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Management of temporomandibular joint ankylosis with combination of gap arthroplasty surgery and physiotherapy Ramadhanty, Nurul; Kasim, Alwin; Tasman, Abel; Adiantoro, Seto; Drajat, Dikki
Padjadjaran Journal of Dentistry Vol 28, No 1 (2016): March
Publisher : Faculty of Dentistry Universitas Padjadjaran, Indonesia

Background. Temporomandibular joint (TMJ) ankylosis is a union of the articular surface of the temporal bone to the disc-condyle complex that restricts mandibular movements due to either a fibrous or bony union between the head of the condyle and the glenoid fossa. Common etiological factors are trauma, infection, and pathology in the joint or systemic diseases. The diagnosis of TMJ ankylosis is established through physical and clinical evaluation, and imaging examination. Currently, the surgical techniques used to treat TMJ ankylosis are gap arthroplasty, interpositional arthroplasty, joint reconstruction, and distraction osteogenesis. Purpose. To provide overview about management of temporomandibular joint ankylosis with gap arthroplasty combined with physiotherapy post surgery. Case. A 12-year-old female patient came to Department of Oral and Maxillofacial Surgery with complaint of opening mouth restriction, which occured since one year prior to admission. After complete physical and radiographic examination, patient then was diagnosed with TMJ ankylosis due to neglected odontogenic infection. The treatment was performed with gap arthroplasty under general anesthesia. Patient then underwent physiotherapy after the surgery, including application of heat on the affected region and exercises to open and close mouth. Discussion. Ankylosis of TMJ is an uncommon case that results in chronic and severe limited mouth opening. The critical factor of successful treatment of TMJ ankylosis is early detection, correct surgery approach, implementation of an intensive physiotherapy program, and a good post-operative conduct. Therefore on this patient, gap arthroplasty was the chosen surgery approach followed by intensive physiotherapy. Conclusion.Management goal in TMJ ankylosis isÂ to increase the patientâs mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. Careful surgical technique and subsequent attenÂtion to physiotherapy are both considered essential to achieve a satisfactory result.

FAKTOR-FAKTOR YANG MEMPENGARUHI LUARAN PENANGANAN ATRESIA ESOPHAGUS Dian Adi Syahputra; Bustanul Arifin Nawas; Dikki Drajat Kusmayadi
Jurnal Kedokteran Syiah Kuala Vol 17, No 2 (2017): Volume 17 Nomor 2 Agustus 2017
Publisher : Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/jks.v17i2.8985

Abstrak. Atresia esofagus merupakan bentuk kelainan kongenital yang memiliki tingkat mortalitas tinggi berkaitan dengan berbagai komplikasi yang dapat muncul sebelum dan sesudah tindakan operasi definitif. Penelitian ini bertujuan untuk mengetahui faktor – faktor yang mempengaruhi luaran penanganan atresia esofagus. Penelitian ini adalah penelitian analitik retrospektif dari data yang terdapat pada rekam medis pada tahun Januari 2002 hingga Agustus 2009 dari 2 rumah sakit di Bandung, Jawa Barat. Uji Fisher's Exact Probability Test dan Kruskal Walis digunakan untuk menilai luaran masing – masing kelompok. Pada penelitian ini terdapat 26 penderita (13 laki – laki dan 13 perempuan). Rentang usia saat penderita datang ke rumah sakit yaitu 3 ± 1,41 hari. Berat badan lahir rata - rata adalah 2.475 ± 35,35 gram. Pada penelitian ini terdapat hubungan yang signifikan antara keadaan sepsis pra operasi (p= 0.032) dan lama penggunaan ventilator (p= 0.022) dengan luaran penderita atresia esofagus. Sementara tidak terdapat hubungan yang signifikan antara berat badan lahir (p= 0.11), kehadiran pneumonia (p=0.11) , kehadiran kelainan jantung bawaan (p= 0.99) dan jenis ruang rawatan (p= 0.683) terhadap luaran penderita atresia esophagus. (JKS 2017; 2: 72-76) Kata Kunci: atresia esophagus, faktorresiko, luaran Abstract. Esophageal atresia is a congenital anomaly that have high mortality rate associated with complication appears before and after definitive treatment. Analytic retrospective study to identified risk factors that influence outcome of esophageal atresia. Data were reviewed from medical record of patients with esophageal atresia within January 2002 to August 2009 that hospitalized in 2 hospitals in Bandung, West Java. Fisher's Exact Probability and Kruskal Walis Test were used for the statistical analysis. There are 26 patients (13 boys and 13 girls) with average age when the patients came to hospital is 3 ± 1,41 days old. Mean birth weight among all patients is 2.475 ± 35,35 grams. In this study, sepsis condition before operation and lenght of using ventilator are significant to outcome with (p= 0.032) and (p= 0.022). While birth weight, pneumonia, congenital heart disease, ward during treatment were not significant with (p= 0.11), (p=0.11), (p= 0.99), and (p= 0.683). (JKS 2017; 2: 72-76) Keywords : esophageal atresia, risk factors, outcome

Perbedaan Kadar Plasminogen Activator Inhibitor-1 Cairan Peritoneum Tikus Wistar antara yang Diberi Vitamin E Topikal atau Ketorolak Intramuskular atau Simvastatin Oral atau Kombinasi Ketiganya pada Tikus Wistar yang Dilakukan Abrasi Ileum Kadek Deddy Ariyanta; Dikki Drajat Kusmayadi; Rizki Diposarosa
JBN (Jurnal Bedah Nasional) Vol 1 No 2 (2017): JBN (Jurnal Bedah Nasional)
Publisher : Program Studi Ilmu Bedah, Fakultas Kedokteran Universitas Udayana

Tujuan: untuk membuktikan adanya perbedaan kadar plasminogen activator inhibitor-1 (PAI-1) cairan peritoneum tikus Wistar antara yang tidak diberi obat, diberi obat tunggal vitamin E topikal atau ketorolak intramuskular atau simvastatin oral dengan yang diberi obat kombinasi ketiganya pada tikus Wistar yang dilakukan abrasi ileum. Metode: penelitian eksperimental laboratorik, menggunakan tikus Wistar jantan. Tiga puluh ekor tikus Wistar dilakukan abrasi ileum dan dibagi 5 kelompok: kontrol (K); perlakuan 1, diberi vitamin E topikal (P1); perlakuan 2, diberi ketorolak intramuskular (P2); perlakuan 3, diberi simvastatin oral (P3); dan perlakuan 4, diberi kombinasi vitamin E topikal, ketorolak intramuskular, dan simvastatin oral (P4). Cairan peritoneum diambil 7 hari kemudian untuk mendapatkan kadar PAI-1 cairan intraperitoneum. Uji beda kadar PAI-1 cairan peritoneum dengan uji one way ANOVA dan Dunett’s T3. Hasil: kadar PAI-1 cairan peritoneum tikus Wistar yang dilakukan abrasi ileum antara kelompok kontrol dengan kelompok kombinasi (p=0,046), kelompok vitamin E dengan kombinasi (p=0,000), kelompok ketorolak dengan kombinasi (p=0,000), dan kelompok simvastatin dengan kombinasi (p=0,002). Simpulan: kadar PAI-1 cairan peritoneum lebih rendah secara bermakna pada kelompok yang diberi perlakuan kombinasi dibandingkan dengan pemberian obat tunggal dan yang tidak diberi.

Pengaruh Sinbiotik terhadap Penurunan Kadar C-Reactive Protein Serum Pasca operasi pada Anak Appendisitis Komplikata Vita Indriasari; Bustanul Arifin Nawas; Dikki Drajat Kusmayadi; Rizki Diposarosa
Jurnal llmu Bedah Indonesia Vol. 43 No. 1 (2014): September 2014
Publisher : Ikatan Ahli Bedah Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.46800/jibi-ikabi.v43i1.69

Background. Appendicitis is the most common cause of acute abdomen in children. Complicated appendicitis due to perforation associated with high morbidity. Several perioperative conditions fascilitated systemic inflammation and postoperative infectious complication. Synbiotic has a potential effect on reducing inflammatory response which reflected with lower serum c-reactive protein (CRP) level, so that the infectious complication could be avoided. Aim.This study aimed to observe the effect of synbiotic on postoperative serum CRP level reduction in children with complicated appendicitis. Method. A randomized double blind study was done in 26 children with com- plicated appendicitis. The subjects were divided into synbiotic and placebo groups. Synbiotic was given 1 time preoperatively and continued 5 days afer surgery. Serum CRP level were examined preoperatively (CRP 0), postoperative day 1 (CRP 1), and 6 (CRP 6). Statistical analysis was done with Independent-t test (p<0,05 considered significan)t. Result. The mean age of the patients was 9,85 years. The onset of abdominal pain was 3,92 days. The mean reduction of CRP 0 –CRP 6 between synbiotic and placebo group was 65,21% ± 31,37 SD vs 78,29% ± 12,39 SD, p=0,073; and the mean reduction of CRP 1–CRP 6 was 73,54% ± 22,04 vs 74,56% ±17,58, p=0,897. Wound infection was lower in synbiotic group (7,69% vs 38,46%). Conclusion. There was no difference in postoperative serum CRP level reduction between synbiotic therapy and placebo in children with compli- cated appendicitis

Management of temporomandibular joint ankylosis with combination of gap arthroplasty surgery and physiotherapy Ramadhanty, Nurul; Kasim, Alwin; Tasman, Abel; Adiantoro, Seto; Drajat, Dikki
Padjadjaran Journal of Dentistry Vol 28, No 1 (2016): March 2016
Publisher : Universitas Padjadjaran

Background. Temporomandibular joint (TMJ) ankylosis is a union of the articular surface of the temporal bone to the disc-condyle complex that restricts mandibular movements due to either a fibrous or bony union between the head of the condyle and the glenoid fossa. Common etiological factors are trauma, infection, and pathology in the joint or systemic diseases. The diagnosis of TMJ ankylosis is established through physical and clinical evaluation, and imaging examination. Currently, the surgical techniques used to treat TMJ ankylosis are gap arthroplasty, interpositional arthroplasty, joint reconstruction, and distraction osteogenesis. Purpose. To provide overview about management of temporomandibular joint ankylosis with gap arthroplasty combined with physiotherapy post surgery. Case. A 12-year-old female patient came to Department of Oral and Maxillofacial Surgery with complaint of opening mouth restriction, which occured since one year prior to admission. After complete physical and radiographic examination, patient then was diagnosed with TMJ ankylosis due to neglected odontogenic infection. The treatment was performed with gap arthroplasty under general anesthesia. Patient then underwent physiotherapy after the surgery, including application of heat on the affected region and exercises to open and close mouth. Discussion. Ankylosis of TMJ is an uncommon case that results in chronic and severe limited mouth opening. The critical factor of successful treatment of TMJ ankylosis is early detection, correct surgery approach, implementation of an intensive physiotherapy program, and a good post-operative conduct. Therefore on this patient, gap arthroplasty was the chosen surgery approach followed by intensive physiotherapy. Conclusion.Management goal in TMJ ankylosis is to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. Careful surgical technique and subsequent attention to physiotherapy are both considered essential to achieve a satisfactory result.

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