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Posisi :  RMO  Spesialis  Sub-Spesialis

Gigi
DELINEASI KEWENANGAN KLINIS

Kewenangan Klinis
No Catatan
U M DS TSF TK Daftar
Perawatan Klinis
1
(General Dentistry Core Privileges)
2 Rehabilitation of Dental Arches :
Operative restorations – amalgams, composites,
3
veneers
Crown & bridge preparations, post and core
4
procedures
5 Prosthetic replacement of teeth
6 Space maintenance
7 Bleaching of discolored teeth
8 Basic Endodontics :
9 Basic non-surgical pulp capping
10 Pulpotomy
11 Pulpectomy
12 Root filling
13 Basic periodontics :
Basic periodontal therapy including curettage,
14
splinting,
occlusal adjustment scaling and root
15
planting
16
17 Basic oral surgery :
18 Single uncomplicated extractions
19 Multiple uncomplicated extractions
20 Care of burns of the mouth
Avulsed / luxated teeth, repositioning and
21
stabilization
22 Anesthesia :
23 Local anesthesia
24 Diagnostic blocks
Perawatan Klinis
1
(Orthodontist Core Privileges)
Comprehensive Orthodontic examination and
2
consultation.
3 Fixed and removable retainers
4 Fixed and removable appliances
Perawatan Klinis
5
(Endodontics Core Privileges)
6 Comprehensive Endodontics examination and
 consultation
Complicated non-surgical root canal therapy for all
7
permanent teeth
8 Surgical root canal therapy
Perawatan Klinis
9
(Periodontics Core Privileges)
Comprehensive periodontal examination and
10
consultation
11 Osseous surgery
12 Pedicle soft tissue graft
13 Free soft tissue graft
14 Distal wedge procedure
Gingival flap procedure; gingivoplasty/
15
gingivectomy
16 Mucogingival surgery
17 Periodontal pulpal procedures
Tooth extractions (including impactions) associated
18
with periodontal surgery.
19 Vestibuloplasty
20 Tooth movement for periodontal purposes
21 Surgical tooth exposure
22 Frenectomy / frenotomy
Perawatan Klinis
23
(Oral Surgeon Core Privileges)
24 Intraoral incision & drainage or minor infections
1 Removal of benign tumors with biopsy
2 Transplantation of teeth
3 Reimplantation of teeth
4 TMJ diagnosis and non-surgical treatment
5 Major maxillofacial infection
6 Ranula
7 Osseointegrated implants and associated grafting
8 Caldwell Luc
9 Open reduction internal fixation of facial fractures
TMJ reconstruction (including grafting) and total
10
joint
11 Reconstruction of maxillofacial traumatic defects
12 Craniofacial Reconstruction
13 Otoplasty
14 Orthognathic surgery
15 Rhytidectomy
16 Blepharoplasty
17 Palatoplasty
18 Maxillectomy
19 Mandibulectomy
20 Preprosthetic surgery
21 Cleft lip and palate repair
22 Scar revision, dermabrasion, chemical peel
23 Intraoral biopsy
24 Extraoral biopsy
25 Wound debridement (intraoral)
Administration of major regional block anesthesia
26
(except caudals, spinals, epidurals)
27 Peripheral nerve blocks
28 Local anesthesia
Routine dentistry (restorative, prosthetic,
29
endodontic, periodontal)
30 TMJ arthoroscopy, lysis, lavage
31 Multiple uncomplicated extraction
32 Alveoloplasty, alveolectomy
33 TMJ manipulation
34 Torus pallidus, torus mandibularis
35 Facial lacerations
36 Local flaps of maxillofacial region
37 Tooth resection
38 Tracheotomy
39 Bone grafting
40 Excision or biopsy of salivary gland
41 Microneuro surgery
42 Skin grafting to maxillofacial region
43 Suture laceration (intraoral)
44 Single extraction
45 Frenectomy
46 Benign tumors
Perawatan Klinis
47
(Oral Medicine Core Privileges)
Evaluation of the dental patient and medical risk
48
assessment.
Diagnosis and management of oral and salivary
49 gland diseases;

Ulcerative, vesicular and Bullous lesions.

50
Red and while lesions of the oral mucosa.
51
Pigmented lesions of the oral mucosa
52
Benign tumors of the oral cavity
53
 Oral cancer
54
Salivary Gland Diseases
55
56 Oral manifestation of HIV/AIDS
57
58
59

Komentar

U= Usulan M= Mandiri DS= Dengan Supervisi TSF=Tidak ada Staf atau Fasilitas TK= Tidak ada Kompetensi

Nama
<tanda tangan>
Tanggal

Sub-Komite Kredensial Komite Medik

Nama Jabatan Tanda tangan Nama Jabatan Tanda tangan
Ketua Ketua

Anggota Sekretaris

Anggota

Mitra

Bestari

RS. Hosana Medica Bekasi RS. Hosana Medica Bekasi