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Penutupan Fistula Celah Langitan N, Ien.I, A.K, (I PI,,,/T Protesa Akrilik Lepasan Pada Anak
Penutupan Fistula Celah Langitan N, Ien.I, A.K, (I PI,,,/T Protesa Akrilik Lepasan Pada Anak
Penutupan Fistula Celah Langitan N, Ien.I, A.K, (I PI,,,/T Protesa Akrilik Lepasan Pada Anak
Sjahril Noerdin
BagicnInnrKodohcrxi Gigi Amk F'akultas
KedokeranGigi Uni\crsitasLrdorrusiil
Abstract
Abstrak
r r r I h r i r h K l ' l ' l K (X
l II
rr€,!11].lL o*o u'
bc$13i,,nn,rtrijsiprllldrdrl.'tl]str.rrLr )ansbtik ,Dalans
ricrourpok-ke[ra ?'l:l']':.'jtt^ gLgrsusu
hanrp'r sc rrr
.rnlLperelrpu.ru
s,:or,riir lemtnurtj8.trrlL \anaber fistul,celahlangilalldcngan
pcinvatar)dan pcrr'rsrlr_n plnl prolcsr
rLr\trlinhu scbrgra hilrlng. lcnnrggaNcnrpe;ulit lurd'rktn
gtgi dirrahkiu tuluk rrenrperbrikrlcugkrtru
r,,brr1t,,r) Pcnultrpanllsltrh denge plLrlprotcsirrknlik rul'rn'
proscsrrrrrrbulilernb;'ng\'rrr! i|tnt ,rllerrrpcrldrcu
,,'r""f,r.l" po,t" r.ug lcbihboik nrertgikulr |'|celJh|.||lgiltlndiltrrlpl\l
i'",i"i..'..J"i't*;'."-',lasi|llrlanrlaporarr|.rsusln|dnn.lkllrpcnl|l||p.lllf|5l
Inci.rr:rsikestrlil.lnpcnrngirtungigagcligr nNkcelahl'rngitrl]
170
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111
_frn arr nr'rr\xt
llotltl Htalth d.rkrergrgi \arll
drlikulan olch
1' l r . r n r .d r p r L r n ( r r r : r l r . t m rI u i r l ' r lr rlti orr
( )ryLtntzdttI)n \'ng
dcotofasiilln]a Te.dapal Pcrbedaan
n\ril dari pertunblrhar d:rn pc*cNbLrngtxl
Bxrdach dkli (1992) me gcmuraKrn
nirk.rll"-f.rsr.rrp.ndJrrrr c(l.lr l'rr-rr'rri
bah\a penderita cclah hngitrn brlltcrrl
pemrgaran tang sirngat Salah satunla rdalah profil mtrkr . \ing
Ncruirlkan
c' lrh brbrr J:rrr konkrl-. disebabkLrnhanrbatar pcrtLrrrbrnrn
l.rrrjl.ks o.rnrrrl r r1:rr'dJr'ik'
L K ( ' r r " l J r rd J 1 l o m p l J l : r l J s c c p . 4 r g J r ( r r r i adl.rr r i r n t t k l t t ' t r " . 1 ' r < t c n
i.l.rlr..rrrqrtarr
LL;hIr L(pJr orrrlrrl.rrrp(rrrb(dJ"r u-"rl:rl
rhrL kGuuhannra ncmcrlukrn suitlr
' r . r l . r k . r rk': r ' . r - r r r ' .'rr r r u I ' r r ' ' l a r r r r r r r l t i - kcparehan bentuk korkaf muka bcrgrrrlLr[u
d . ' r b . r . r l r r \ : r , r .d. rrlf o r r I r l r ' d : ' r rr " J ' n r '
drsrplrn.dengiln nrerrbentlLksuirttr /f"'- r!r:rrr
,,,r{ "' Peranandoklcr gigi dalurr sualtt d.ur \\.rllLr p.lrls.rrr.:lr'brJ'rltrr\" a
darrgrgi-geligidr rahalg premrksrla Drrsan\i
r.rrn koofdinasr. p.rx\ltin dengan anggoti h r l ' o p rl s l r l
-
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b r | | n u t rl r. r r J n gd r r r
sD.sirlis lirrnn)a rdxlah nrc birntlrpela\anirn
dari kesclLrruhan Pendcrrtl l|lng bercolah ttrcmptttlet
\lnu diDerlukan
\li'.rlrr\.r l'(rrlrrr"rr\'r ilsidels dettk \ang tinggr pac:l l:lhrp
,.r,r\..rr.urrr\.r
penanggulaDgrr nlododiferensiasidibanding d'rn masrrrrLrt
t|lrdokan penccgaholl drr r! Kclainan rrng did:rpatscbrgt:rn
uDrlrrrl\;l
dan pcn\akitgigl dxn rnlrlut padl Dnrnrn\a
besxf rdill.rh
I Grgi agcncsis.khususpad'rgigr preflolrr
Pcu.rtalaksaoirlrn pcnangand cclah brbrl
prda garrscclillrn\3
dlrnrnsrsiflatcral
t1.rn cclah llngrtan rncrupaken suanL
2 Cigi lcbih remtana padx gans cclrh dltn
. , r r . : . r ' . rur r. r r q r b . r t I r r r 'l : r: 'L r 'rrl a r r g\ x n ' '
r t r
r . , u ' . d . ' r i 0 . u . r ' ' p . 'I i h r p l ' r l r ' r p a rrrr r l Prcmaksila
I Cigi iirst.
lncruDaki pehksanaalr secara benlrutrn _
r n' l n r r k l ' n r ' r " r : r
I C r ! r \ a r r 5k J l . r r r r ' h
\rns'rncnrbcakan hasrl \xng lerblrlk- setelLlh \.rrrj rrrl" rL
,rclrlLrrpenclrtia11l;cnelrtian l.lngka prnlang r ' . , . t . ,' ' ' g ' t : r & l l '
b.rdekatan dcnganclcnn) I
l , - u kL l r\ l r n r nn r . , , ,r lr r rp . r . ^ b i r ' r rb' r nr l r n f
i l \ l a l L r o > r :Jr. r r , r ' : l r l ' n r ' r r r r r ' l r ' r r r r h ' l
\Lrsihh u unr \irn! diirmpxr pida cclxh '.,n.' b,'^ 't " t"'l'
bibr d:ln ctl.rh l.rngrtin brlatcral adrl:rh 1 , . n u " ' 1 ' , ,rirt,r r r g
siqi ttrDrbuh ckloPrk
lolL nrclirrars pcndck.lonfiglrtuslnas.tltrp
glgi dar t' io-rhirmbatn,ue'upsi gigi Padl pcrldcrita
\lnq lidak h3;norris. pennasalahfu ' J d'ttr CB & CL. khususnlapadr gigi kxornus
n.rlsrl:rdatrJhlrilrutop(rrsrsf urLrur'rrr\
p!nrngcn
' l prohlrnlr Dll:'rrir
7 ErLrpsr bc cbrhan dirrr grgi-g0lrgl
Pcmncanan gigr-gcligr mcrtrprkilt
drl('rlrr-ba\3h karcni tidirk lrdl lx\xn
pcrnrirsxlahiln\ing adrl 1'rlepas drrr pcnat'r
l"Ls.rrirn celahbrbrr dan ccl|lh l rgrt'rndrn
hIl ll1rtrdak kakh sulrin\!rdclrgrniirdckrn
t rllLr' rr'tr'''r 'rl' Pcnqahnar krn':s Pada iln'rl \ rng
poriodont'l n,"n,o*ti.i cclah larrgitan nrtntrrul
reradinrr k.rnes darr pcn\xkrl
t."ut"rst.in dan NtondclsohDhdrk drdrpat
nlcrrcxlur hrrgsi nrouguD\ah )'rng bxrk
pcrbed;rarbcrmakra dari rang tak bcrcclrh
pcng-aturalrlengkLLngdxn aftI Pcnumbnhnrr
i . " " ' r " ' r ' r . r r , u r r r ' r ' rDt ( r r d i t p i lI l' r ' ( r r l 'r r l
gigr-gcligi. scrta cslctika pcrca\a drnn\a'
dipcduliln seormg dokler g1g' lnak \rnq
b"nggu,tn bicrra Ptdr P$dcfrtr
rrcin.rdrl. dar rncnrplkxn serr pcra\\rlln korcDildtrx.llx\xnr1
bcrcchb daPrl tcrlxdi
rlllg mcnrbrrnrhklrn \akttr r:rng rclatifcuktrp
lt\ xl sccarr lc'padLl \ritu iiklor ,qosal fiLroi rtlrkuli|srn\r
i"n,i P"l.kr"tt""n
.-r .r'.r .,r.,rr ',. -' l.r- L hJl !u".o ,"ng".' diiunlpci poda ccl'rh lxrrgrtrn
b:rgrprsrLrr
'' _- _ _ kxrcna tcrdapxt hubungar anlrrr tottgglt
rrrLngLLnrLrngllrr dlrr
ntrlut dan rongga hidung Orot prlltum
tl2
.) rtrt)t,t li\trLt t..lrlt Lrrrttltl \ t , ^ ) L i t1 1 r l r r " l r t t ^l t ) ' rl, l,"A
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't,ttttttt li\rrlr I r|ti ldlltkt,r \lr,rtln" l'lrr l\1n(* IIttLl, l,t)l"1, l'lld ltntl
beflllrbuiganle$at lelepon
I'omi selalLr S sunxn glgr sulLrng Prsren inrk
biasun\alcngkLrp. kccuilr padr drerlh lxnpir
I'rsr.n tidok lncmPLrn\ri kelLrlra[ Pasrcn
klrn unluk rrtclgikutrtcrapi berbrcttrx grgi di rcgio cclah Cirgi g':ligr p'rdr
ilrxnlrLr
pcrb.rlrNrncclah daplt b.rgcsfr Lc /)'rlrrtll
tlrr inluranrnrsudahd]laksrnakon.
atau lcbib ke /rrbLrl dcngrn irrxh nlahkotir
berl.r\\anxD dcng b.rlls cchhnr I JiLr
posisr gigr menlimpang rrrrrlng ikrn
l'cnrbrhasntr rncnghasilkan nrrngan cehh \ g rtLrP
besar di longkung gigi sehtnggr tilKol
KrNus peDLrtlLpan cclah langitan
berbicarx dapat tcrgiLnggrr Dcngirn
n!rnllrkr dimcnsiperDirsalahan \ang cuklrp (l.n-!llnp ot(srr
drtrtuprrla ft[ngan cclih
Lonrr-.ltks dan nlclncrlLrk r p€nongrn.rrr \ xng
, l r hI : r p l . r r r d r f r l r r rl r 'rrr' r"n
rt.rtrrrl nlrltr-rnter-drsrplrncr ScmLrr rrrrk
\.rr! mc g.rLrnrr dcibrntrtas krrrlroiisrnl'
Pislcn !nl1g nlcngrlirrrrr'l'rordlrrs
rrr firsLrk cchh bibrr d cclxh lengrliu'
' . r r r r \ . 1 r ' . r r r . . rI kn x l r l l J s l r l: .l r J L l r l! ' ! l orotisial berupa cclah brbrr d'rn ccirlr
I langitrn. pada desamrlI mcngshrrr gxnggtr'rrr
rl.ur mulut \rng me pcngaftrhrketcpltan bicarx. gangguanbLrlnsadrn Inli'iisl tclrngr
rrktu dan konsekucnsiintoncnsi trrldaktu1
bngiiul tongah- tuli scrta Pc'n sxlrhrn
bldilh untuk nlemperbaiki dcf'ck fisrk \ang estotlkamxupuopsikologrs\rtrg \elxnltrnr\r)
r\rlx Pcfkcmbangmkcnrurpu.rnberkonttt- d.rpet mengganggLrpurlicrrbrngln rnak'
r L.r'r bcrgrDrungdilri bcb.rapx perrrxsah- (lxrr
Berrtn\.rgtngguanlcfgrntLL|g(litrrl!rrts
Lr.r)Iillor firngsilarrigxnofgrn Drrnlarrn\x parrhn\r defbrmrt.rs Orgxn-orgrn,\rng
r ' . . ' o' r r d . t r l d : r r ; i
terlibal pidx proscsbcrbrc.rn sfprrlr l]rrng
r'.1rgi beniuk lcngktrng rxhalg atirs' ' drn organ anikLrlasi ldrlxlr srrnil dcrU,]r)
i.,luautrn leuk lrdlh. danlengkunggrgi
orgln \LIngjugxbcrpcrir Prdil l)rcs'snr:urrn
NlcnuruI l-rutcrslcindrn \lclrdclsohn PlinenqillaDdari p:tstcn \rn-! nr'ngllrnrl
pr rrierrtrdcngancclrh br.!sin\3mcn]l)un\ll dctbmrtas ror drtLrlrrkrnprl(lr Jspck
rtrrr:rl.rnran karrcs\ rg hanrp'fsumxdcng'rn be rlcxrl nrtlk:lnscrtr llsl)rL
Dendcn!:irrlrn
.'n.ri ,'u'n,.rtt'tctxprpath lirstrsplsrcl rnxk
Lri .dr kcl.rrnxn Tcrnratl kcbcrsrhrtr KJcrlibatan 1crirprs \i'r1rl drL'rrn
rrrlLLtnra bu|uk. dan scmul gigrnr'r httcs pcDdcrrliL cclirJlbrbrr Lliur ccLih
pcnirDgirnxn
\r,rlt.thottlt .rr'l.i .rtItl tunt/!n1 curir\) hnqitrn srnqet dlpcrltrkrrr'kilrenl sccllri
()l.h kiucna r$ Pcrlu di fcstorlsl rn ill'l11
nr.rta dopat mcnbrnru rncnr:tksrnl:rllirn
srrpalanlcniadischa!dnlrkrrxt rl "r"' I
5rgr-gclrginre I ' J l x \ . r r x r r 1 . r r r 3r . r b . r r ( l
.eir,r drpar bcrfirngsrseblg.ri fclcnsr d'rfi plttt i . . . r . " p r r ' ;u . ' 1 n ' . ' r ' r " r i i r: r r r r , I r J r r r" ' r l
'"
r )r.sir xtlu obtlr.:rtor Dil lkrn pcre\alurr bcrlatih din bc(rsihr berbrclr'l dcngilr
padl grgrgcligi untukkeDudiartdi
rrLLpot.mr nomral iuga mcmbcrrkln pcrringrnll d:rn
i.storirsL clrr0krrnr.rhkotrlog r N'lxhkotir
Dasukan rang drpit drrdrlrrr silLrh \t11r
L.,q.rrrrdisilr lLrgr bcrfungsr igrr drptrt ' r .r r r r . h , r r r r b' r.rrr,r " i r ' r ' l r ' rr ' ' r r : r l r
rr:frb.ri rctensi drn \tubilrsllsrbasr plrt \lcnrngktrtn\tl/,/t/t' r lkir!idcngrnb:trr
ir (n.sr|l\ir \lirsxhh tL nbtrh kcnrbrng
d:rnl1raman.mcnrakaiprotcsrgrgt rang lLtg't
l:n.![rrrg |ilhang!rrgr hllrtrsdrpet nlo lrmrn
borlirngsrnronutLrprtisrrl;l ccloh.lilngltxnn\I
.l!il rilrlqiln slmDarl lcllxrnbit ekspallsl m.nrbx\ir da pxk sangxlposrlrlbx!1rpasrcrr
' r r r r n r l - r rkl r n
t . .r.l .i.rrr ..'':.rr: d.rr' \{lklu nrakrn drn mrnutDdiprt drpcrperrrrrK
sLLsun.rn gigi \xng pxnh P.rLrtupanProtcstr \.' rof!:f1
I r r l u r r l r ( l h ' l l l l r L l . r .l l l l a l r l r r ' r " '
.lrirxrlfkxn dapot rlrcngxtasirasl bxu nrhrt hidurrs rti0 s.rltrr.tll P'rnllrr\rn
rlLLrirttcrs.LnqkLrtn\r nrilkr iur dicchh drn pasicn irnirk dirDrt.turlrtruh
mcurungkrnklrn
sriin!ln\l bcasrn dall bclkcnlbu{ socrr:l lrornl:rl nllprl
grngguan irdrnli rasl L) r \rng lroirN
175
nr!r)\cri!ngkandrdxlinr rongg.rscrn lcllDga Padapasrcrr|lU tehh drl.rkuk r korcksl
lrdirl rnudirhuntuk ldrinGksr.sehinggas.rltr bcdah dafl celah liDgitan (r.r/ /.//.//c). lcl.rpr
\itu prr s\ irr:rt unftrk dapat drlilkukan tcrladi hnnblurn roplrasr dar hokl /1l.ttt.
l)crlrbedilhxn pun dipat Drudaht.rcapai llal- sehrnggadidapal lubang di laDgrt-laDgitdafl
huL Inr tcntu lncnlbuat suasiura kcluarga mulut ke dasar hidung. Cclah langrtrn dapal
nr.frbrik Dcng r mrkin bcrtambah besarn\a drperbriki dclgan nohkukon korcksi
.rn.rl. l.kln\\xtrr.rr d:tn pcr.rsron IodckaD prlaturn supatx dapat bcrbicara nonnal.
(lJr ofiug tua. teflrianra ibu. dapat teratasl V.rr.rl,.rrpl.u pr.t(sil :llnlrl leprs.rnscbrg:ti
(lrnl| p0r-slapar untukdapatbersckohhsccara obturiltor akrD sulrt tcrclpilr pcnutlrpitll
l.r\rl sollrpunlir collh ltrngita'r antorx ulut dar
Prdx pcrangir)irlr p:lslcn dengan celah hidung karenakuraru rrpat Ddxra(uir tightl
hrbr biLrrerrldrn cclah hngitar. dipcrlukln AlaI pht rnr lunrs discsuaikaD dengan
pcrr\rtrn sodrri nrungkin agr. nrcndapctkan pcnunrbuhan dan pcrkcmbangaD fisik.
|!rutupxn celahlargitxn\ang x\\al. sehinggi sed gk.rD b.firn iiot *rilik odnlah
nr.rmpubcrbicrrrbrik dau jcl.rsdibLLndingken pcngganli tirng buruk bagl larirgin Dnrlut
"
kir Lrcrr\.rt setclahlcbrh larrut lrDdrhn norn1el Trndlkin nrenrakarplat protcsa Inl
.rrr.rl r'cLonstnrksr pcrbxrkrrr rnr scrLng xkrn [rcn\ebabkan pasicn hirus scfrng
rr rrrrebrbkrn pcrrLrlIrkirtlndri) garl!:guxrl konnol kc doker grgr. supi\a plalDvadapat
]llfrtr.ri:rn p.IlulnbLrhrn dirn bagian drscsuiukirnirtau digaDti iika tclirh urorgecil.
L]lllksrh' Belornrdr suatukonseNusuuruk lDi d.rprt lncnlob:rbkanbix\c peraNatar\xng
drpir bcrtindik )ang tcrbark dalanr tnggr dan nreningkatkanemosi.
penxr lrnan pcril$rtan cchll l:rngiti:ln KcsehataDjanngan gici dan mulut anck
Sch\cckendrek(1978) bcryeDdapotbirh\\a dapat ditiDgkatknn. durgan nlcmborikxn
Lc n:rlnpuin berbLcrrabrrk drpat torcrpil pcrcr,rDgan scrtc binlbing:rn ling
(lr rgif mclak!krn Jcpar.lsi r\\.ll pxdi bcrlrubungandcngirn dict sc|-tapongctahan
r. rrLluPirn .irnn-crn [u1grr:rD\aflg hIritk. nrlsalah kxnes gigi pada orangluil. schingga
Llff!ir r enuirdr rrr!lirlukar pcrutLrpil| pcrrnaD mcrcka sargal pcntiDg ntuk d:par
bf(1rh trr Ing.rn Lcr:rs prlanrn sampar nlcnlngani hal ini. Pcnccgah:rnil\\al
"
|]rlrlllbLrh r nriksiln sclcsai lern\rtl dil.rkukantcrh.rdap kenNngkrnan cdrn\i gigi
trndrkrn ur tid.rl nrcnrbr\\r lr.lsil scpcrtr lrl-rrl'.rtr''r!rncsr. miloLhr.r.dJu inLcn(nsi
i urrr drharrpkrn lorcllif bcrLala Tindakilu \ang perlu
l_rrdrk:tn lLrir-tilhilp dia lorcLsr drlakuklu dxn hubungann\xtcrludap proses
trr r tr t)r!)txnnsi ) luf.rl cclitlrhrrgLtrnxklrr pc bcd:rhirn.harus dapat drtcliskan dcngin
In!,rb.rL pcrk.nrb.rngrn bcrbrc.rn\tlng brrk b.rlk Pcnt|lrgdrburt pcrcDclnllrnprogram
rlr r spo tan. lilrpx iida lanrbxha i tcf\cnsl pcrlccgehan dan r enrorritorkcbLrtuhan din
llcfbrcrranonnrl rrrLrngkin daprt drcapii irkx PASTCn XnAk. padASait !irng saDra nrcnroti\asr
nr.nrpLrn\ii kcrcli:rn grgl-mu1ui\xng b.,,^ dtrn Drenanrbah pcngctahuin dui pssrer
([rr r.hrl Adln\r cclah langitan..]/r,r./hr. scldiri daDkeluargr Suxt progtum
Jlr fdldr nrcn\rugkut berbxgai tingkatan \ang mcngikut sertakaDonng tua dar pasi
:1r,r\Iurrl ilblofnril. \'ang dapat dapatnrcngLrrlngikarics scccrabcrnriknn
'Iindakan
r. rp.rrmnrhi bcrbrcrr.r Lrngkung.n gigr pcnccgrhln dln sirmn \
,,1[rt rrengal:rnrpcrubrhansep:rn1ugnrLrsr drkcnullkln olch Cool!\ i l9()q) u
p.rtunrbuhrn \.rng drs.bibkrn k.routr nrcnrclrhara kcschiIllnuDrLrDr \rrlg brrk
lrcnrbuhlrt pctkcrnbirngirn normxl dxrl nrcngo\.rluilsr ponumbuhan pida
p.(l\\rtrn \xns drbc!lkan lni silnglt pcntrng rr
langitanadalahseb.rgribcrikut
l).rg (lok0r grgr a|lrl dan sehniut|lla olch . Program pcDdidikan b.rsi ofang
rulrl bcrllh bcrslmr lcrapis \icara. unluk nrcn\argkut /r?,9r,'rr. pcrkcnr
nr. r.nrukrr |lrdik.rsr drn tindrku psrkologr.dict d.rn pcnccg.rhan
p.Drl).drhrn" pcn\rkilgigr drn muh't
t76
t,,rdtt\ui 11\hth t tLllt l!,stt \l.nnLri I'lltt l').tt! .lLtiltli L4\twi lldr.lrak
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r d l l o r ! ( L / t l r l )d r l t d l d ! . B o s t o n L r l l l c 2 l SnJ|lirhDW. Jtr.ognt:nhlr ])(tk \ t,l
fiosn:rnd ao l9r I i1-l'5 ll nkn .\IdIlorfultratl.(icttrtit. t:rthttalorrl
('ln.al '' cd London:
(b.lrn RJ. dirlr Ptirdbatgll Srtklro"Es ol 1c o\l .lJpe./r 2
) t L a t la d h ! . A \ e n Y o r k : M c c r t r - H i l l wB S.llrdersCo. l99l: l:12
B o o kC o l 9 ( ) l : 6 i - 7 1 ) 21 BennettME dkk. Ps\chothemp\for persons
Iho.tuor JB dkk Thc incidencc. $r1h criniolncial detbn itics: can trc !rctrl
c l r s s i f i c r l i o l l c t r o l o g \ x t r d e n r b r i o l o g \o l ' \rrrhour rhcorl ale/i htlutt' t )1xtr)/at I
orrl clcfts \iarr, (rrril 1 9 9 6 :I ( : i ) l 6 l - r i I t)l)t:tl) (l) .106-10
Birrkrcr A Flrobg\ of Clejis. /'.?(r/u//tr 2 : Ha\cscS.1,,in,/,ErdlI'n)htt,t\.1\\\t(!trtl
l'r,,vri .!rr!.fr I{o\irl ALr!1ftliurr(ollcge oi' \lh (l"lt lllak In P[occedrlSsol ll'c
S!rgco l9t)-t la l6 Confcrcrc.rConnnunrcrti\cProblcrrlsIn
Hogcn VN{ .!',t2v,,, or t lali I ry. antl Clefi Pxhlc. A$ericao Speeclrrrld Hcirfrng
"'cd. Associrrioi Rcpons.1965:l-10
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