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.