HI!

Group 1:
Karlyn Arnelisa 17-004
Istighfaroh Irawan 17-007
Fitria Arfina Eka Putri 17-009
Muhammad Rifki 17-011
Heru Sulfan 17-016
Syaella Olvira Muiza 17-020
Siti Herdiyanti 17-035
Muhammad Jumhari 17-044
Syaidatul Fauziah 17-061
Muhammad Salman Rafi 17-067
Desti Rosman 17-070
Dwitia Putri 17-073
Rahmad Ansori Nasution 17-0 96

Scenario 3
 A male was 35 years to come to RSGM with pain and easily was
bleeding on the gums accompanied the smell of the mouth. From
anamnesis it turns out the patient was five years is not have a fixed
and nonsmoker heavy in addition to the patient frequently
comsume mie instan. This time the patien often feel the paint as eat
spicy and feel like metal. Patients in condition of the febris with
temperature 38 ˚C.
“My gum sick The inquest ektra oral : Detected the Limfadenopati
and white to The inquest intra oral :
 Gingiva regio 13 dan 23 the lesi punched out, craterlike depression
grey “ on top of the paila interdental the margin gingiva
 Most gingiva lined pseudomembran that are white to the grey
 Gingiva easy bloody and smell the metal
Inquest Radiograf : Not seen the missing bone. After the dentis to
provide informatin on the patient and enforce diagnosis next do
action introduction ( emergency ) in the patient
STEP Clafication of terms

1
 1. Punched out lession
2. Craterlike depression
1 3. Limfadenopati
Clarification 4. Pseudo membran
of terms 5. Febris condition
STEP Finding Problems

2
 1. Why gingiva patients easy bloody and smell the metal ?
2. Is there influence on the case ?
3. What the cause of punched out lession?
4. What kind of the disease suffered by the patient ?

2 5.
6.
7.
What causes the pseudomembran on gingiva ?
Why the patient often feel the patient as eat spicy ?
How a examination of limfadenopati ?
Identification 8. What an emergency done dentist to the patients in accordance
scenario ?
the Problem 9. If the process that occurs in the gum that normal to be like in
the scenario ?
10. Does phases of treatment dentist in the case ?
STEP Brain Storming

3
 1. Why gingiva patient easy bloody and smell the metal ?
Answer :
 Since the death of tissue on papilla interdental

3  Because there bleeding steadily

 Of the damage to the blood vessels and the invasi bacteria on
epitel network
Brain 2. Is there influence on the case ?

Storming Answer :
 A factor predisposisi
 Age wit other factors ( factors predispotion ) interconnected
getting older predisposisi local and systemic increasing
 3. What the causes of lesi punched out ?
Answer :
 Associated with NUG which is a symptom of NUG, which is tissue
death and the pseudo membrane part caused by bacterial etiology,

3
host response, predisposing factors, immune system, and habits
4. What kind of the disease suffered by the patient ?
Answer :
 NUG due to damage to the gingival tissue and absence of bone loss.
Brain NUG occurs due to microbial disease in the gingiva due to disruption
of the host system and is supported due to predisposing factors such
Storming as lack of immune, bad habits (smoking) that occur in one tooth or
several teeth and due to other predisposing factors.
5. What Causes the pseudomembran on gingiva ?
Answer :
 Because of factor predisposition like OH bad
 6. Why do patients often feel pain when eating spicy food only?
Answer :
 Not only can you eat spicy food because of hot or other foods

3 7. How the examination of limfadenopati ?

Answer :
 The examination with palpasi
Brain 8. Why complaints are accompanied by fever ?

Storming Answer :
 Because of the response from the body
 The body's response to turning off foreign objects, bacteria will
decrease due to the heat
 9. Do emergency actions taken by the patient according to the
scenario ?
Answer :
 Reduce inflammation, treat chronic diseases, reduce symptoms,
improve systemic conditions.

3
10. What are the stages that occur in normal gums to become like in
the scenario
Answer :
 Stage 1 (erosion)

Brain  Stage 2 (lesion extends to the gingival margin)

 Stage 3 (attached to the gingiva)
Storming  Stage 4 (the alveolar bone is already in NUP)
11. Are the treatment stages in this case?
Answer :
 1-2 days of evaluation, do scaling
STEP Problem Analysis

4
 4
Problem
Analysis
STEP Learning Objective

5
 1. Able to know and explain the diagnosis of
the case.

5 2. Able to know and explain the clinical

manifestations of NUG.
3. Able to know and explain the etiology of
Learning NUG.
Objective 4. Able to know and explain NUG treatments.
5. Able to know and explain prevention NUG.
LO.1 Necrotizing Ulcerative Gingivitis (NUG) is
a microbial disease in the ginggiva
Able to know caused by disruption of the host system,
and explain the characterized by death and exfoliation of
diagnosis of the gingival tissue and accompanied by
several signs and symptoms.
the case.
  Punced-out lesions
 Craterlike depression

LO.2  Lesions can extend to the margins of the gingiva, but can sometimes also be attached to the
attached gingiva and oral mucosa.
 Craters are lined with gray pseudo-membranes with well-circumscribed gingival erythema
edges.
Able to know  Gingival margine is red, shiny and hemorrhagic.
 Lesions can damage the gingiva and the layer below the periodontal tissues.
and explain the  Fetal odor and >> saliva
clinical  It can be found in chronic gingivitis or periodontal pocket
manifestations
of NUG.
LO. 3
Bacteria
Able to know Host Response
and explain the Local Predisposing Factors
etiology of
NUG. Systemic Predisposing Factors
Psychological Factors
 Treatment:
LO. 4  RM insulation using cotton rolls
 Apply topical anesthesia (2-3 minutes)
 Gently swab using a cotton pellet to get rid of
Able to know pseudomembrane and debris.
and explain  Clean the area using warm water or Hydrogen
Peroxide (H2O2)
NUG
 If possible cleansing the supragingival calculus
treatments. using USS.
 Patients w / NUG moderate and severe 
amoxicillin 500 mg (every 6 hours  10 days).
Erythromicin 500 mg (every 6 hours 10 days)
or metronidazole 500 mg (2x1  7 days)
LO. 5
Plaque control
Able to know Propylaxis
and explain Prevention of trauma from occlusion
prevention Prevention with systemic action
NUG.
Community dental health education
Prevent recurrence of disease
THANK YOU
FOR YOUR
ATTENTION