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LESI SPESIFIK

DENTOMAKSILOFASIAL
ERWIN SETYAWAN, DRG., SP.RKG
Lesi memiliki gambaran radiograf yang mirip
Anamnesa
Pemeriksaan klinis
Lesi dikategorikan :
Struktur internal
Radiolusen
Mixed
Radiopak
Batas
Jelas
Tidak jelas
Sifat pertumbuhan
Benign/slow growing/non agressive
Malignant/fast growing/agrressive
DESKRIPSI SISTEMATIS DARI SUATU LESI
Site or anatomical position
Size
Shape
Outline/edge or periphery
Relative radiodensity and internal structure
Effect on adjacent surrounding structures
Time present, if known

Ada juga yg mendeskripsikan dgn metode 4SBCA :


(Site, Size, Shape, Simetry, Border, Content, Association)
SITE OR ANATOMICAL POSITION
Localized to the mandible, affecting:
the anterior region
the body above or below the inferior dental canal, or
related to the teeth
the angle
the ramus
the condylar process
the coronoid process
both sides (bilateral)
several sites
Localized to the maxilla, affecting:
the anterior region
the posterior region
both sides (bilateral)
several sites

Generalized, affecting:
both jaws
and/or other bones multiple lesions may also affect the :
cranial vault
long bones
cervical spine
Originating from a point or epicentre relative to
surrounding structures, e.g.:
in bone or soft tissue
above or below the inferior dental canal
in or outside the inferior dental canal
in or outside the maxillary antrum
inside or outside a tooth follicle
at a tooth root apex.
SIZE
Pengukuran dalam satuan ukuran (mm, cm)
Penggambaran area lesi
Contoh : lesi radiolusen berada di angulus mandibula dengan ukuran
mulai dari apikal 47 sampai sigmoid, dan dari batas anterior ramus
mandibula sampai inferior dental canal
SHAPE
Unilocular
Multilocular
Pseudolocular
Round
Oval
Scalloped or undulating
Irregular
OUTLINE / EDGE OR PERIPHERY
RADIODENSITY AND INTERNAL STRUCTURE

Uniformly radiolucent
Radiolucent with patchy opacities within (mixed)
Radiopaque
EFFECTS ON ADJACENT SURROUNDING STRUCTURES

The teeth there may be evidence of:


Resorption, which is a feature of long-standing, benign but locally
aggressive lesions, chronic inflammatory lesions, and malignancy
Displacement
Delayed eruption
Disrupted development, resulting in abnormal shape and/or density
Loss of associated lamina dura
Increase in the width of the periodontal ligament space
Alteration in the size of the pulp chamber
Hypercementosis
Surrounding bone there may be evidence of:

Expansion:

Displacement or involvement of surrounding structures, including the:


Cortex of the inferior dental canal
Mental foramen
Lower border cortex of the mandible
Floor of the antrum
Floor of the nasal cavity
Orbits

Increased density (sclerosis)

Subperiosteal new bone formation

An increase in the normal width of the inferior dental canal

Irregular bone remodelling, resulting in an abnormal shape or unusual overall


bone pattern.
STEP-BY-STEP GUIDE
Step I
Deskripsi lesi (4SBCA)

Step II
Anatomi normal
Artefak
Patologis

Step III
Jika lesi adalah patologis/kelainan dapatan, kelompokan mnrt jenis
penyakitnya

Step IV
Cari kemungkinan diagnosanya sesuai klasifikasi

Step V
Bandingkan dgn gambaran lesi2 yg mirip
KLASIFIKASI KISTA & TUMOR WHO 2005

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16
KLASIFIKASI LESI BERDASARKAN VARIASI RADIOPAKNYA

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18
19
KLASIFIKASI LESI BERDASARKAN DENSITAS RADIOPAK

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CONTOH LESI RADIOPAK

Compound odontome

Complex
odontome
irregular exostoses
Cementoblastom
a
compact osteoma
cementoma
CONTOH LESI RADIOLUSEN

Unilocular
ameloblastoma
Multilocular
ameloblastoma
REFERENSI

Whaites E. Essentials of dental radiography and radiology. 4th ed. toronto:


churchill livingstone elsevier; 2007.

White SC, Pharoah, MJ. Oral Radiology Principles and Interpretation 6th Ed.
Philadelphia: Mosby Co; 2009.