This document outlines principles and techniques for biopsy. It discusses developing a systematic approach including health history, lesion history, clinical and radiographic examination, and laboratory tests. Different types of biopsies are described such as incisional, excisional, aspiration and oral cytology. Guidelines are provided for indications, techniques, specimen handling, and documentation for biopsies of oral soft tissue and hard/intraosseous tissue lesions. Principles of surgery include anesthesia, tissue stabilization, hemostasis, incision design, and handling of biopsy specimens.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. Oral biopsy; why, when, and how? Biopsy is the removal of the tissue from the living organism for the purpose of microscopic examination and diagnosis. Looking for a definitive diagnosis is the aim of biopsy. Types of Biopsy include incisional, excisional, drill, fine needle and frozen section biopsy.
BIOPSY AND HEALING OF THE BIOPSY WOUND / dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
ORAL BIOPSY:
Introduction
Definition
History
Uses of Oral Biopsy
Indication for Oral Biopsy
Contraindication of Oral Biopsy
Precaution in Oral Biopsy
Armamentarium
Types of Oral Biopsy
Special consideration
Biopsy Arifact
Obtaining a Good Oral Biopsy
Complication of Oral Biopsy
Conclusion
Ford Motor Company -The Open and Mobile Platform Shreya Ganapathy
Ford Motor Company -The Open and Mobile Platform
The future of competitive MRM solutions lies in delivering increased functionality and interoperability via flexible software platforms.
Bill Frykman, Business & Product Development Manager, Ford Motor Company ( Presenting at the Fleet and Asset Management USA 2010 conference for Telematics Update)
This presentation is in association with the Fleet and Asset Management Europe 2011 conference which is on the 4th and 5th of April in Amsterdam!
http://www.telematicsupdate.com/fleeteurope/
Dr. Ahmed M. Adawy, Professor Emeritus, Dep. Oral & Maxillofacial Surgery. Former Dean, Faculty of Dental Medicine
Al-Azhar University. Oral biopsy; why, when, and how? Biopsy is the removal of the tissue from the living organism for the purpose of microscopic examination and diagnosis. Looking for a definitive diagnosis is the aim of biopsy. Types of Biopsy include incisional, excisional, drill, fine needle and frozen section biopsy.
BIOPSY AND HEALING OF THE BIOPSY WOUND / dental crown & bridge coursesIndian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
ORAL BIOPSY:
Introduction
Definition
History
Uses of Oral Biopsy
Indication for Oral Biopsy
Contraindication of Oral Biopsy
Precaution in Oral Biopsy
Armamentarium
Types of Oral Biopsy
Special consideration
Biopsy Arifact
Obtaining a Good Oral Biopsy
Complication of Oral Biopsy
Conclusion
Ford Motor Company -The Open and Mobile Platform Shreya Ganapathy
Ford Motor Company -The Open and Mobile Platform
The future of competitive MRM solutions lies in delivering increased functionality and interoperability via flexible software platforms.
Bill Frykman, Business & Product Development Manager, Ford Motor Company ( Presenting at the Fleet and Asset Management USA 2010 conference for Telematics Update)
This presentation is in association with the Fleet and Asset Management Europe 2011 conference which is on the 4th and 5th of April in Amsterdam!
http://www.telematicsupdate.com/fleeteurope/
In the vast landscape of dentistry and oral pathology, the role of oral biopsy emerges as a beacon of diagnostic clarity amidst the complexities of oral lesions.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
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Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
2. Principles and Techniques ofPrinciples and Techniques of
BiopsyBiopsy
It is important to develop a systematic
approach in evaluating a patient with a
lesion in the Oral and Maxillofacial
region.
3. These steps include :These steps include :
A detailed health history
A history of the specific lesion
A clinical examination
A radiographic examination
Laboratory investigations
Surgical specimens for histopathologic
evaluation
4. Health HistoryHealth History
An accurate health history may disclose predisposing
factors in the disease process or factors that affect the
patients management.
Up to 90% of systemic deseases can be discovered
through history taking.
The same can be true of oral lesions when one is
familiar with the natural progression of the more
common disease processes.
5. Medical conditions thatMedical conditions that
warrant special care include:warrant special care include:
Congenital heart defects
Coagulopathies
Hypertension
Poorly controlled diabetics
Immunocompromised patients
7. Questions to AskQuestions to Ask
Duration of the lesion
Changes in size and rate of change
Changes in the character of the lesion.
– Lump to ulcer, etc
Associated systemic symptoms:
– fever
– nausea
– anorexia
8. More Questions to AskMore Questions to Ask
Pain
Abnormal sensations
Anesthesia
A feeling of swelling
Bad taste or smell
Dysphagia
Swelling or tenderness of adjacent lymph
nodes
Character of the pain if present
9. Historical Reasons for theHistorical Reasons for the
Lesions:Lesions:
Trauma to the area
Recent toothache
Habits
11. Clinical EvaluationClinical Evaluation
The anatomic location of the lesion/mass
The physical character of the lesion/mass
The size and shape of the lesion/mass
Single vs. multiple lesions
The surface of the lesion
The color of the lesion
The sharpness of the boundaries of the lesion
The consistency of the lesion to palpation
Presence of pulsation
Lymph node examination
12.
13. Radiographic ExaminationRadiographic Examination
The radiographic appearance may provide
clues that will help determine the nature of the
lesion.
A radiolucency with sharp borders will often be
a cyst
A ragged radiolucency will often be a more
aggressive lesion
Radiopaque dyes and instruments can help
differentiate normal anatomy
15. These include:These include:
Tumor of hyperparathyroidism
Multiple myeloma
Determination of serum calcium,
phosphorus, and alkaline phosphatase and
protein can be very useful in excluding
certain pathological processes.
16. Indications for BiopsyIndications for Biopsy
Any lesion that persists for more than 2 weeks
with no apparent etiologic basis
Any inflammatory lesion that does not respond
to local treatment after 10 to 14 days.
Persistent hyperkeratotic changes in surface
tissues.
Any persistent tumescence, either visible or
palpable beneath relatively normal tissue.
17. Indications for BiopsyIndications for Biopsy
Inflammatory changes of unknown cause that
persist for long periods
Lesion that interfere with local function
Bone lesions not specifically identified by
clinical and radiographic findings
Any lesion that has the characteristics of
malignancy
18. Characteristics of lesions that raise theCharacteristics of lesions that raise the
suspicion of malignancy.suspicion of malignancy.
Erythroplasia- lesion is totally red or has a speckled red
appearance.
Ulceration- lesion is ulcerated or presents as an ulcer.
Duration- lesion has persisted for more than two weeks.
Growth rate- lesion exhibits rapid growth
Bleeding- lesion bleeds on gentle manipulation
Induration- lesion and surrounding tissue is firm to the
touch
Fixation- lesion feels attached to adjacent structures
19. What is a Biopsy?What is a Biopsy?
Biopsy is the removal of tissue for the
purpose of diagnostic examination.
20. Types of BiopsyTypes of Biopsy
Oral cytology
Aspiration biopsy
Incisional biopsy
Excisional biopsy
21. Oral CytologyOral Cytology
Developed as a diagnostic screening
procedure to monitor large tissue areas
for dysplastic changes.
Most frequently used to screen for
uterine cervix malignancy
May be helpful with monitoring
postradiation changes, herpes,
pemphigus.
22. The Disadvantage of oral cytologicalThe Disadvantage of oral cytological
procedures include:procedures include:
Not very reliable with many false positives.
Expertise in oral cytology is not widely
available
The lesion is repeatedly scraped with a
moistened tongue depressor or spatula type
instrument. The cells obtained are smeared on
a glass slide and immediately fixed with a
fixative spray or solution.
23.
24. Aspiration BiopsyAspiration Biopsy
Aspiration biopsy is the use of a needle and syringe
to penetrate a lesion for aspiration if its contents.
Indications:
– To determine the presents of fluid within a lesion
– To a certain the type of fluid within a lesion
– When exploration of an intraosseous lesion is
indicated
25. AspirationAspiration
An 18 gauge needle on a 5 or 10 ml
syringe is inserted into the area under
investigation after anesthesia is obtained.
The syringe is aspirated and the needle
redirected if necessary to find the fluid
cavity.
26. Incisional BiopsyIncisional Biopsy
An incisional biopsy is a biopsy that
samples only a particular portion or
representative part of a lesion.
If a lesion is large or has different
characteristics in various locations more
than one area may need to be sampled
27.
28. Incisional BiopsyIncisional Biopsy
Indications:
– Size limitations
– Hazardous location of the lesion
– Great suspicion of malignancy
Technique:
– Representative areas are biopsied in a wedge fashion.
– Margins should extend into normal tissue on the deep
surface.
– Necrotic tissue should be avoided.
– A narrow deep specimen is better than a broad shallow
one.
29.
30. Excisional BiopsyExcisional Biopsy
An excisional biposy implies the complete removal of
the lesion.
Indications:
– Should be employed with small lesions. Less than 1cm
– The lesion on clinical exam appears benign.
– When complete excision with a margin of normal tissue is
possible without mutilation.
33. AnesthesiaAnesthesia
Block anesthesia is preferred to
infiltration
When blocks are not possible distant
infiltration may be used
Never inject directly into the lesion
36. IncisionsIncisions
Incisions should be made with a scalpel.
They should be converging
Should extend beyond the suspected depth of the lesion
They should parallel important structures
Margins should include 2 to 3mm of normal appearing
tissue if the lesion is thought to be benign.
5mm or more may be necessary with lesions that appear
malignant, vascular, pigmented, or have diffuse borders.
37. Handling of the TissueHandling of the Tissue
SpecimenSpecimen
Direct handling of the lesion will expose
it to crush injury resulting in alteration
the cellular architecture.
39. Margins of the BiopsyMargins of the Biopsy
Margins of the tissue should be identified
to orient the pathologist. A silk suture is
often adequate. Illustrations are also
very helpful and should be included.
40. Surgical ClosureSurgical Closure
Primary closure of the wound is usually
possible
Mucosal undermining may be necessary
Elliptical incision on the hard palate or
attached gingiva may be left to heal by
secondary intention.
41. Biopsy Data SheetBiopsy Data Sheet
A biopsy data sheet should be completed
and the specimen immediately labeled.
All pertinent history and descriptions of
the lesion must be conveyed.
42.
43. Intraosseous and Hard TissueIntraosseous and Hard Tissue
BiopsyBiopsy
Intraosseous lesions are most often the
result of problems associated with the
dentition.
44. Indications for IntraosseousIndications for Intraosseous
BiopsyBiopsy
Any intraosseous lesion that fails to
respond to routine treatment of the
dentition.
Any intraosseous lesion that appears
unrelated to the dentition.
45. Palpation of the area of the lesion with comparison
to the opposite side.
Any radiolucent lesion should have an aspiration
biopsy performed prior to surgical exploration.
– Information from the aspiration will provide valuable
information about the lesion.
• Solid
• Fluid Filled
• Vascular
• Without Contents
Clinical ExamClinical Exam
46. Principles of SurgeryPrinciples of Surgery
Mucperiosteal flaps should be designed to allow
adequate access for incisional/excisional biopsy.
Incisions should be over sound bone
Cortical perforation must be considered when
designing flaps
Flaps should be full thickness
Major neurovascular structures should be avoided
47. Principles of SurgeryPrinciples of Surgery
Osseous windows should be submitted with the
specimen
Osseous preformations can be enlarged to gain
access
Avoid roots and neurovascular structures
The tissue consistency and nature of the lesion will
determine the ease of removal
48. Principles of SurgeryPrinciples of Surgery
Incisional biopsies only require removal of a
section of tissue
Soft tissue overlying the lesion should be
reapproximated following thorough irrigation
of the operative site.
The specimen should be handled as previously
described
49.
50. Biopsy Results: What If ?Biopsy Results: What If ?
They don’t corroborate your clinical impression
– Repeat the biopsy!!!
– Determine if the tissue was looked at by an Oral
Pathologist
– The results show malignancy
51. When To Refer For BiopsyWhen To Refer For Biopsy
When the health of the patient requires special management
that the dentist feel unprepared to handle
The size and surgical difficulty is beyond the level of skill
that the dentist feels he/she possesses
If the dentist is concerned about the possibility of
malignancy