Goeno Subagyo, Goeno
The Postgraduate Program in Clinical Dental Science with Special Interest in Oral Medicine, Oral Medicine Department, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia

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The Noteworthy Case: Atypical Palatal Ulcer Which is Progressivelly Develop to Oral Squamous Cell Carcinoma in Diabetic Elderly Prayudha, Satrya Ayu E.; Chrismawaty, B. Esti; Agustina, Dewi; Subagyo, Goeno
The Indonesian Journal of Dental Research Proceeding Book
Publisher : The Indonesian Journal of Dental Research

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Abstract

Background: Oral ulcers are commonly painful lesions that are associated with numerous etiologies. Palatal ulcer could be referred as atypical oral ulcer due to unusual site predilection. The correct differential diagnosis is necessary to establish the appropriate treatment, with regards to all possible causes. Purposes: This report was intended to explain Oral Squamous Cell Carcinoma [OSCC] which is presented as atypical palatal ulcer resembling Necrotizing Sialometaplasia [NS]. Case and management: A 65 year old male, edentulous with history of uncontrolled type 2 Diabetes mellitus and experienced a gradually enlarging palatal ulcer. According to the patient, a fish bone pricked his hard palate just before the complaint. There was no lymphadenopathy, and intraoral examination revealed a solitary shallow ulcer on the right side of hard palate, covered by white pseudomembranous layer without erythematous halo. The margin of the ulcer was distinctive without induration. A month later, the lesion was progressively painful and interfere the oral function. The differential diagnoses were traumatic ulcer suspected to Eosinophilic Ulcer, Necrotizing Sialometaplasia [NS], and OSCC. Treatment plans included palliative measures and medical consultation regarding the need of biopsy. The biopsy was performed two months later. At that time, the ulcers were enlarged with indurated margin and necrotic center. A biopsy confirmed the diagnosis as OSCC with moderate differentiation. For proper treatment, the patient was referred to Oncology Department, Sardjito General Hospital. Conclusion: An atypical persistent solitary oral ulcer, especially in elderly, should prompt urgent investigation, since an oral malignancy must be foremost on the differential diagnoses list. This case report showed a progressively development of OSCC, even without preceding premalignant lesion. It is the dentists responsibility to identify any suspicion of oral premalignancy, so that proper referral can be performed earlier for reducing the mortality.
Sebaran Geographic Tongue pada Mahasiswa Fakultas Kedokteran Gigi Universitas Gadjah Mada Yogyakarta Puspita, Sartika; Subagyo, Goeno; Agustina, Dewi
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 10, No 2 (2010)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v10i2.1572

Abstract

Tongue is barometer of health and sytemic condition. Geographic tongue hasn ’t been dangerous and asymptomatic lesion in papilla of the tongue. The aim of this study is to know geographic tongue distribution on dentistry student of Gadjah Mada University of Yogyakarta. The study was descriptive research. Limitation of the population are student of the Faculty of Dentistry, Gadjah Mada University in the academic year 1999-2003. The samples were 362 people. The method were clinical examination of dorsum of the tongue and oral hygiene index (OHI). The result were analyzed with chi-square test. The result of this study are 8 (2,21%) from 362 samples are geographic tongue, 5 male (6,25%) and 3 female (1,06%). Eight cases of geographic tongue are distributed in the each academic year, they are 3 cases (4,17%) on academic year of1999, 1 case (1,32%) on academic year of2000, 2 cases (2,82%) on academic year of2001, 1 case (1,43%) on academic year of2002 and 1 case (1,37%) on academic year 2003. The conclution is that gender is significant but oral hygiene and academic year aren ’t significant in case of geographic tongue. Distribution of geographic tongue on dentistry student of Gadjah Mada University have variation.Lidah adalah barometer kesehatan yang mencerminkan kondisi sistemik. Geographic tongue adalah kondisi yang tidak membahayakan biasanya merupakan kondisi asimtomatik dengan etiologi tidak diketahui yang menyangkut epitel lidah. Tujuan penelitian ini adalah untuk mengetahui gambaran sebaran geographic tongue pada mahasiswa Fakultas Kedokteran Gigi Universitas Gadjah Mada Yogyakarta. Jenis penelitian adalah penelitian deskriptif. Batasan populasi adalah mahasiswa Fakultas Kedokteran Gigi Universitas Gadjah Mada Yogyakarta angkatan 1999 - 2003. Jumlah sampel berjumlah 362. Cara penelitian yaitu dengan melakukan pemeriksaan klinis pada permukaan dorsal lidah dan status kebersihan mulut (oral hygiene index/OHI). Hasil penelitian dianalisis dengan uji chi-square. Hasil penelitian menunjukkan dari 362 mahasiswa yang diperiksa ditemukan 8 kasus (2,21%) geographic tongue yang terdiri dari 5 pria (6,25%) dan 3 wanita (1,06%). Delapan penderita geographic tongue tersebar di tiap tahun angkatan akademik, terdiri dari 3 orang (4,17%) angkatan 1999, 1 orang (1,32%) angkatan 2000, 2 orang (2,82%) angkatan 2001, 1 orang (1,43%) angkatan 2002 dan 1 orang (1,37%) angkatan 2003. Semua penderita geographic tongue memilki status kebersihan mulut baik. Disimpulkan bahwa sebaran geographic tongue di Fakultas Kedokteran Gigi Universitas Gadjah Mada bervariasi, jenis kelamin berpengaruh terhadap kejadian geographic tongue, sedangkan tahun angkatan akademik dan status kebersihan mulut tidak berpengaruh terhadap kejadian geographic tongue.