASE Yus A. Putra Wibawa, Lilies Dwi Sulistyani…………………………………………………………………

153

19. LIFE THREATENING ODONTOGENIC INFECTION

Hardi S Riyadi, RachmitaAnne………………………………………………………………………… 159

20. INFECTION ON LARGE ERUPTED COMPLEX ODONTOMA OF MANDIBLE: A RARE CASE

Yayan Amman, Vera Julia……………………………………………………………………………... 165

21. MANAGEMENT OF RADICULAR CYST IN THE MAXILLA WITH SURGICAL ENUCLEATION:

A CASE REPORT

M Ramaditto R, Vera Julia, Benny S Latief……………………………………………………………

169

22. SURGICAL EXPOSURE OF IMPACTED MAXILLARY CENTRAL INCISOR WITH INVERTED

POSITION IN PRE-ORTHODONTIC TREATMENT: A CASE REPORT

R. Hari Triwijaya, Lilies Dwi Sulistyani…………………………………………………………………

173

23. MARSUPIALIZATION IN PEDIATRIC RANULA

I1ham Ramadhan, Lilies D.

Sulistyani……………………………………………………………………

177

24. SURGICAL MANAGEMENT OF AN IMPACTED MANDIBULAR THIRD MOLAR WITH

OROCUTANEOUS FISTULA: CASE REPORT

Riadin J. Patomo, Retnowati, Corputty Johan……………………………………………………………

183

25. MODIFIED SURGICAL TREATMENT OF HIGH BUCCAL FRENUM ATTACHMENT TO

IMPROVE PROSTHETIC STABILITY: A CASE REPORT

Yona One Sidarta, Fredy Mardiyantoro………………………………………………………………….

187

26. THE PRINCIPLES OF SELECTING BIOPSY TECHNIQUE ON ORAL SOFT TISSUE

PATHOLOGY

Mohammad Farid Ratman, Rachmitha Anne…………………………………………………………….

191

27. MANAGEMENT OF DENTOALVEOLAR TRAUMA WITH EYELET WIRE SPLINT IN 7

YEARS OLD PATIENT: CASE REPORT

Tri H.W. Prasetyo, Dwi Ariawan………………………………………………………………………

195

28. SURGICAL MA AGEMENT OF SUBMANDIBULAR GLAND SIALOLITHIASIS: A CASE

REPORT

Yohan E. Marpaung Benny S. Latief, Dwi Ariawan……………………………………………………..

199

29. DELAYED BLEEDING 30 DAYS AFTER REMOVAL OF IMPACTED MANDIBULAR

THIRD MOLAR

Nakul Uppal………………………………………………………………………………………….

203

30. REMOVAL OF IMPACTED THIRD MOLAR IN MAXILLARY SINUS ASSISTED BY

ENDOSCOPY (A CASE REPORT)

Oditya Hamzah, Nur Aini, Lilies D. Sulistyani, M. Syafrudin

Hak……………………………………….

205

31. CASE REPORT: MAXILLARY & MANDIBULAR ORIF IN PATIENT WITH FRONTAL,

INFRAORBITAL, MAXILLA AND MANDIBLE FRACTURES

M. Zain Anggriadi, Pradono……………………………………………………………………………...

209

32. THREE-DIMENSIONAL MODEL UTILIZATION FOR RECONSTRUCTION IN ORAL AND

MAXILLOFACIAL SURGERY: A CASE REPORT

Ista Damayanti, Vera Julia, Benny S. Latief, Dwi Ariawan……………………………………………

213

33. FOLLICULAR AMELOBLASTOMA: A CASE REPORT Ira Suciati, Dwi

Ariawan………………………………………………………………………………….

217

34. MORTAL PULPOTOMY TREATMENT TO MAINTAIN DENTAL ARCH SPACE ON 8 YEARS

OLD PATIENT

Retno Oktasari, Sarworini B. Budiardjo………………………………………………………………….

221

35. DE TAL TREATMENT FOR CEREBRAL PALSY'S PATIE T AGE II YEARS OLD

Berthauli Ester Nurrnaida Sirait, Margaretha Suharsini…………………………………………………. 225

36. MODIFIED OPEN COILED SPACE REGAINER FOR MESIAL DRIFTING OF TOOTH 36 IN A

7 YEARS OLD BOY (CASE REPORT)

Wahyu Rahdelita, Margaretha Suharsini…………………………………………………………………

229

37. IDENTIFYING CLINICAL DIAGNOSIS OF AGGRESSIVE PERIODONTITIS CASES

Benso Sulijaya, Sri Lelyati Masulili, Robert Lessang, Siti Wuryan Prayitno, Agustine Irene Sukardi. 235

38. MANAGEMENT OF PERIODONTAL TISSUE DEFECT WITH REGENERATIVE THERAPY

Billy Martin, Yulianti KemaI, Felix Hartono……………………………………………………………. 239

SECTION THREE: LITERATURE REVIEW

1. MEDICAL RECORD AS EVIDENCE AND LEGAL DEFENSE FOR DENTIST

Tjen Dravinne Winata, Irin Kirana……………………………………………………………………....... 247

2. HOSPITALITY IN DENTAL CLINIC

Sri Rahayu, Wahyu Sulistiadi…………………………………………………………………………… 251

3. MECHANISM OF MANY NATURAL MATERIALS AS MATERIAL OF EXTRACORONAL

WHITENING : A BRIEF REVIEW

Meitsalisa S. Mardina, Meiny F. Amin…………………………………………………………………….

255

4. PROPER TIMING FOR DENTAL IMPLANT PLACEMENT:WHEN TO RUSH IT AND WHEN

TO TAKE IT SLOW

Ferdinand Dino……………………………………………………………………………………………..

259

5. TISSUE GRAFT FOR GINGIVAL RECESSION AND FURCATION INVOLVEMENT

Hendri

Poemomo…………………………………………………………………………………………...

263

6. CORTICOTOMY FOR ACCELERATING ORTHODONTIC TOOTH MOVEMENT

Angelique Julikadewi……………………………………………………………………………………… 269

7. PROPER AND lUDICIOUS USE OF ANTIBIOTICS IN PEDIATRIC DENTAL PATIENT

Sri Ratna Laksmiastuti…………………………………………………………………………………….. 275

8. TRANSMISSION OF STREPTOCOCCUS MUTANS AND DENTAL CARlES RISK IN CHILDREN

Udijanto Tedjosasongko…………………………………………………………………………………… 281

9. HYALURONIC ACID AS A PREVENTIVE ANTIBACTERIAL AGENT AGAINST DENTAL

BLACK STAIN

Adita Gayatri, Margaretha Suharsini………………………………………………………………………

287

10. ADENOID HYPERTROPHY AND PALATINE DIMENSIONAL CHANGES IN CHILDREN

WITH MOUTH BREATHING HABIT

Astri Kusurnaningrum, Sarworini B. Budiardjo……………………………………………………….......

291

11. HEAD POSTURE AND FACIAL PROFILE OF CHILDREN WITH ADENOID

HYPERTROPHY- ASSOCIATED MOUTH BREATHING HABIT

Joshua Calvin, Sarworini B. Budiardjo…………………………………………………………………….

297

12. ORAL HEALTH STATUS OF PATIENTS WITH LEUKEMIA

Aliyah, Heriandi Sutadi……………………………………………………………………………………. 303

13. TOOTH ERUPTION IN CHILDREN WITH DIABETES MELLITUS

Danar Pradipta Rani.Margaretha Suharsini………………………………………………………………... 309

14. HUMAN Vrn.USES ACCELERATE THE PERIODONTAL DISEASES

Dewi N. Mustaqimah, Devie Falinda…………………………………………………………………........ 315

15. A SYSTEMATIC REVIEW OF PERIODONTAL DISEASE AND CARDIOVASCULAR DISEASE

Sandra Olivia Kuswandani, Yuniarti Soeroso, Sri Lelyati Masulili………………………………………. 319

16. PREVALENCE AND RISK FACTORS OF DENTAL EROSION: ASYSTEMATIC REVIEW

Annisa Septal ita, Diah A. Maharani, Annasastra Bahar………………………………………………… 325

17. EFFECTIVENESS OF SILVER DIAMINE FLUORIDE IN DIFFERENT CONCENTRATIONS

TO ARREST DENTAL CARlES - A LITERATURE REVIEW Rani Anggraini, Risqa R. Darwita, Melissa Adiatman……………………………………………………

333

18. MASTICATORY REI-IABILITATION AS A THERAPY FOR COGNITIVE IMPAIRMENT

Kartika lndah Sari……………………………………………………………………………………........ 339

19. ORAL APPLIANCE THERAPY FOR TREATMENT OF SLEEP BRUXISM

Ade Amahorseya…………………………………………………………………………………………... 343

INFECTION ON LARGE ERUPTED COMPLEX ODONTOMA OF MANDIBLE:

A RARE CASE

Yayan Andrian1, Vera Julia2

1Oral and Maxillofacial Surgery Residency Program, Universitas Indonesia, Jakarta, Indonesia

2Department of Oral and Maxillofacial Surgery Department, Universitas Indonesia, Jakarta,

Indonesia

Correspondence e-mail to: drg.yayan.andrian@gmail.com

ABSTRACT

Background Odontoma is a benign tumor composed of ephitelial and mesenchymal hard tissue of

tooth. According to WHO (2005), odontoma is classified to compound and complex odontoma.

Odontoma occur at the second decade of life. Compound odontoma is more common than complex

odontoma with a ratio of 2 : 1. Erupted odontoma is a rare case and can be related with pain, infection

or late permanent teeth eruption. Odontoma therapy can be done by surgical removal procedure

followed by histopathologic examination. Surgical prosedure should be done in an atraumatic way to

prevent pathologic fracture at the mandible. Objectives: To report management of infection on large

complex odontoma located at the angle of the mandible. Case Report: A 26-year-old female patient

came to Cipto Mangunkusumo Hospital with a chief complaint of swelling at the left mandible since

11 days before admission. From physical examination, there are swelling at the left cheek, with soft

concistency, fluctuative, reddish appearance, warm on palpation, tenderness, and pus was collected

from aspiration. From intra oral examination, we found irregular, firm, yellowish mass at 36-38

region. From panoramic radiograph, we found large radioopaque lesion with well defined border

extending from 36 until ascending ramus. We performed incisional biopsy with the result that the

odontoma was infected at the left mandible. We performed surgical removal of odontoma under

general anesthesia with prior antibiotics administration (coamoxyclav 625mg and metronidazole

500mg for 5 days). To prevent pathological fracture, we prepared a reconstruction plate. But, during

the operation, we decided not to use the plate since the remaining bone was still thick enough.

Conclusions: Infection on erupted odontoma should be treated with antibiotics prior to the surgical

removal procedure. The surgical procedure must be conducted carefully to prevent pathological

fracture.

Key words: odontoma, erupted odontoma, infected odontogenic tumor

INTRODUCTION

Odontoma, a benign malformation of dentine

tissue, is a dysplasia of mesenchymal and

epithelial part of dentines. Odontoma is the

most prevalent case of odontogenic tumor,

with the percentage of 22% compared with

other odontogenic tumor cases.1 According to

WHO, odontoma classifies as per-tissue

composition, which is a complex and

compound type.2 The difference between these

two types could be seen from its tissue

characteristics. In compound type, tissue

components are more easily distinguished

compared to complex type odontoma. In

complex odontoma, epithelial and

mesenchymal components are mixed,

altogether resulting in indistinguishable

dysplastic tissues. Meanwhile, in compound

odontoma, enamel matrix structure, tubular

dentine enamel, and pulpa tissue could be well

distinguished. From all odontoma cases,

compound odontoma occur more frequently,

with a percentage of 67% compared to 33%

complex odontoma cases. Although both of

these odontoma cases could occur in any

location intraorally, compound odontoma is

often found in the maxilla, while complex

odontoma in the mandible.3

Risk factors in the development of odontoma

Include age, gender, history of trauma and

infection, systemic disease, or a genetic

mutation. Odontoma is commonly found in

children and young adults, explaining why the

first two decades of life is a vulnerable age for

experiencing odontoma.4,5 In his study, Hitchin

stated that odontoma is caused by genetic

mutations and can be inherited.6 While

Andreason and Basstony stated that local

trauma can be one risk factor in development

of odontoma due to disturbances of tooth

development stages.7

Odontoma is usually asymptomatic, and is

often found during routine radiological

examination.8 In some cases, odontoma might

cause complaints in patients as if the odontoma

erupted into the oral cavity.9,10 The eruption

can be seen as a yellowish-white hard mass

that may arise in the dental region. Odontoma,

which has erupted, is more likely to be

infected, so the patient can come to the

clinician with complaints of pain due to

infection.11,12 Patients may come with

complaints from common signs of

inflammation, namely: the appearance of

bumps, which feels warm and painful.

CASE REPORT

A 26-year-old female patient came to Rumah

Sakit Cipto Mangunkusumo (RSCM), with

chief complaint of swelling on her left cheek

since 11 days before admission. On clinical

examination there was swelling on her left

cheek with a soft consistency, there were

fluctuations, colored red and has a warmer

temperature than the surrounding tissue, there

was pain during palpation, and we found pus

during aspiration. On intra-oral examination,

we found hard bumpy yellowish-white lesions

in the region of 36-38.

On the panoramic radiograph, there was a

radiopaque imaging of firmly bounded mass in

the region of 36 to ramus ascendens. We did

incisional biopsy in the mandible with the

histopathological readings of infected

odontoma. We performed surgical removal of

odontoma under general anesthesia. Previously

we gave antibiotics (coamoxyclav 625 mg and

metronidazole 500 mg for 5 days). Although

we prepared a reconstruction plate, during the

operation it was decided not to use the plate

since healthy bones still had adequate

thickness.

Operative Procedure

Patient in supine position on the operating

table under general anesthesia. Asepsis and

antisepsis of surgical area was done with

povidone iodine then operating area is

narrowed using sterile cloth. Incision design

was drawn using metylen blue from distal

region 32 up to distobuccal region 38, then

vasoconstrictor was injected. The incision is in

accordance with the design, then the flap was

opened using rasparatorium, mass

identification was done.

Odontoma was separated into several sections

using a fissure bur without pressure, then

removed in parts using a clamp to the base of

odontoma, of which is fibrous tissue, was

discovered and later be excised to achieve

healthy bones. Irrigation with povidone iodine

rinsed with sterile NaCl. Suprasorb was

inserted into the cavity, flaps was put and

primary closed using silk 3.0 with interrupted

sutures technique.

DISCUSSION

In this patient, chief complaint of left cheek

swelling has been felt since 11 days before

hospital admission. Swelling accompanied

by pain along with pus and blood discharge.

Pain in the case of odontoma is often

caused by localized infections that

accompany its erruption. Patients

complained signs of inflammation, such as

pain, swelling, discoloration of the skin into

red, feels warm during palpation. Left

cheek’s lump was first felt one year before

hospital admission, without other

complaints. It was originally a small bump,

of which it continued to expand.

Complaints of recurrent infections were

denied by the patient. Lumps are settled,

not intermittent (Figure 1, 2).

From intraoral clinical examination, we found

odontoma eruption, which is likely to be the

focus of infection. Incision and drainage was

done in the patient, and then broad spectrum

antibiotics, co-amoxiclav, and antibiotics for

anaerobic microbes, which is metronidazole,

were given. Antibiotics were intended to

overcome the infection process that took place

in erupted odontoma.

Eruption appeared in the form of solid mass in

the region of 36-38 with yellowish-white

appearance, hard on palpation, bumpy, have

firm boundaries. Clinical features confirmed

by X-ray panoramic showed radiopaque

circumscribed mass. Odontoma excision in

patients without reconstruction plate, taking

into account that the thickness of healthy

bones are still adequate. Excision done without

inducing further injury, by separation

odontoma into small sections. Excision was

also done without pressure to avoid fracture

during surgery (Figure 3-5).

Patient experienced paresthesias after the

surgical procedure. This incident is related to

the position of odontoma which is located near

the mandibular canal, so that the excision of

the tumor mass resulted in local trauma to the

third branch of trigeminal nerve. First day after

surgery, patient complained paresthesias in the

left mandibular. Paresthetic parts is reduced

during three days control after surgery. This

shows that paresthesia experienced by the

patient is not caused by permanent nerve

injury (Figure 6, 7).

Meanwhile, a good prognosis could be seen in

this patient. Ad vitam bonam, because

odontoma is not a life threatening disease. Ad

sanactionam bonam, odontoma does not

usually happen recurrently. Prognosis ad

functionam also bonam, the remaining healthy

bone is thick enough so that patient just had a

small fracture risk. Patient is advised to avoid

eating hard foods in 3-6 months,

corresponding to the bone healing period.

Patient is advised to carry out periodical

controls in the third month, sixth month, and

one year postoperatively for evaluative

purposes.

CONCLUSION

The eruption of odontoma into oral cavity is

usually associated with some inflammation, its

impact to patients may come with complaints

such as pain, swelling, discoloration of the

skin into red, feels warm during palpation, and

delayed eruption of the permanent teeth. This

paper presents a rare case of odontomas with

localized infections that accompany its

eruption. Operative procedure of infection on

erupted odontoma should be treated with

antibiotics prior to surgical procedure. The

surgical procedure must be conducted

carefully to prevent pathological fracture.

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Figure 1. Panoramic Pre operative

Figure 2. Separation of odontoma

Figure 3. Odontoma cavity and suprasorb within

Figure 4. Mass of odontoma Figure 5. Panoramic post operative

Figure 6. Parasthesia area D1 post operative Figure 7. Parasthesia area D3 post

operative