Oral Diagnosis

8/9/2019 Oral Diagnosis

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y Direct Diagnosis

y Clinical Diagnosis

y Pathological Diagnosis

y

Working or Tentative Diagnosisy Definitive Diagnosis

y Post-Treatment Diagnosis

y Spot Diagnosis

y Differential Diagnosis


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y prediction of possible outcome

y Based on the following: Length of time the Disease can

Degree of Tissue Damage Loss of Function

Susceptibility to Recurrence

e eliminated


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y Complete of Comprehensivey Executive typey Requires collection of all appro

y

Screeningy Serves as a compromise betweebecause of its practical aspect

y TIMEy COSTy SKILL

y Examination that indicates grosy Most popular and widely usedy May utilize a Health Questionn

riate diagnostic data

complete and less extensive.

s disease in broad survey

ire


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y Incomplete or Emergencyy No set or routine followed

y Designed to manage the chief c

attention.y Focused on relieving the C/C

y Periodic Health Maintenance/Ry Any deviation that might have

the last complete and thorou

y The ideal time interval for a thomos.

mplaint that requires immediate

ecallccurred during the interval fromh exam

rough and complete exam is 6 to 12


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y Subjectivey Coming from the patient

y Which includes the chief comp

y

Symptomsy Example: PAIN

y Objectivey What the physician perceives w

y Includes discernable deviation

y Signsy Example: Change in color, Chang

a

int of the patient

th the patient

rom normal structure

e in size and contour


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y Identification

y Chief Complainty In patients own words relating to t

y

History of Chief Complainty Chronological account of the C/C

taken.

y Medical History

y Personal/Social/Economic

y Review of Systemsy Element of patient history that ex

physiologic system in accord with

he present abnormal condition.

rom the time of onset to time history is

lores the health and function ofhe patients experience and perception.


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y General Patient Apprasialy Evaluation of the patients gait, posy Asthenic, Sthenic, Hypersthenic, a

y Vital signsy Height andWeighty Blood Pressurey Heart ratey Respiratory ratey Pulse Rate

y Extraoral Examinationy Intraoral Examination

y Supplementary/Adjuctive Diagnos

ture, speech.nd Pyknic ,

tic Data


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y Visualy Inspection systemic visual assessy Active, Passive and Transilluminat

y Palpation use both sense of toucy A. Compressible

y

Spongy structure that deforms witoriginal contour.y Doughy stucture that offers greate

content and then sly Pitting, Collapsing

y B. Non Compressibley Bony, Hard rigid or unyielding sen

y Indurated hardness without rigid sy Rubbery feature of Malignant neo

y Method of Palpation1. Bidigital lips2. Bimanual floor of the mouth3. Bilateral - TMJ

enton

and sight.

minimal resistance and quickly regainsdegree of resistance suggesting a semisolidwly returns to its original shape.

ation of the tissues

ensationlasm


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y Removal of a sample of a tissue i

y Most useful and accurate diagn

y Also important in providing val

the prognosis and type of treaty Types

y Excisional

y Incisional

y Intraosseousy Aspiration

y Punch

n a living individual.

stic tool available.

able information in determining

ent necessary.


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y Excisionaly Indicated for a lesion less than 1y Sessile or pedunculated; locate

y Insicionaly Indicated when the lesion is wi

y Intraosseous

y Aspirationy To obtain information about th

large, deep seated, relatively inaintraosseous lesion.

y Punch

cmabove or just beneath the mucosa

espread

nature of the fluid content of a

ccessible lesion soft tissue mass or


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for Dental Practitioner


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y Dyspneay Orthopnea; Nocturnal Dyspnea

y Swelling of the feet and legs

y Chronic lack of energyy Asthenia; Lassitude; Faintness

y Difficulty in sleeping

y Polyuriay Hematuria; Anuria

y

Cough with frothy sputumy Swollen abdomen

y Confusion or Impaired memory


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y Served by free nerve ending in t

y Can be initiated by a variety of sy Mechanical (very intense press

y Thermaly Chemical

e skin and visceral tissues.

timuli:re)


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y Neuralgia: severe, unremcauses such asviral infection

y Trigeminal Neuralgia (Tic Dolo

y Glossopharyngeal Neuralgiay Psychalgia: neuralgia of n

y Causalgia: severe burninof nerves by

velocity shocky Odontalgia: throbbing, int

odontogenic i

tting pain and due to a variety ofdiabetes, extraction of teeth,, and vitamin deficiency.eux)

organic basis.

pain associated with deforationissile or bullets that produce high

.rmittent pain which isorigin.


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y Tooth ache: the most com

y Phantom Pain: refers to pain iamputated.

y Headache: pain causedintracranial v

Also known a

y Migraine: Recurrent par

usually unilaty Visual Aura: a symptom pr

migraine.

on cause of orofacial pain.

n a limb that has been

y dilation and distension ofessels.s Cephalaglia

xysmal vascular headache

ral.ceded by the pain caused by


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y Arterialy Bright red pulsating and inter

y Venous

y Dark red oozing and steady fly Capillary

y Bright red oozing and steady

y BoneyBright red and oozing.

ittent

w

low


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y Extravascular Factors perivascy When vessels course closely to t

y When there is a loss of elasticit

y

Intravascular Factorsy Hypothromboplastinemia/thro

y Thromboplastin formation is im

y Shortage of thromboplastin may

y Hypothrombinemia

y Fibrinogenopeniay Absence of fibrinogen

lar tissueshe skin

boplastin defeciencyeded by a defeciencyof platelet

be a result of circulating anticoagulants


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y Vascular Factors pathosis of tthe capillary and material wall iy Hereditary

y

Infection demostrs

y Nutrition defecien

y Hypersensitivity

y Hormones ACTH, E

e vessel wall itself. Weakness ofa common cause.

ted in streptococcal invasion ofarlet fever & meningococcemia.

cy in ascorbic acid

strogen, play a vital role in bruising


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y Purpuray Purplish spots produced by sma

y Petechiaey

Small purpura spots (pin pointy Ecchymosis

y Large purpura spots

y Hematomay

Extravasation of blood into theand swelling and the location is

ll bleeding vessels

leeding)

oft tissue, clot formed with painusually deep.


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y One of the largest organ in the b

y Primary Lesions:y Macule: a circumscribed area oy Patch: a flat lesion > 1cm in d

y Papule: small, circumscribed py Pustule: cloudy or white fluid fy Nodule: large, circumscribed py Vesicle: small blister like elava

intraepithelial collecti

y Bulla: a raised lesion < 0.5cmy Wheal: a transient pink or red

central pallor.y Telangiectasia: dilation of capil

ody.

color change without elevationameter.

alpable elevation of the skin.lled with pus.lpable elevation of the skin.ion of the skinn due ton of f luid up to 5mm

diameter; large vesicle.swelling of the skin, often with

laries.


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Secondary Lesiony Crust: dried exudate which may

hemmorrhagic.

y

Lichenification: thickening of they Scar: final stage of healing of d

involves the deeper derm

y Erosion: partial break in the epidescarring unless secondar

y Ulcer: full-thickness loss of the epy Athrophy: thinning and transluce

y Desquamation: shedding of epith

have been serous, purulent, or

skin with exaggeration of skin creases.estructive process whichs resulting in a smooth shiny lesion.

rmis which heals withoutinfection occurs.

dermis which heals without scarring.cy of the skin.

lial elements in scales or sheets


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y Common chronic benign hyper

y Characterized by symmetricalplaques with a thick silvery scal

y Dental Relevance:y Joint involvement may impair o

y Patients may be immunosuppre

y Rarely oral changes may be see

roliferative condition of the skin.

ell-defined erythematous.

al hygiene

ssed.

.


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y These are antibody mediated grthe appearance of blisters or erosite.

y

Blistering may occur in differeny Subepidermal Blister

y Bullous pemphigoid

y Mucous Membrane Pemphigoid

y Epidermolysis bullosa

y Intercellular Blistery Pemphigus vulgaris

up of disorders characterized bysion of the skin and/or mucosal

sites:


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y Basal Cell Carcinomay The most common malignant n

of the keratinocyte.y Seen as erythematous nodular le

superficial dilated capillaries.

y Commonly seen in sun-expose

y Tumors enlarges slowly and is lmetastasize.

eoplasm arising from the basal layer

ion with pearly opalescent edge and

sites

cally destructive but rarely


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y Squamous Cell Carcinomay Also arises from keratinocytes b

either by lymphatics or more ra

y They characteristically arise dey May be seen as nodular or ulcera

y Treatment is more invasive.

ut has the potential to matastasizeely hematogenous disssemination.

novo in sun exposed site.ive and it is often painful.

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Oral Diagnosis