ABSTRAKPendahuluan: Ulser merupakan kelainan pada mukosa mulut yang dapat dialami oleh setiap orang. Ulserasi dapat terjadi akibat berbagai etiologi salah satunya adalah trauma iatrogenik. Trauma iatrogenik adalah trauma yang disebabkan secara tidak disengaja oleh praktisi kesehatan pada saat perawatan medis atau prosedur diagnosis. Tujuan dari laporan kasus ini adalah untuk membahas lesi ulserasi pada mukosa mulut akibat trauma iatrogenik yaitu penggunaan tongue retractor pada saat melakukan bedah flap gingiva pada wanita berusia 22 tahun. Laporan kasus: Pasien datang dengan keluhan sariawan pada bawah lidah sebelah kiri sejak ± 5 hari yang lalu dan pasien merasa sakit saat makan dan menggerakan lidah. Kurang lebih 7 hari yang lalu dilakukan pembedahan pada gusi kiri bawah. Dua hari kemudian terasa sakit pada daerah bawah lidah yang berdekatan dengan gusi tersebut dan terlihat sariawan yang cukup besar. Pasien sudah menggunakan antibiotik, analgetik, obat kumur selama satu minggu. Pemeriksaan ekstraoral terdapat deskuamasi pada bibir. Pemeriksaan intraoral menunjukkan ulser di dasar mulut kiri, berbentuk oval atau memanjang, diameter ± 15 mm, tepi eritema, batas ulser tidak beraturan, permukaanya ditutupi pseudomembran berwarna putih kekuningan. Diagnosis pada pasien ini adalah ulser traumatik terkait trauma iatrogenik. Pasien diberikan triamcinolone acetonide 0,1% dan multivitamin.Setelah tiga hari menggunakan obat tersebut, rasa sakit sudah hilang dan sariawan sembuh dalam waktu 3 minggu. Simpulan: Ukuran lesi trauma iatrogenik pada kasus ini cukup besar dari pada ulser lainnya dan berbentuk oval yang sesuai dengan instrumen penyebab trauma tersebut. Manajemen kasus ulser traumatik yang utama adalah harus menghilangkan faktor penyebabnya dan pemberian obat anti inflamasi serta nutrisi yang adekuat untuk membantu proses penyembuhan ulser. ABSTRACT Introduction:Ulcer is an oral mucosa abnormality that can be experienced by anyone. Ulceration can occur due to various etiologies, one of which is iatrogenic trauma. Iatrogenic trauma is trauma caused accidentally by a health practitioner during medical treatment or diagnostic procedure. The purpose of this case report was to discuss oral mucosa ulceration lesions due to iatrogenic trauma, namely the use of tongue retractors when performing gingival flap surgery in a woman aged 22 years old. Case report: The patient came with complaints of canker sores under the left tongue since approximately five days before and the patient feels the soreness each time she eats and moving her tongue, approximately seven days before, a surgery on her lower left gingiva was performed. Two days after, the pain in the lower area of the tongue adjacent to the gingiva was felt, and visible sore was quite large. The patient has been using antibiotics, analgesics, and mouthwash for one week. An extraoral examination performed was lips desquamation. Intraoral examination revealed ulcers at the base of the left mouth, oval or elongated, ± 15 mm in diameter, erythema margins, irregular border...

Introduction Down syndrome is a congenital genetic disorder caused by an error in cell division, resulting in the presence of an additional third chromosome 21. Down syndrome is one of the leading causes of intellectual disability. Millions of these patients face various health issues. This study aimed to provide information about the challenges in the management of chronic ulcer mimicking OSCC in Down Syndrome child with motoric disorders. Case A 12-year-old boy with Down Syndrome and motoric disorders was referred to Oral Medicine Department. In the extraoral examination, the patient had a dysmorphic face and dry lips. Lymph node examination could not be assessed because the patient wore a cervical collar. The intraoral examination showed an irregular ulcer with 1×0.7 cm in diameter, indurated margin, and white-yellowish base at the right lateral border of the tongue. The 55 teeth were sharp and caused an occlusion trauma to the right lateral border of the tongue. The patient was diagnosed with a chronic traumatic ulcer mimicking OSCC based on clinical examination. The medication given to the patient were sodium chloride 0.9%, povidone-iodine mouthwash 1%, and petroleum jelly. Conclusion Children with Down syndrome often suffer from orofacial abnormalities which can affect their oral health and their family’s quality of life. Dental and oral care for Down Syndrome children with motoric disorders required some challenges and collaboration with their parents, families, and caregivers.

Recurrent intraoral herpes (RIH) is a reactivation of herpes simplex virus 1 (HSV 1) and is treated with an antiviral. In this pandemic situation, limited access to health care may lead to many consequences. This case report reports the difference in clinical response between acyclovir and valacyclovir in RIH and treatment in the pandemic situation. A 24 years old man complained of ulcers and pain in the mouth in the last two weeks. The patient had a history of recurrent ulcers since a year ago. Intraoral examination showed multiple ulcers, with erythema halo, 0.2-0.3 cm in diameters on the tongue, uvula, and pharynx. The patient had difficulty in eating. The IgG anti-HSV 1 test showed a positive result, and the lesions were diagnosed as RIH. The patient was treated with acyclovir, benzylamine HCl, and vitamin B12. One month after treatment, the lesions improved, but new lesions still emerged. Therefore, valacyclovir was substituted for acyclovir. Since the patient had difficulty in going to the hospital due to the lockdown policy, medication for two weeks was prescribed for him. One month after treatment with valacyclovir, there was no more new lesion emerging. In conclusion, there was a difference in clinical response between acyclovir and valacyclovir. It is assumed that the patient has resistancy to acyclovir which resulting in poor improvement. The pandemic condition forces us to be flexible in handling patients and adapting to government conditions and rules.Keywords: recurrent intraoral herpes; acyclovir; valacyclovir

rasa sakit sehingga terjadi penurunan kualitas hidup. Penanganan kondisi rongga mulut pasien yang menjalani kemoterapi oleh dokter gigi mendukung peningkatan kondisi kesehatan umum dan kualitas hidup pasien. Laporan kasus ini bertujuan untuk membahas sebuah kasus pasien dengan mukositis setelah menjalani kemoterapi untuk penanganan leukemia limfoblastik akut.Kasus: Perempuan, 21 tahun, dirujuk dari bagian penyakit dalam ke bagian penyakit mulut dengan keluhan rasa perih dan sulit membuka mulut sejak 3 hari yang lalu setelah menjalani kemoterapi menggunakan methotrexate untuk leukemia limfoblastik akut yang diderita. Bagian penyakit dalam memberikan ceftriaxone intravena (IV), dexamethasone IV, klorheksidin dan nistatin. Pemeriksaan intra oral menunjukkan lesi erosif pada lidah, mukosa labial dan bukal. Lesi didiagnosis sebagai mukositis oral skala 3 menurut World Health Organization. Nilai kualitas hidup pasien berdasarkan The Functional Assessment of Cancer Therapy - General (FACT-G) memiliki nilai 46 dan Oropharyngeal Mucositis Quality of Life (OMQoL) dengan nilai 58. Tatalaksana farmakologis berupa obat racikan diphenhydramine Hcl, sucralfat, dan aluminum hidroksida-magnesium hidroksida digunakan secara kumur. Obat kumur khlorhexidine dan nystatin disarankan untuk dihentikan. Pasien juga disarankan untuk tetap menjaga kebersihan rongga mulutnya dengan berkumur dengan natrium klorida dan povidone iodine berelang setelah makan. Lima hari setelah pemberian terapi, kondisi pasien membaik (skala 2) dan terdapat peningkatan nilai FACT-G menjadi 54 dan nilai OMQoL menjadi 93.Kesimpulan: Mukositis dapat menyebabkan rasa sakit pada pasien sehingga peran dokter gigi dapat membantu mengurangi keluhan pasien tersebut dan diharapkan dapat meningkatkan kualitas hidup pasien