SCENARIO 1

GROUP 5
BLOCK 13
SUPERVISOR : drg. Intan Batura Endo
Mahata, MM
MEMBERS

1. Aprilia Kuntari (18-001) (Leader)

2. Fanny Eka Widya (18-009)
3. Winda Astri Elisa (18-014)
4. Sabrina Primedia (18-021)
5. Nadia Yasmin (18-023)
6. Suci Indah Kurnia (18-028)
7. Aryufasa Ferotrima (18-029)
8. Vanya Fiona (18-030)
9. Retno Adinda Putri (18-042)
10.Naufal Althof (18-075)
(Secretary)
11. Yola Febiola Wijaya (18-085)

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SCENARIO

SCENARIO 1
A man accepting 24 years came to RSGM with complaints of
swollen cheeks in the lower jaw from the history of the patient had
one week of lower right back tooth pain difficult to open mouth,
fever, difficulty trying and breathing. Extra-oral examination
revealed swelling involving the fascia of the submandibular region,
submental and bilateral language, reddish color, palpation felt
hard, intra-oral examination showed 45.46 open deep caries area,
raised tongue and hypersaliva, diffuse radiolucent radiographic
examination at 45, 46. The dentist will explain the treatment to be
performed.

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LEARNING
OBJECT 01
Students are able to understand and
explain the diagnosis at
scenario

02
Students are able to understand and
explain the etiology and symptoms of
the scenario

03
Students are able to understand and explain
examinations subjective and objective in the
scenario

04
Students are able to understand and explain
examinations
radiography in the scenario

05
Students are able to understand and
explain pathogenesis
in the scenario.

06
Students are able to understand and
explain management 4
in the scenario
 Swollen pipes in the
lower jaw
TOPIC TREE

SUBJECTIVE OBJECTIVE SUPPORTING

EXAMINATION EXAMINATION EXAMINATON

ANAMNESIS
EXTRA INTRA CT
RONTGEN
ORAL ORAL SCAN

DIAGNOSIS

PREDISPOSITI PATHOGEN COMPLICATI PREVENTIO MANAGEME

ON FACTORS
ETIOLOGI SYMPTOMS ONS
ESIS N NT

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Students are able to understand and explain the
diagnosis at
scenario

Phlegmon (Ludwig Angina) is a

very severe infection that spreads
from decay of the teeth under the
floor of the mouth. This infection
causes severe swelling in the floor
of the mouth which can cause the
tongue to push upward so that it
obstructs the respiratory tract.

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Students are able to understand and explain the etiology
and symptoms of the scenario

Etiology Angina Ludwig usually Many common

comes from odontogenic symptoms,
infections, especially from the such as fever,
second or third lower molars. weakness, and
Other rarely reported causes of fatigue,
Ludwig's angina include trismus,
sialadenitis, peritonsillar edema, pain,
abscesses, infected open dyspnea,
thirogloss cysts, epiglottitis, tachypnea, or
intravenous drug injections into stridor etc.
bronchoscopy, lacerations,
infections, and trauma
ETIOLto the SYMPTO
floor of the mouth.
OGI MS
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Students are able to understand and explain
examinations
subjective and objective in the scenario

SUBJECTIVE
24-year-old male patient with complaints of
swollen lower jaw for 1 week, lower back right
gig pain, difficulty opening mouth, fever,
difficulty swallowing and breathing.
OBJECTTIVE
swelling was seen bilaterally, sub-mental and
sublingual region of the spasia of the
submandibular region. reddish color, palpation feels
hard. Intraoral examination revealed a region of 45,
46 open deep caries, tongue not raised, and
hypersalivation
SUPPORT
Blood tests appear leukocytosis which indicates an acute infection.
Checking the time of blood clots is important for the action of a
drainage incision. Culture and sensitivity tests to determine infecting
bacteria (aerobic and / or anaerobic) and determine antibiotic 8
selection in therapy.
Students are able to understand and explain
examinations
radiography in the scenario

 Radiographic
technique
1. Cervical X-ray
2. Panoramiks X-
ray
3. Chest X-ray
4. CT scan

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Students are able to understand and explain
pathogenesis
in the scenario.

Periapical tooth abscesses from the second and third molars

penetrate the inner cortex of the mandible. Because this root
extends to the mandibular insertion of the mylohyoid muscle,
submandibular infection ensues. Communication around the
posterior margins of the mylohyoid muscle results in rapid
involvement of the sublingual and contralateral spaces. The
mandible, hyoid, and superficial layer of cervical fascia are in
the extent of tissue expansion as edema develops. This
results in Superior and posterior displacement of the floor of
the mouth and base of the tongue. The resulting airway
compromise can be dangerous until it is almost complete.

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Students are able to understand and explain
management
in the scenario

High-dose antibiotic
therapy for aerobic and
anaerobic bacteria is
given parenterally

1 2 3

Free the Exploration is carried out for

airway the purpose of decompression
(reducing tension) and
evacuation of pus or tissue 1
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 Treatment of
Ludwig’s angina
CONCLUSION must be carried
out appropriately
and adequately,
so that no further
This infection causes spread of infection
severe swelling in the occurs
floor of the mouth
which can cause the
tongue to push
upward so that it
obstructs the
respiratory tract. Supporting
examinations in
the form of blood,
culture and X-ray

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THANKS
Does anyone have any
questions?

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