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Abstrak :
Kesalahan kognisi dan metakognisi dalam proses penalaran klinis adalah faktor yang paling berperan pada terjadinya kesalahan diagnosis. Lesi jaringan lunak mulut merupakan lesi yang sulit dideteksi maupun didiagnosis dibandingkan dengan lesi karies. Tujuan: Tujuan penelitian ini menentukan intervensi yang paling efektif dalam meningkatkan akurasi deteksi dan diagnosis lesi jaringan lunak mulut. Metode penelitian: Penelitian ekperimental pada mahasiswa Fakultas Kedokteran Gigi Universitas Indonesia. Tahap persiapan adalah adaptasi lintas budaya dan pengembangan berbagai instrumen untuk mengukur faktor – faktor yang berperan pada penalaran klinis. Tahap Intervensi adalah mengukur akurasi deteksi dan diagnosis lesi jaringan lunak mulut sebelum dan sesudah intervensi penalaran reflektif dan pendekatan algoritme. Hasil: 44 mahasiswa, didominasi oleh mahasiswi semester satu. Validitas dan reliabilitas DTI dipertanyakan (Cronbach’s alpha 0,632) dan SMQ-II sangat baik (Cronbach’s alpha 0,923). Skor DTI subjek < 150 (75%). Motivasi subjek untuk belajar ilmu penyakit mulut termasuk tinggi (64.8±12.1) terutama pada domain motivasi karir. Faktor afektif subjek berada pada kategori positif. Kesalahan proses diagnosis yang sering terjadi adalah inakurasi bagian kritis dari riwayat penyakit (47.7%). Terdapat penurunan selisih akurasi deteksi dan diagnosis lesi jaringan lunak mulut antara ekaminator dan mahasiswa pada seluruh intervensi. Intervensi pendekatan algoritme meningkatkan sensitivitas akurasi deteksi (40%) dan diagnosis (55.84%) diagnosis utama (n=252 diagnosis). ......Cognitive and metacognitive error in clinical reasoning was the most important factors regarding diagnostic error. Oral soft tissue lesion was considered as hard to detect/diagnose compared to carious lesion. The objectives of this study are to determine interventions which most effective in increasing the oral soft tissue lesion detection and diagnosis. Method: Experimental study on Faculty of Dentistry Universitas Indonesia student. The preparation phase comprises cross cultural adaptation and instrument development. The intervention phase measure oral soft tissue lesion detection and diagnosis before and after the reflective reasoning and diagnostic algorithm approach. Result: 44 subjects mostly the first semester dentist profession program female student. Validity and reliability of DTI was questionable (Cronbach’s alpha 0,632) while SMQ-II was excellent (Cronbach’s alpha 0,923). DTI score was < 150 (75%). Subjects’ motivation in learning oral medicine was high (64.8±12.1) particullary on career domain. The diagnostic process error mostly on Inaccurate/misinterpreted critical piece of history data (47.7%). There was a reduction on the difference amount of oral soft tissue lesion detection and diagnosis accuracy between examinator and student on all intervention. However, the diagnostic algorithm approach increasing the oral soft tissue lesion detection (40%) and diagnosis (55.84%) of the adjuvant diagnosis (n= 252 diagnosis)

Abstrak :
Objective: to determine the daylong effect of Antiplaque toothpaste active compound and the effect of tooth brushing or combination of tooth brushing and tongue cleaning on Volatile Sulphur Compounds (VSC) levels. Methods: Clinical experimental double blinded microbiological and clinical oral examination. Subjects mainly from dental faculty student with or without a chief complain of halitosis. One hundred and twenty subjects were divided into four groups that consist thirty samples each group. Two group are treatment groups using Antiplaque toothpaste and two groups are control groups using placebo toothpaste. The daylong effects of VSC levels are measured by Halimeter and organoleptic. The intra oral status were measured including periodontal status and tongue index, result: There are a reducton of VSC levels in booth treatment and control group, but the reduction only significant in group using Antiplaque toothpaste (Willcoxon signed rank test, p<0,05). There are a reduction of VSC levels in both treatment using Antiplaque toothpaste, but the combination of tooth brushing and tongue cleaning reduced VSC levels significantly lower than tooth brushing treatment (Mann Whitney U test, p< 0,05). COnclusion: Tooth brushing and combination of toothbrushing and tongue cleaning using Antiplaque toothpaste significantly reduced VSC levels.