How do we diagnose?
1) Clinical diagnosis
2) Radiographic diagnosis
3) Historical diagnosis
4) Laboratory diagnosis
5) Microscopic diagnosis
6) Surgical diagnosis
7) Therapeutic diagnosis
8) Differential diagnosis
Clinical Diagnosis
- The strength of the diagnosis comes from the clinical appearance
- Requires good illumination
- Sometimes palpation
- Look at color ,shape, location and history of lesion
- No need for biopsy or surgical intervention
Examples of conditions diagnosed from a clinical diagnosis
- fordyce granules
- melanin
- fissured tongue
- geographic tongue
Radiographic Diagnosis
Radiographs provide sufficient information to establish the diagnosis although clinical and historical information may contribute
Examples of conditions diagnosed through radiographs
- periapical abscess
- caries
- root resorption
- supernumerary teeth
Historical Diagnosis
- Important component in every diagnosis
- Personal history
- Family history ( genetic disorders: medical and dental)
- Past and present medical history (updated)
- Past and present dental history (updated)
- History of drug ingestion
- History of present
Examples of when family history contribute a significant role
- Amelogenesis - Dentinogenesis
- Chemical burn - Amalgam Tattoo
Laboratory Diagnosis
- Clinical Lab tests including blood chemistries and urinalysis
Example: Paget's disease-tests will show a high level of alkaline phosphate
- Clinical appearance and radiographic images may be the first clues in finding Paget's disease-lab tests confirm i
Microscopic Diagnosis
- Biopsy specimen is taken from lesion
- Often main component of definitive diagnosis
- Skill of practitioner is important in performing the biopsy
- Brush biopsy may be used to obtain cells from oral mucosal epithelium. This distinguishes cells from bein
require biopsy
White lesions that are present in the mouth for more than two weeks...
Surgical Diagnosis
Diagnosis is made using the information gained during the surgical procedure
Examples of conditions diagnosed through surgical diagnosis
Traumatic bone cyst
Empty void in bone
Therapeutic Diagnosis
- Nutritional deficiencies are common conditions to be diagnosed by therapeutic means.
- Angular Cheilitis - Vitamin B Complex deficiency(Vitamin B 12/Iron especially, loss of vertical dimension or fungal/bacterial infections), prolonged sun/wind exposure
Acute Necrotizing Ulcerative Gingivitis
has distinct clinical features
- It responds to hydrogen peroxide destroying anaerobic bacteria causing ANUG ; the principle of therapeutic diagnosis is based solely on clinical and historical findings with conformation by the response of the condition to
Differential Diagnosis
- Often the pathology could be one of several different conditions
- Data collection (all the pieces of the puzzle)
- A listing of probable causes of a particular disease manifestation
- The final or definitive diagnosis emerges from a thorough evaluation
slides 96-115
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