Hubungan Potensial antara Gigi Molar Ketiga dan Stomatitis Aftosa Rekuren: Laporan Kasus
DOI:
https://doi.org/10.35790/n69c4990Keywords:
stomatitis aftosa rekuren; gigi molar ketiga; trauma oklusi; ulkus mulutAbstract
Abstract: Recurrent aphthous stomatitis (RAS) is a painful, recurrent, and multifactorial ulcerative lesion of the oral mucosa. Triggering factors include genetic predisposition, nutritional deficiencies, stress, and local trauma such as third molar impaction. Although the direct causal relationship between third molars and RAS is still limited to observational evidence, occlusal trauma can trigger or exacerbate lesions in susceptible individuals. We reported a 21-year-old woman presented with a complaint of recurrent canker sores near her lower wisdom teeth that recurred every few months. Examination revealed ulceration of the posterior lingual gingiva due to occlusal trauma between the upper and lower third molars. Treatment included oral health education, pharmacotherapy with hyaluronic acid, and a recommendation for third molar extraction. The lesion improved within one week; however, the last follow-up after two weeks showed persistent inflammation due to the predisposing trauma factor had not been eliminated. In conclusion, mechanical trauma resulting from occlusal contact with the third molar is suspected to have played a role as a triggering factor for recurrent aphthous stomatitis (RAS) in this case. A conservative approach involving education, pharmacotherapy, and control of triggering factors yielded good clinical results. Evaluation of the third molar should be considered in patients with recurrent RAS as part of comprehensive management.
Keywords: recurrent aphthous stomatitis; third molar; occlusal trauma; oral ulcer
Abstrak: Stomatitis aftosa rekuren (SAR) merupakan lesi ulseratif pada mukosa mulut yang bersifat nyeri, rekuren, dan multifaktorial. Faktor pemicu meliputi predisposisi genetik, defisiensi nutrisi, stres, serta trauma lokal seperti impaksi gigi molar ketiga. Meskipun hubungan kausal langsung antara molar ketiga dan SAR masih terbatas pada bukti observasional, trauma oklusi dapat memicu atau memperburuk lesi pada individu yang rentan. Kami melaporkan kasus seorang perempuan 21 tahun dengan keluhan sariawan dekat gigi bungsu bawah yang berulang setiap beberapa bulan. Pemeriksaan menunjukkan ulserasi pada gingiva lingualis posterior akibat traumatik oklusi antara gigi molar ketiga atas dan bawah. Terapi yang diberikan meliputi edukasi kesehatan gigi, farmakoterapi dengan hyaluronic acid, dan anjuran ekstraksi molar ketiga. Lesi membaik dalam satu minggu, follow up terakhir setelah dua minggu menunjukkan inflamasi menetap karena faktor predisposisi trauma tidak dihilangkan. Simpulan studi ini ialah trauma mekanis akibat hubungan oklusal gigi molar ketiga diduga berperan sebagai faktor pencetus SAR. Pendekatan konservatif melalui edukasi, farmakoterapi, dan pengendalian faktor pencetus memberikan hasil klinis yang baik. Evaluasi terhadap gigi molar ketiga perlu dipertimbangkan pada pasien dengan SAR rekuren sebagai bagian dari penatalaksanaan yang komprehensif.
Kata kunci: stomatitis aftosa rekuren; gigi molar ketiga; trauma oklusi; ulkus mulut
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