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Step 1

BIOPSY : PEMOTONGAN DAN PENGAMBILAN JARINGAN DAN CAIRAN YG TERKENA LESI UTK DIPERIKSA SECARA

MIKROSKOPIS

Step 2

LESI PUTIH LEUKOPLAKIA

Step 7

1. Definisi Lesi Putih

-suatu daea! "# a$%&'a( )ada 'u*&sa 'u(ut "# )d )e'e+*saa% *(+%+s ta')a* (e$+! )ut+! d)d ,a+%#a% se*+ta%"a da% $+asa%"a a#a* (e$+!

t+%##+ ($! *asa atau 'e'+(+*+ te*stu "# $e$eda d ,a+%#a% %&'a( d+de*at%"a-suatu (a)+sa% )ut+! )d 'u*&sa 'u(ut "# ta')a* a%"a'a% !&'&#e%"t+da* !&'&#e%"

/. Penyebab terjadinya lesi putih dan apa saja macamnya

• Pe%"e$a$ Les+ )ut+! A*+$at $e$a#a+ 'a0a')e%e$a(a% (a) e)+te(ada%"a 'ate+a( eu)e2+s+a()e'adata% stu*tu ,a +*at d+$a3a!

e)+te(*&'$+%as+ *et+#a%"a4 et+&(&#+s da% )at&(&#+s%"a

• Ma0a'-'a0a' Les+ Put+!  ada d+ LBM/

5. Apa diagnosis dan DD nya

• D+a#%&s+s%"a: S)e0*(ed atau 6e&0u&s (eu*&)(a*+a

•

DD :o L+0!e% )(a%us Les+ Mea! da% Mea!Put+!

Pe%"e$a$ : *e(a+%a% +'u%&(&#+* 

Ta%da: se$a#+a% $esa 3a%+ta d+atas us+a 78t! $es+2at *a'$u!a%

Leta*: 'u*&sa $u*a( (+da! $+$+ )a(at' #us+ dasa 'u(ut

o 9!+te S)&%#e %ae6us  (es+ )ut+!

B+asa%"a d+,u')a+ )ada 3a*tu (a!+ atau )ada a%a* *e0+(

Ta%da: 3a%a )ut+! )ada 'u*&sa $e*eut da% se)et+ $usa

Leta*: 'u*&sa )+)+ (+%#+ a(6e&(a dasa 'u(ut

o *as+%&'a se( s*ua'&sa  (es+ )ut+!

 )e%"e$a$: ++tas+ *&%+s se)et+ te'$a*au da% a(*&!&( +%2e*s+ 0a%d+da a($+0a%s de2+s+e%s+ %ut+s+ ad+as+ +'u%&su)es+

(eta*: d+&&2a+%# dasa 'u(ut #us+ 'u*&sa $u*a( $+$+ )a(atu'

ta%da: $e%tu* $u(at $e(+*u atau t+da* $eatua% 'e%&%,&( dasa (es+ *asa 'uda! $edaa!

o e+t&)(a*+a (es+ 'ea! da% (es+ 'ea!)ut+!

Leta* : (+)ata% 'u*&$u*a( 'a%d+$u(a &&2a+%# dasa 'u(ut

Ta%da : (es+ $e$atas ,e(as $e%tu* !&'&#e% ta')a* 'ea! atao E+t&(eu*&)(a*+a (es+ 'ea! da% (es+ 'ea!)ut+!

Leta*: (atea( (+da! 'u*&sa $u*a( )a(atu' '&((e

Pe%"e$a$: )e&*&* $eat a(*&!&(+s'e da% *e$es+!a% 'u(ut "a%# ,e(e*

7. Klasifikasi dari leukoplakia ciri2 dan contoh!

• !&'&#e% (eu*&)(a*+a (eu*&)(a*+a da)at 'e%,ad+ se'a*+% 'e(uas 'e%e$a(

-  )&(a #a+s !a(us $e*eut da% )a)+(&'a(t&sa

-  $e0a* )ut+! *ada%# $e3a%a *e$+ua% )e'u*aa% (+0+% ata $e$atas ,e(as t+da* d+,u')a+ ada%"a +%duas+ 'e%&%,&(4

-  $eu)a (es+ )ut+! "a%# data da% t+)+s. Les+ +%+ da)at te(+!at se$a#a+ eta*a% "a%# da%#*a( de%#a% )e'u*aa%"a%# !a(us atau $e*eut.

- Te*stu%"a *&%s+ste%. T+)e +%+ $+asa%"a as+')t&'at+* 

• e&s+2 (eu*&)(a*+a

-  $e3a%a )ut+! 'e%#*+(at d+seta+ +%duas+ 'e%&%,&(4 )ada )a()as+ )e'u*aa% (es+ teasa *asa da% d+,u')a+ ada%"a )e'u*aa% (es+

"a%# e&s+

• S)e0*(ed atau 6e&0u&s (eu*&)(a*+a %&% !&'&#e% (eu*&)(a*+a4

-

Les+ ta')a* 'e%&%,&( $e3a%a )ut+! t+da* 'e%#*+(at t+'$u(%"a +%duas+ 'e%"e$a$*a% )e'u*aa% 'e%,ad+ *asa da% $e(e*u*-(e*u*da(a' 3a*tu "a%# e(at+2 s+%#*at a*a% $eu$a! 'e%,ad+ *as+%&'a se( s*ua'&sa

-  $eu)a (es+ )ut+! atau )ut+! d+seta+ 'ea!e+t&)(a*+a4. Pe'u*aa% (es+ +e#u(e $+sa ata %&du(a s)e0*(ed (eu*&)(a*+a4atau

e&)!"t+0e&)!"t+0 atau 6eu0&us (eu*&)(a*+a4. Pada 6eu0&us (eu*&)(a*+a )e'u*aa% (es+ ta')a* suda! 'e%&%,&( $e3a%a )ut+!

teta)+ t+da* 'e%#*+(at. T+)e (eu*&)(a*+a +%+ $+asa%"a d+seta+ de%#a% *e(u!a% +%#a% $eu)a*et+da*%"a'a%a% atau %"e+ "a%# te(&*a(+s+ - 0&%t&!:

1. e+t&(eu*&)(a*+a : $e0a* 'ea! de%#a% (eu*&)(a*+a "a%# te)+sa!-)+sa! da% t+da* da)at d+!a)us

/. (eu*&)(a*+a %&du(e: (es+ de%#a% sed+*+t )e%&%,&(a% 'e'$u(at $ea3a%a 'ea! da% )ut+! se!+%##a ta')a* #a%u(a-#a%u(aatau

%&du( *eat&t+* "a%# tese$a )ada $ea* at&2+* 'u*&sa da(a' 3a*tu "a%# e(at+2 s+%#*at a*a% $eu$a! 'e%,ad+ *as+%&'a se(

s*ua'&sa5. (eu*&)(a*+a 6eu*&+d: (es+ t+da* $eatua% Mu(t+)(e t+da* 'e%#*+(at 'e'$e%tu* t&%,&(a% de%#a% *eat+%+sas+ "a%# te$a(

;. Penyebab leukoplakia

• <a*t& L&*a(

o Tau'a: #+#+ta% ++tas+ *ae%a )e'a*a+a% )&tesa "a%# *ua%# $a+* 

o Ke'+0a( atau te'a(

<a*t& *aust+* : Te'$a*au A(*&!&( Ba*te+a(

• <a*t& s+ste'+* 

o Pe%"a*+t s+ste'+* se)et+: s+2+(+s tet+e e&st&'+a a%e'+a s+d&2e%+* "a%# d+se$a$*a% &(e! )e%"a*+t *e(e%,a sa(+6a

o I%2e*s+ 0a%d+da a($+0a%s

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• <a*t& Ma(%ut+s+ 6+ta'+%:

o De2+s+e%s+ 6+ta'+% A "a%# da)at 'e%#a*+$at*a% 'eta)(as+a da% *eat+%+sas+ da+ susu%a% e)+te(

o de2+s+e%s+ 6+ta'+% B *&')(e*s "a%# da)at 'e%+'$u(*a% )eu$a!a% !+)e*eat&+*

o de2+s+e%s+ 6+ta'+% C  eat *a+ta%%"a de%#a% )e'$e%tu*a% se'e% +%tase(u(a "a%# )e%t+%# u%tu* 'e'$a%#u% ,a+%#a% )e%"a%##a

!u$u%#a%%"a de%#a% (es+: u%tu* )ea3ata% su))&t+2 'e(a(u+ e#e%eas+ ,a+%#a% se!+%##a 'e')e0e)at 3a*tu )e%"e'$u!a%4

=. Karakteristik leukoplakia

• Meu)a*a% (es+ )ut+! #e,a(a )e *a%*eteda)at $e0a* "# susa! d+ !a)us t+da* se'$u! *ua%# (e$+! /'+%##u

• Pe'u*aa% (es+ ta')a* (+0+% da% !&'&#e%$e0a*/ $e*eut da% $e$e0a*-$e0a*3a%a%"a 'eu)a*a% 6a+as+ (e'$ut da+ (es+/ )ut+!

ta%s(use% )u0at sa'a)+ a$u/ atau )ut+! sa')a+ 0&*(at

• Leta*%"a d+ (atea( da% 6e%ta( (+da!dasa 'u(ut*e'ud+a% d+ 'u*&sa a(6e&(ad+ $+$+ teda)at d+ daea! t+#&%u' et& '&(a da% )a(atu'

'&((e $e%tu*%"a t+)+s da% 'uda! )e0a!

• Se$a#+a% $esa )ada )+a 7;-=;t!

• Be0a* )ut+! sa')a+ 'ea! )ada 'u*&sa 'u(ut )e'*aa% ata 'e%&%,&( $e$atas ,e(as

•  $+asa%"a t+da* sa*+t teta)+ se%s+t+2 te!ada) se%tu!a% )a%as 'a*a%a% )edas da%++ta% (a+%%"a

>. "agaimana mekanisme#patofisiologis leukoplakia

• I%2e*s+ *a%d+da a($+0a%,a'u 

• Kae%a asa)'e%#a%du%# ta 'e%"e$a$*a% t+'$u( ,a'u 'e%#++tas+ 'u*&sa )ada 'u(ut $e0a* )ada 'u*&sa 'u(ut

• Asa)'e%#a%du%# ta da% %+*&t+%++tas+ $eu(a%# )ada 'u*&sa 'u(ut'u*&sa 'e%e$a(?t+'$u( ,a'u  $e0a* 

•  Leukoplakia membuktikan bahwa perubahan epitel pada penyakit ini disebabkan oleh transformasi displastik. Perubahan patologi yang 

utama pada leukoplakia diperlihatkan oleh diferensiasi epitel yang abnormal dengan peningkatan permukaan keratinisasi menghasilkan

 penampakan mukosa yang putih. Hal ini diikuti pula oleh penebalan pada epitelium, bahkan epitel bisa menjadi atrofi atau akantosis

(perubahan lapisan tanduk)• Pada stad+u' a3a( ta%da )e%"a*+t +%+ ada(a! $e0a* )ut+! "a%# *ada%#*ada%# $e3a'a *e!+%ta%. Pe'u*aa%%"a (+0+% ata da% $e$atas

 ,e(as. Pada ta!a) +%+ $e(u' ada +%duas+ atau $e%,&(a%. Pada stad+u' *edua $e0a* +%+ $+asa%"a 'u(a+ teasa *asa "a%# d+seta+ de%#a%

 $e%,&(a%.

D+ stad+u' t+#a $e0a* ta')a* sa%#at 'e%&%,&( $e3a%a )ut+! teta)+ t+da* 'e%#*+(a). Be%,&(a% 'e%"e$a$*a% )e'u*aa% 'e%,ad+ *asa 

da% $e(e*u*-(e*u*. J+*a suda! 'e%"e%tu! stad+u' +%+ (eu*&)(a*+a $e)&%te%s+ suda! 'e%,ad+ tu'& #a%as

@. "agaimana cara pera$atan leukoplakia

• La%#*a! a3a(U%tu* 'e%#!+(a%#*a% *e$+asaa% 'e&*&* *a(au (a%#*a! +%+ t+da* $+sa !+(a%# $au d+(a*u*a% $+&)s" )e'e+*saa%4

• Asu)a% 6+t C&# de3asa 188-1/8 '#!a+ u%tu* )e&*&* 178 '#!a+

• Me%#e(+'+%as+ 2a*t& ++tas+ "a%# 'e(+)ut+ )e%##u%aa% te'$a*au &*&*4 a(*&!&( 'e')e$a+*+ !"#+e%e 'u(ut 'e')e$a+*+ 'a(&*(us+

'e')e$a+*+ #+#+ t+ua% "a%# *ua%# $a+* )e'$e+a% 6+t B *&')(e*s da% 6+ta'+% C eat *a+ta%%"a de%#a% )e'$e%tu*a% se'e% +%tase(u(a 

"a%# )e%t+%# u%tu* 'e'$a%#u% ,a+%#a% )e%"a%##a !u$u%#a%%"a de%#a% (es+: u%tu* )ea3ata% su))&t+2 'e(a(u+ e#e%eas+ ,a+%#a%

se!+%##a 'e')e0e)at 3a*tu )e%"e'$u!a%4

. mengapa dilakukan biopsy pada pasien

- *ae%a d+ta*ut*a% (es+%"a 'e(uas 3a(au)u% 2a0t& ++tas+%"a suda! !+(a%# 'a*a d+ $+&)s"

-  )e'e+*saa% $+&)s+ d+(a*u*a% u%tu* 'e%e#a**a% d+a#%&s+s (es+ "a%# d+0u+#a+ se$a#a+ *e#a%asa% da% ,u#a se$a#a+ a(at $a%tu d+a#%&st+* 

u%tu* 'e%#e6a(uas+ (es+ "a%# $u*a% *e#a%asa%. B+&)s+ d+a*u+ se$a#a+ suatu 0aa "a%# a'a% 'uda! da% da)at d+)e0a"a u%tu* 'e%e#a**a%

d+a#%&s+s )ast+

- Ja+%#a% "a%# d+du#a te*e%a *a%*e a*a% d+)&t&%# se*+ta /-5 '+(+'ete ,a+%#a% )e'e+*saa% suda! da)at d+)e&(e! sete(a! 7-; !a+.

18.  bagaimana tahap2 timbul bercak putih

I+tas+ "a%# teus 'e%eus da+ !as+( )e'$a*aa% te'$a*au 'e%"e$a$*a% )e%e$a(a% )ada ,a+%#a% 'u*&sa 'u(ut. Se$e(u' #e,a(a *(+%+s

te(+!at ++tas+ da+ asa) te'$a*au +%+ 'e%"ea%# se(-se( e)+te( 'u*&sa se!+%##a a*t+2+tas%"a 'e%+%#*at. Ge,a(a +%+ $au te(+!at $+(a a*t+2+tas

se((u(e $eta'$a! da% e)+te( 'e%,ad+ te$a( teuta'a ta')a* )ada 'u*&sa $u*a( 'u*&sa "a%# 'e%#!ada) )+)+4 da% )ada dasa 'u(ut.

Peu$a!a% 'u*&sa 'u(ut te(+!at se$a#a+ $e0a* )ut+!. Be0a* )ut+! tese$ut 'u%#*+% d+se$a$*a% *ae%a e)+te( "a%# te$a( ,e%u! de%#a%

sa(+6a a+ (uda!4.

11. Kenapa pasien giginya tidak terkena karies padahal perokok berat dan bagaimana hub merokok terhadap gigi

• Mu%#*+% )as+e% a,+% 'e%##&s&* #+#+ *ae%a 'e%"ada+ $a!3a 'e&*&* +tu d)t 'e%+'$u(*a% *a(*u(us

• Hu$u%#a%%"a +tu #+#+ $e3a%a *u%+%# *ae%a &*&* $a%"a* 'e%#a%du%# ta da% %+*&t+%

1/. %engapa timbul rasa nyeri padahal tidak ada karies pada gigi

• Kae%a $e0a* )ut+! se%s+t+6e te!ada) a%#sa%#a%#e,a(a%"a '++) sa*+t #+#+

• hasil pembakaran rokok dapat menyebabkan gangguan sirkulasi peredaran darah ke gusi sehingga mudah terjangkit penyakit 

15. %engapa timbul bercak putih pada perokok#pasien

• Te,ad+ *ae%a ++tas+ teus 'e%eus )d 'u*&sa da+ te'$a*au "# )a%as ,ad+ ,a+%#a% 'u*&sa a*a% 'e%e$a(

• B+sa ,u#a *ae%a te'$a*au "# $(' te$a*a "# tes+s+) )ada s+s+ )&ste+&*a(au a%te+& ut* 'e%0+u' $au te'$a*au

•  Rokok mengandung tembakau yg apabila kita mengisap asap rokok yang berkepanjangan maka akan menyebabkan iritasi mukosa mulut 

 sehingga menyebabkan eritematosus

• Me%uut )e%e(+t+a% S+(6e'a% da+ se'ua *asus Leu*&)(a*+a ; ada(a! )e&*&*. I+tas+ "a%# teus 'e%eus da+ !as+( )e'$a*aa%

te'$a*au 'e%"e$a$*a% )e%e$a(a% )ada ,a+%#a% 'u*&sa 'u(ut. Se$e(u' #e,a(a *(+%+s te(+!at ++tas+ da+ asa) te'$a*au +%+ 'e%"ea%# se(-

se( e)+te( 'u*&sa se!+%##a a*t+2+tas%"a 'e%+%#*at. Ge,a(a +%+ $au te(+!at $+(a a*t+2+tas se((u(e $eta'$a! da% e)+te( 'e%,ad+ te$a( teuta'ata')a* )ada 'u*&sa $u*a( 'u*&sa "a%# 'e%#!ada) )+)+4 da% )ada dasa 'u(ut. Peu$a!a% 'u*&sa 'u(ut te(+!at se$a#a+ $e0a* )ut+!.

Be0a* )ut+! tese$ut 'u%#*+% d+se$a$*a% *ae%a e)+te( "a%# te$a( ,e%u! de%#a% sa(+6a a+ (uda!4. Paa a!(+ 'e%#ata*a% $a!3a (eu*&)(a*+a

'eu)a*a% (es+ )a-#a%as d+ da(a' 'u(ut. Peu$a!a% (eu*&)(a*+a 'e%,ad+ #a%as 5-=.

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17. Kenapa bercak terdapat pada gigi di region sebelah kanan jika di hub dengan kebiasaan merokok 

• Mu%#*+% *e$+asaa% 'e(eta**a% &*&* 

• Kae%a asa) %"a "# teus 'e%eus

1;. %engapa nyeri dirasakan hanya pada saat panas

• Kae%a se%s+t+6e teda)at a%#sa%#a% )a%as

• Infeksi umum yang menyebabkan rasa tidak nyaman pada lidah adalah thrush (candidiasis), dimana jamur 

berbentuk lapisan putih pada gigi yang terlalu cepat bertumbuh yang menutupi lidah. Nyeri intensif pada

seluruh mulut bisa disebabkan oleh sindrom mulut terbakar.

•  $+asa%"a $e0a* )ut+! +%+ 'e%"ea%# (a)+sa% d+%d+%# te(ua &%##a 'u(ut a(+as 'u*&sa s+s+ )+)+ (+da! da% ,u#a #us+. $a#+a% 'u(ut +%+(a!

"a%# )a(+%# se%s+t+2 te!ada) $e$a#a+ sea%#a% )e%"a*+t &%##a 'u(ut

1=. Adakah Perbedaan bercak putih yg diakibatkan jamur dg leukoplakia

- Hu$u%#a% 0a%d+da de%#a% (eu*&)(a*+a  Ka%d+da 'a')u 'e%#!as+(*a% *as+%&#e%+* %+t&sa'+%e 'e(a(u+ ea*s+ $+&*+'+a ,a+%#a%.

- Ge,a(a sea%#a% )e%"a*+t +%+ u'u'%"a d+a3a(+ de%#a% $e0a* )ut+! *e0+( d+ se*+ta &%##a 'u(ut. Da(a' )&ses%"a $e0a* +%+ a*a%

'e'$esa da% se'a*+% 'e(e$a seta te$a(. Be$eda de%#a% ,a'u $e0a* )ut+! (eu*&)(a*+a u'u'%"a su(+t d+!a)us*a% *ata Ju(+a%+.

Perubahan epitel pada gambaran histolopatologis leukoplakia dibedakan menjadi & yaitu' doc(leukoplakia )S) hal 1*!

P+LA P,%,-.KSAA/ P,/0AK. KA/K,- 

1! Pemeriksaan fisik 

Pe'e+*saa% 2+s+* 'eu)a*a% 0aa "a%# *(as+* da% )e%t+%# da(a' d+a#%&s+s tu'&. De%#a% 0aa +%+ da)at d+*eta!u+ (eta* da% d+a'ete tu'& seta

!u$u%#a%%"a de%#a% ,a+%#a% atau &#a% se*+ta%"a. D+a'ete d+te%tu*a% de%#a% 'e%#u*u d+a'ete te$esa tu'&. Ke0e)ata% 'e'$esa tu'& 

da)at d+u*u de%#a% 'e%e%tu*a% d+a'ete. Se$e%a%"a *e0e)ata% )etu'$u!a%tu'& !aus d+u*u 'e%uut 6&(u'e. Hu$u%#a% tu'& !aus

d+%"ata*a% des*+)t+2 : $e$as $e#ea*atau 'e(e%#*et de%#a% ,a+%#a% se*+ta%"a. K&%2+#uas+ *u(+t"a%# 'e%utu) tu'& ,u#a )e%t+%# d+%"ata*a%.

M+sa(%"a )ada *a%*e )a"udaa stad+u' (a%,ut se+%# te(+!at *&%2+#uas+ *u(+t se)et+ *u(+t ,eu* $+su( da% tu*a*.Pa()as+ *e(e%,a #eta! $e%+%#

e#+&%a( d+(a*u*a% 0e'at de%#a% )&(a tete%tu u%tu* 'e%#eta!u+ *e'u%#*+%a% ada%"a

'etastas+s.

2! Pemeriksaan sitologi#histopatologi

Tu'& "a%# (eta*%"a da(a' d+usa!a*a% d+)e+*sa 'e(a(u+ 2+%e %eed(e as)+at+&% $+&)s" $+)s+ as)+as+ ,au' !a(us4 tue0ut %eed(e $+&)s" $&%e

'a&3 )u%0t+&% atau)u% $+&)s+ +%s+s+e*s+s+. Pe'e+*saa% ,a+%#a% de%#a% 0aa d+ atas )e(u d+(a*u*a% se(a+% u%tu* d+a#%&st+* *a%*e ,u#a u%tu* 

'e%e%tu*a% su$t+)e tu'& *ae%a ada *a+ta%%"a de%#a% )&(a )e%#&$ata%.

! Pemeriksaan sifat kimia$i atau biologis

Rea*s+ !&'&% atau s+t&stat+*a te!ada) se( tu'& )e%t+%# d+*eta!u+ u%tu* *e)e%t+%#a% tea)+. Ka(au 'u%#*+% )ada set+a) ,e%+s tu'& d+ (&*as+

tete%tu d+$uat sau s*e'a )&(a )e%a%##u(a%#a% 'u(a+ da+ d+a#%&s+s sa')a+ )ada tea)+ "a%# d+se$ut )&t&*&( )e%a%##u(a%#a% tu'&. B+asa%"a

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ada(a! 'e%#e%a( da% 'e%#a)(+*as+ s+ste' T.N.M. T Tu'&

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'e%,ad+ (e$+! )a%,a%# !+)et&)+4. D+s+%+ !as+( )e'$a*aa% &*&* "a%#

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!as+( )e'$a*aa% &*&* da)at 'e%"e$a$*a% #a%##ua% s+*u(as+

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Kanker -ongga %ulut +ral! Premaligna5 Karsinoma Sel

Skuamous

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Premalignansi oral

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4ubungan Patologi dan molecular dari penyakit

 Premalignansi & displasia

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at+)+* s+t&(&#+ *(as+* "a%# 'e%#+%d+*as+*a% s+*(us se( "a%!# 0e)atte'asu* )(e&'&2+* !+)e*&'as+ da% 'e'$esa%"a u*ua% +%t+ se(

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ta%)a )e'e+*saa% !+st&)at&(&#+s.

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SPEKTRUM KLINIS PREMALIGNAN RONGGA MULUT

DAN LESI KANKER Se)et+ +(ustas+ se$e(u'%"a (es+ )e'a(+#%a &%##a 'u(ut da)at 'ea!

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7/26/2019 LI LBM 2 BLOK 10

http://slidepdf.com/reader/full/li-lbm-2-blok-10 6/7

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