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DIAGNOSTIC TOOLS IN DENTISTRY
• English Activity
Valencia, Spain.M51
18-5-17
INDEX OF WORK
• Introduction
• Saliva
• X-Ray
• Biopsy
• Bibliography
INTRODUCTION
• Diagnosis
Is the identification of the nature and cause of a certain phenomenon.
It’s used in medicine, science and business.
SALIVA
• Saliva is a watery substance secreted by the salivary glands.
• Comprises:a. water 99,5%.
b. electrolytes.
c. mucus.
d. glycoproteins.
e. enzymes.
f. antimicrobial agents.
g. epithelial cells.
h. White blood cells.
SALIVA
• Saliva can be seen in many cases as a reflection of the physiological function of the body.
• It’s useful for early diagnosis.
SALIVA
SALIVA
• Cardiovascular disease.
• Atherosclerosis, the leading etiological factor, is triggered by the presence of inflammation, which results in deposition of lipids in the arterial walls and progressive narrowing of the arterial lumen.
• People with increased C-reactive protein (CRP) are more likely to be unaware of their susceptibility to develop cardio- vascular disease.
SALIVA
• Cardiovascular disease.
• Salivary CRP levels were found to correlate with plasma CRP levels obtained from blood samples of a population at risk for cardiovascular complications.
• Detect cardiac troponin (cTn), a biomarker for the detection of AMI.
SALIVA
• HIV / AIDS
• Human immune deficiency virus (HIV) affects the immune system.
• It is a sexually-transmitted disease that also spreads through infected blood transfusions and from diseased mothers to infants.
SALIVA
• HIV / AIDS
• HIV Test can detect both HIV-1 and HIV-2 viruses with an oral swab.
• A swab is left in place for 2–5 min between the lower gingival and buccal mucosa to collect antibodies in the saliva.
SALIVA
• Oral Cancer.
• Oral squamous cell carcinoma (OSCC) is the most common form of oral cancer.
• Research groups have found that salivary levels of specific proteins are increased in whole saliva of patients with OSCC (CD44).
SALIVA
• Salivary tests will pave the way for chair-side diagnosis of multiple oral and systemic diseases at the dental office.
• The advent of sensitive and specific salivary diagnostic tools and the establishment of defined guidelines will make salivary diagnostics a reality in the near future.
Dental X-rays
• Dental X-rays are a type of image of the teeth and mouth.
• Are used in dentistry as a fundamental diagnostic tool.
• With them we can see pathologies that at first sight we can not detect.
• In them we see the structures of the oral cavity reflected according to their density.
INTRODUCTION
CLASSIFICATION
Dental x ray machine
• Interproximal radiographs
• Periapical radiographs • Occlusal radiographs
• Panoramic radiographs
OBJECTIVES
• Quantity, size and position of teeth.
• Teeth that have not come out or teeth impacted.
• Dental caries.
• Bone damage (such as that produced by periodontitis).
• Dental abscesses.
• Fractured jaw.
• Problems in the way the upper and lower teeth fit Other anomalies of mandibular teeth and bones.
Parallel technique:
• The radiograph is placed in a position parallel to the longitudinal axis of the tooth to be examined, in a central beam directed perpendicular to the radiograph and the longitudinal axis of the tooth
Bisector technique:
• At the point where the radiograph has contact with the tooth, the plane of the radiograph, and the longitudinal axis of the tooth form an angle, the radiologist must imagine a plane that divides by half the angle formed by the film and the longitudinal axis of the tooth, this plane is called bisector, which creates two equal angles
RISKS
• Exposure to radiation from dental radiographs is very low.
• A lead apron may be used to cover the body and reduce radiation exposure.
• Pregnant women should not be given x-rays unless absolutely necessary.
Laboratory tests of interest in dentistry
• Haematological
• Hemostasis
• Blood biochemistry
• saliva
Blood count
• Erythrocyte series: number of red blood cells, hematocrit, hemoglobin
• Leukocyte series: Total count, neutrophils, monocytes…
• Platelet series: normal value : 150.000-400.000 mm3
Blood chemistry
• Blood glucose
• Creatinine
• alkaline phosphatase
• Transaminases
Infections diseases:
• VIH
• Hepatitis
• TBC
It is better to prevent a complication through diagnosis than to resolve it intraoperatively
BIOPSY
• A biopsy is a medical test which consists in a sample of tissue taken from the body in order to examine it more closely.
• To determine the presence or extent of a disease.
• The tissue is generally examined under a microscope by a pathologist, and can also be analysed chemically.
BIOPSY
• Excisional biopsy: entire lump or suspicious area is removed, including healthy tissue around
• Incisional biopsy: only a sample of tissue is removed with preservation of the histological architecture of the tissue’s cells.
WHY IS IT IMPORTANT?
• Biopsies are most commonly performed for insight into possible cancerous and inflammatory conditions.
• Lesion with similar clinical or radiological morphology.
• Provides definitive diagnosis, prognosis and treatment information.
BIOPSY
• Contraindications:
1. Patients with conditions that can preclude the safe use of local anaesthetic and those with severe bleeding diseases and coagulopathies.
1. Invasive procedures on the bone: NO in patients with bisphosphonates treatment.
2. Risk for metastasis.
BIOPSY
• In most cases biopsies are carried out under local anaesthesia (an injection into the area to numb it).
• The injection takes a couple of minutes to work and means that the biopsy will be painless.
BIOPSY
• The biopsy usually leaves a small hole that often requires stitching.
• In the majority of cases the stitches used are dissolvable and take around two weeks to disappear.
• The whole process (local anaesthetic injection, biopsy and stitching) usually takes around 15 minutes from start to finish.
BIOPSY
BIBLIOGRAPHY
• http://emedicine.medscape.com/article/1079770-overview.
• https://www.baoms.org.uk/patients/procedures/1/oral_mouth_biopsy.
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756071/.
• http://www.ada.org/en/member-center/oral-health-topics/x-rays.