ca dan keganasan 2013
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KeganasanRonggaMulut
goeno subagyo
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Speaking
Chewing
Tasting
Swallowing
Laughing
Smilling
Kissing
Happiness
Crying
Socializing
You are not healthy withoutgood oral health.
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The essence of our humanity
Kesehatan Oral - Kesehatan Umum
C.Everett Koop
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Inter-Relationships Between Oral
and Systemic Health and Disease
SISTEMIKORAL
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Its a Two-Way Street
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The mouth mirrors the body
Penyakit mulut dapat mempengaruhi perawatan
penyakit sistemik
Perawatan penyakit sistemik dapat mempengaruhi
kesehatan mulut
Penyakit mulut dapat meningkatkan risiko penyakit
sistemikKesehatan mulut mempengaruhi kualitas hidup
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dokter gigi mempunyai tanggung jawab
profesional dan moral untuk mempelajarikesehatan umum pasien sebelummemberikan perawatan dental
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Wanita usia 65 tahun dengan polimedikasi
untuk penyakit kardiovaskuler, dengan
rampant caries (karies yang berkembangcepatmelibatkan beberapa gigi)
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drill fill bill75year-oldwomenwithpolymedicationforcardiovasculardiseases
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WHO Oral Health Program
(a) oral health is integral and essential to general
health,
(b) oral health is a determinant factor for quality of life
(c) oral health and general health are interrelated
(d) proper oral health care reduces premature mortality
(Petersen 2003).
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ManifestasiKeganasandiMulut
Sistemik
Keganasan
Lokal
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Manifestasi Oral keganasan
Non-Hodgkin lymphoma
(large ulcer on the soft palate)
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Manifestasi Oral Keganasan
Chronic lymphocytic leukemia(severe gingival enlargement and ulcerations)
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Manifestasi Oral Keganasan
Spontaneous gingival bleeding of
same patient with cirrhosis
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Manifestasi Oral Keganasan
Swollen, shiny, bleeding gingiva ofa patient with acute myelogenous leukemia
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Manifestasi Oral Keganasan
KEGANASAN
ANEMIA
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Manifestasi Oral Keganasan
Laki-laki 60 tahun dengan
ulkus kronis pada sisi lateral
lidah kiri. Mempunyai kebia-
saan merokok dan minum
minuman keras.
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Laki-laki perokok 57 th.dg nonpainful lesion
pd dasar mulut
selama 7 bln.
Leukoplakia
Candidiasis
Lichen Planus
Oral Cancer
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Oral Cancer
ORO-PHARYNGEAL CANCER
IS THE ELEVENTH
MOST COMMON CANCER WORLDWIDE
World Health Organization 2005
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Oral Cancer
30,000newcasesdiagnosedyearly
8,000deathseachyear
5yearsurvivalrate:50%
Oral cancer is the sixth most common cancer among men
IncidenceandSurvivalofOral
orPharyngealCancer
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Oral Cancer
A 5 -year survival rate for African
American men with oral cancer is
approximately 34%.
With early detection and treatment, the 5-
year year survival rate can increase up to
85%.
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Oral Cancer
EarlyDetectionSavesLives
5-year survival for localized disease is 85%
5-year survival for metastatic disease is 19%
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A Precancerous LesionAmorphologicallyalteredtissueinwhichcancerismorelikelytooccurthaninits
apparentlynormalcounterpart
(WHO publication,1997))
Potentially malignant disorders
(WHO 2005)
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The risk of malignancy being present in a lesion
or condition either at the time of initial diagnosis
or at a future date.
Potentially malignant disorders
(WHO 2005)
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Clinical Lesions
Potentially malignant disorders
LeukoplakiaErythroplakia
Lichenplanus
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WhiteLesions
Lichen planus
Frictional keratosis
Tobacco pouch keratosisNicotine stomatitis
Actinic cheilitis
Leukoedema
Linea alba
Hypertrophic candidiasis
Hairy leukoplakia
White spongue nevusSquamous cell carcinoma
etc
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Leukoplakia: Clinical Features
Leukoplakia usually affects people over
the age of 40 years (average age is 60
years).
Prevalence increases rapidly with age
particularly in males.
Approximately 8 % of the males over the
age of 70 years are reportedly affected.
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Leukoplakia: Clinical Features
Approximately 70 % of the oral leukoplakiasare found on the lip vermilion, buccal
mucosa and gingiva.
Note: Lesions of the tongue, l ip verm i lionand f loo r of the mouth account for more
than 90 % of those that show dysplas iaor
carc inomaupon histologic examination.
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Clinical classification1. Homogeneous oral leukoplakia
Most common type
Consists of uniformly
white plaques
Occurs mainly on buccal
mucosa
Low transformation
potential
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2. Non-homogeneousleukoplakia
Nodular leukoplakia
Small aggregated hemispherical red or white surfacealterations or excrescences, may show a red background or
substrate.Stronger risk of dysplasia or malignant potential than
in homogeneous leukoplakia.
Speckeled leukoplakia
Speckled leukoplakia
Less common More serious
Consists of white flecks or fine nodules
on an atrophic erythematous base
Stronger malignant potential than
homogeneous leukoplakia
Regarded as a combination of or a transition
between leukoplakia and erythroplasia.
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http://2.bp.blogspot.com/-XucD6KJXuik/TsE4K9SjOCI/AAAAAAAAEPs/ix1XKxVv3iE/s1600/Homogeneous+leukoplakia.png -
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http://3.bp.blogspot.com/-h7DrudY7Nv8/TsE4ciddr8I/AAAAAAAAEP0/ZuSlcTkOgIM/s1600/Speckled+leukoplakia..png -
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http://4.bp.blogspot.com/-8QLHzl4tFsI/TsE5oqhYZaI/AAAAAAAAEP8/5wNgpMDhv_k/s1600/Hairy+leukoplakia..png -
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Homogeneousleukoplakia
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NON-HOMOGENEOUS LEUKOPLAKIA
Nodular (N) and Verrucous (V) leukoplakia
NV
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Erythroplakia
Definition:A red patch that canno t be cl in ically or
pathologically diagnosed as any other condition
Most (~90%) do represent epithelial dysplasia,carcinoma in situ, or squamous cell carcinoma
May be combined with leukoplakic areas =
erythroleukoplakia, speckled leukoplakia
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Erythroplakia
-Erythroplakia
- histology: SCC
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Potentially malignant disorders
Lichenplanus
-Lichenplanusisaninflammotorydisease
ofskinandmucosaofunknown
aetiology,thoughalterationsincell-
mediatedimmunitymaybeimportant.
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A predominantly white lesion withverrucous,nodular, ulcerated or erythematous
features.
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Annular form of lichen planuson the right buccal mucosa. Note thepigmentation and the ring-like pattern of Wickham striae(yellow
arrows).
http://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=Wickham%20striae&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=Wickham%20striae&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&img -
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A reticularform of lichen planus. Note the
bilaterally symmetrical patterns, which arecharacteristic of lichen planus.
http://screening.iarc.fr/atlasoralglossdef.php?key=reticular&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=reticular&img -
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Annular form of lichen planuson the right buccalmucosa. Note the ring-like pattern of white striae
(yellow arrows).
http://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&imghttp://screening.iarc.fr/atlasoralglossdef.php?key=lichen%20planus&img -
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Tanda & Gejala Awal Oral Cancer
Lesi putih atau merah yang menetap Ulkus yang tidak sembuh
Pembengkakkan yang progresif
Perubahan ciri permukaan yang tidakwajar
Gigi goyah tanpa penyebab jelas
Perdarahan /mimisan yang tidak wajar Suara serak yang berkepanjangan
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O l C
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Rolled borderIndurated margins
Bleeding and friable
Verrucous
Ulcerated
Swelling
Oral Cancer
Clinical features:
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What to look for during screening?
1. Oral mucosal changes
2. Bony changes
3. Tooth movements
Changesinthemouth:
Screening Examination
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ScreeningExamination
forOralCancer
Screening exam requires:
Good light
Use of a dental or laryngeal mirror Inspection of high-risk areas
Palpation
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Dengan melaksanakan tiga langkah pemeriksaan diri
sendiri dapat menyelamatkan hidup anda. Dengan cara
demikian dapat membantu menemukan kanker muluttahap dini, sehingga perawatan kanker dapat dilakukan
sedini mungkin.
Bibir Lidah
Dasarmulut
Tigalangkahpemeriksaandirisendiri
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Dasar Mulut Denganmenggunakanujunglidah,
sentuhlahpermukaandasarmulut,
rasakanadakahabnormalitas? Bukalahmulutlebar,amatidasarmulut
danpermukaanventrallidah.
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t l di h i
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pertanyaanyangperludipahami
Mengapa harus melakukan pemeriksaan mulut
sendiri?
(agar kanker dapat di deteksi dini)
Kapan waktu yang paling baik untuk memeriksa
mulut?(setiap 2 bulan sekali setelah membersihkan mulut
dan gigi)
Langkah apa yang harus dilakukan setelah
menemukan abnormalitas di mulut?
(memeriksakan diri ke dokter gigi )
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PENUTUP
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PENUTUP Manifestasi oral keganasan bervariasi karena
keganasan lokal di mulut atau manifestasi keganasandi tempat lain/sistemik.
Mencermati dan mewasdai tandagejala keganasan
di mulut merupakan cara deteksi dini oral cancer.
Deteksi dini oral cancer akan menyelamatkan jiwa
penderitanya
Pemebelajaran pemeriksaan diri sendiri dapat
menjadi salah satu sarana untuk deteksi dini kankermulut, sehingga pemeriksaan dan perawatan dapat
segera dlakukan.
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