KEGAWATDARURATAN

TRAUMA
PADA GIGI
KHOIRUNNISA ILHAM/ PO.713261171021

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TDI ( Traumatic Dental Injury )
Trauma gigi adalah kerusakan yang
mengenai jaringan keras dan atau
periodontal karena sebab mekanis.

Umumnya melibatkan gigi anterior :

insisivus sentralis dan lateralis RA
sulung/permanen
TRAUMA
01 Trauma pada jaringan lunak
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02 Trauma pada gigi-geligi susu

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03 Trauma pada gigi permanen

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 Riwayat Cedera
Mungkinkah luka
Alat apa yang tersebut
Apakah Apakah menimbulkan luka
kecelakaan, pasien disebabkan oleh
serangan/perkela
yang sedang peluru yang Apakah banyak
pingsan ?, diperiksa? Apakah kehilangan
hian?, apa yang kemungkinan
apakah luka itu bersih atau masih tertinggal darah ?
terjadi sebelum
akibat-akibat ada benda asing di pada jaringan ?.
dan setelah
dari luka dalamnya ? Sudah berapa lama
cedera?, apa
pada kepala Mungkinkah itu luka tersebut
jenis pertolongan
luka yang kecil terjadi ?
pertama yang berkembang tetapi dalam ?
diberikan ? ?

Kesadaran Cek luka Penyebab dan Darah

Situasi lamanya luka
 Trauma pada jaringan lunak

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 DENTAL
BRACES CLINIC
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Trauma pada Gigi Akibat tekanan vertikal dan paling
sering mengenai gigi-gigi anterior atas
Geligi Susu
Pasien mungkin
datang dengan :
1.Tanpa gejala
klinik/radiografi
2.Goyang
4. Intrusi
3.pergeseran
5. Avulsi
6. Perubahan warna
7. Fraktur
 Trauma pada Gigi Permanen
Gigi Avulsi Sebagian
Gigi Avulsi Penuh

Fraktur Akar Gigi Anterior Fraktur Gigi Mahkota Anterior

Fraktur Mahkota Gigi Posterior Fraktur Akar Gigi Posterior

 Pertimbangan umum
Riwayat Penyakit
Waktu dan keadaan trauma terjadi
Pemeriksaan Radiologi

Pemeriksaan klinis Peringatan tentang

Ekstra dan intra oral. Luka pada kemungkinan nekrosis
jaringan lunak diperiksa dgn probe.

Gigi yang berdekatan Melengkapi data dan

dan Antagonis mencantumkan detail
Apakah ikut terlibat ? kejadian perawatan
Avulsi
Keluarnya seluruh gigi dari soket akibat
trauma. Secara klinik & foto ronsen, gigi
tidak ada di dalam soket ( Dalimunte,
2003)
Penyebab :

Kecelakaan lalu lintas

perkelahian

Jatuh
Kecelakaan olahraga

Kerusakan Jaringan Periodontal

Penyakit Sistemik (DM,dll)
 Avulsi
Pulpa Tulang alveolar, sementum, ligamen
Gingiva
periodontal, gingiva, dan pulpa akan
mengalami kerusakan pada saat gigi
secara total keluar dari soketnya
Sementum
(jacobsen,2003)
Ligamen Periodontal
Tulang Alveolar Tercabutnya gigi dari soketnya akibat
trauma menyebabkan terputusnya
ligamen-ligamen periodontal dan suplai
darah ke jaringan pulpa. Sebagai
akibatnya pulpa gigi mengalami
Bila gigi avulsi tidak segera dirawat, maka dapat nekrosis dan periodonsium rusak
menimbulkan dampak negatif, yaitu gangguan fungsi, parah (Ram D, 2004)
estetis, dan psikolog.
Avulsi (avulsion) adalah kondisi ketika
otot terentang kuat melampaui
kebebasan kemampuan jangkauan
gerak, atau ketika bertemu dengan
resistensi tiba-tiba/mendadak ketika
melakukan kontraksi kuat.
 Pemeriksaan pasca avulsi

Pemeriksaan ekstra oral

Biasanya terjadi perubahan gigitan, ketidak simetrisan wajah,
pergerakan rahang yang abnormal dan sakit, pembengkakan,
numbness (rasa baal)

Pemeriksaan intra oral.

mukosa & gingiva dibersihkan dengan menggunakan H2O2
3%, larutan salin atau air hangat
Pemeriksaan Rontgen
apakah terdapat benda asing pada jaringan lunak mulut. .

Media
Larutan Salin Saliva Susu Saline fisiologis Air Kelap
Penyimpanan
 Penatalaksanaan Avulsi
01 Replantasi
Sebelum mendapatkan
tindakan perawatan pasien
Resorpsi akar tidak akan terjadi apabila replantasi diinstruksikan untuk
dilakukan dalam waktu kurang dari 10 menit gigi menyimpan gigi dalam media
avulsi, tapi resorpsi akar kemungkinan terjadi alumunium foil atau
50% pada replantasi gigi 10-15 menit pasca Replantasi perintahkan anak untuk
avulsi sehingga jelaslah bahwa replantasi yang menggenggam dengan hati-
segera akan mempengaruhi hasil perawatan hati gigi dalam sapu tangan
ataupun kain bersih dan
segera ke dokter gigi. Gigi

02 Splinting dapat juga disimpan dalam

media penyimpanan untuk
Splint merupakan suatu alat yang digunakan untuk mendukung, melindungi
menghindari dehidrasi ligamen
dan menstabilisasi gigi serta memberikan perlekatan pada saat proses 11 periodontal dan kematian
regenerasi serat-serat ligamen periodontal pulpa.
Bahan yang dapat dilakukan untuk melakukan splinting, dengan Titanium
Resorpsi akar hampir tidak
Trauma Splint (TTS), orthodontic wire splint, wire composit splint,resin
Splinting terhindarkan apabila melebihi 2
splint, porselen veneers ataupun akrilik splint
jam, waktu maksimal dilakukan
replantasi adalah 48 jam
setelah gigi berada diluar soket
 Syarat dari:
& terjadinya trauma.
Replantasi
Syarat replantasi adalah sebagai berikut:
 Harus dilakukan dlm waktu seminimum
mungkin < 30 menit setelah avulsi.
 Gigi harus dalam keadaan bersih.  Tidak
terdapat karies yang luas
 Tulang alveolar tidak hancur agar dapat
menopang gigi yang akan direplantasi.
 Ligamen periodontal tidak tergores.
Splinting
Syarat splinting sebagai stabilisasi kasus gigi
avulsi adalah sebagai berikut:
 Mempunyai sifat pasif & tidak menyebabkan
 Fleksibel, yaitu tidak mengganggu pergerakan
fungsional gigi dan memungkinkan terjadinya
regenerasi ligamen periodontal
 Memungkinkan pemeriksaan tes vitalitas &
akses endodontik pada gigi yang avulse.
 Mudah digunakan dan dilepaskan.
 Nyaman dan mudah dibersihkan oleh pasien
 Dapat dilakukan sesegera mungkin secara intra
oral tanpa memerlukan prosedur laboratorium.
 Harus adekuat, sehingga stabilisasi gigi dapat
terjamin selama perawatan.
 Tidak boleh menyebabkan pergeseran terhadap
gingival.
 Memperhatikan nilai-nilai estetik
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