LAPORAN PLENARY DISCUSSION BLOK 11

KELOMPOK TUTORIAL 1 Anggota : 1. Noviana Eka ST 2. Anindita Purnama W. 3. Anisa Wahyu 4. Dhita Ardian Mareta 5. Camelia Devi 6. Yuni Istiana 7. Ardian Sari R 8. Rifda Muslima Sarie 9. Rusty Faily Firdaus 10. Irma Fauziah 11. Mario Febrianto 12. Hanif Bram 13. Rachmalia Putri P ( 20090340001 ) ( 20090340006 ) ( 20090340011 ) ( 20090340015 ) ( 20090340020 ) ( 20090340027 ) ( 20090340034 ) ( 20090340042 ) ( 20090340048 ) ( 20090340052 ) ( 20090340070 ) ( 20090340074 ) ( 20090340095 )

FKIK PRODI KEDOKTERAN GIGI UMY 2011

SKENARIO 3
A student complained that there was a click sound on his jaw joint when he opened his mouth a bit wider and sometimes his jaw joint struck out. This bothered much his activities. His face looked symmetrical. On mouth cavity examination, it was found out that the midline of the front teeth was asymmetrical. His front teeht were crowding, his three lower molars peeled off, and his occlusal and incisal surfaces of his teeth had been worn -out. I. Clarified the term Clicking : click sound on TMJ Struck out : menabrak Bit wider : more wide Peeled off : lose Worn out : atrisi II. Determined the problems 1. What does the definition of clicking ? 2. What are the causes of clicking ? 3. How does the mechanism of clicking ? 4. What are the types of clicking ? 5. What are the symtomps of clicking ? 6. What are the effect of clicking ? 7. How to diagnose of clicking ? 8. What are the treatment and prevent of clicking ? 9. What does the corelation clicking with oral cavity and missing 3rd molar ? 10. What are the degrees severity of clicking (derajat keparahan clicking )? 11. What are the kinds of sound another clicking ? 12. Where does the resources of sound ? 13. What are the kinds disorder of TMJ ? III. Analized the problems 1. The definition of clicking Clicking is a one of symtomps TMD with fast sound in the jaw when we open and close the mouth. 2. The causes of clicking : y Stress bruxism dislocation TM y Trauma y Malocclution teeth y Open the mouth bit wider y Losing posterior teeth y Decreasing synovial liquid

3. Mechanism of clicking : If the attachment of meniscus on the lateral pole condylaris processus slacken or interrupted, or if the bilaminar zone of damage or degeneration due to trauma or joint disease (especially the superior stratum, namely the elastic fibers), or both, then the stability of the joints will be disrupted. As a result there will be a shift toward anteromedial disc due to lack of restraint against the lateral superior pterygoideus musculus. Decreased anterior lateral shift towards a spontaneous from this disc would cause "clicking" a typical, which would occur if the distance between the incisal increased. Source of "clicking" the joint is related to the shift condylaris processus posterior meniscus through a thick ribbon. With a shortened anterior shift of the meniscus, there was a "clicking" next. 4. The types oc clicking : y Krepitasi Is a clinical sign of structural changes in one or more surface anatomy of the TMJ. y Clicking since devisisasi form Beep kliking occur when opening and closing of the mandible and at the opening of iterative. y Clicking due to hypermobility At the time of maximal mouth opening, mouth opening capacity but not limited to clicking sounds occur at the end of the opening of the mouth and the movement towards the contralateral mandible. y Clicking for inkoordinasi muscle Klicking sound can be heard at different levelsin opening and closing mouth iterative y Clicking due to disc displacement Occurs when abnormal disc position in relation to the head of the condyle.

5. The symtomps of clicking : y Pain in the face y Pain in the ears y Sound in the joint y Dizziness y Vertigo y Protusif retrusif 6. The effect of clicking : y Atrisi y Locking y Inflamation of TMJ y Asymmetris midline y Muscle spasme

y y y

Trismus Ankylosis Rheumatoid atritis

7. Diagnose of clicking : History: a. Pain b. Sound of joint c. Changes in broad movement d. Changes in occlusion e. Information collateral circumstances f. Previous treatment g. Stress Clinical examination: a. Occlusion b. Inter-incisal opening c. Other Movements d. Deviation e. Palpation f. Muscle palpation g. Cervical palpation h. Auscultation Radiography: a. X-ray examination b. X-ray interpretation c. Artrografi d. Fluoroscopy e. Depictions of closed lock f. CT scan and MRI How specific Diagnostic a. Diagnostic injections, usually a local anesthetic ingredient selected without vasokontriktor, especially procaine. b. Atroskopi TMJ c. Evaluation of the superior joint cavity d. Atroskopi anatomy e. Acoustic Analysis 8. The treatment of clicking :  Treatment y Giving medicines : aspirin, ibuprofen, diazepam y Phsioterapi y Manually repositioning y Occlusal splint

Surgery

9. Corelation clicking with missing 3rd molar There is a relationship between clicking with the loss of third molar teeth. With the loss of third molars, it will not happen occlusion with the antagonistic teeth, except that M1 is a key dental occlusion, so that when the M1 tooth is lost there will be a malocclusion, while one of the causes kliking is the presence of malocclusion and the effect on changes kliking midline. 10. The degrees severity of clicking (derajat keparahan clicking ) y no pain, low sound y pain, cant open mouth y no pain, no sound 11. The kinds of sound another clicking y Krepitasi y Crunching y Clanching y Greating 12. The resources of sound y Source kliking joints is associated with a shift prosessus meniscuss condylaris through the thick posterior band. With anterior displacement of meniscuss memendeknnya, occurred next kliking. y Because kliking artikuklaris Discus is the shift out of prosessus glenoidea. 13. The kind disorder of TMJ Dislocation: misalanya luksasi, occurs when the capsule (periodontal ligament) and ligaments Temporo mandibular disorder allowing prosessus condylaris to move more to the front of the eminentia articularis dank e superior at the time of opening the mouth. Closed Lock: is the result of a shift to the anterior discuss ankylosis: an immobilization or fixation of joints due to pathological conditions that can be intrakapsular or extracapsular Atralgia: pain in joints Arthritis: an overview for a variety of inflammatory conditions of the joints, such as osteoarthritis, rheumatoid arthritis Artrosis: degenari process is not due to inflammatory arthritis crepitus: creak or groan noise generated by the affected joint disease discitis: a state where the disc interarticularis and perlekatannya experiencing inflammation and pain when palpated Sublokasi: partial dislocation myalgia: muscle pain Miospasme: spasm or muscle spasms or muscle group Pseudartrosis: false joints, either because of no bone union after fracture, or a state that

deliberately inflicted on corrective surgery TM joints (ankylosis) trismus: mastication muscle spasm.