diagnostic process

Diagnostic process in order:

Clinical

Radiographic

Historical

Laboratory

Microscopic

Surgical

Therapeutic

Differential

Clinical Diagnosis

• strength of the diagnosis comes from the clinical appearance of the lesion.

• establish a diagnosis for some lesions on the basis of color, shape, location, and history of the lesion.

Ex: Fordyce granules, torus palatinus, mandibular tori, melanin pigmentation, retrocuspid papillae, and lingual varicosities

Radiographic Diagnosis

• provides sufficient information to establish the diagnosis.

• additional clinical and historical information may contribute

•

Historical Diagnosis

constitutes the most important contribution to the diagnostic process in every diagnosis.

Ex: amelogenesis imperfecta, dentinogenesis imperfecta, and many other genetic disorders.

Laboratory Diagnosis

Clinical laboratory tests, including blood chemistries and urinalysis, can provide information that contributes to a diagnosis.

• helpful in determining the diagnosis of oral Infections

Microscopic Diagnosis

• of particular importance in the diagnostic process and therefore, although it is a form of laboratory diagnosis, it is discussed separately from laboratory diagnosis.

• microscopic examination of the biopsy specimen (via scalpel biopsy) taken from the lesion in question contributes significant information. This procedure is often the main component of the definitive diagnosis.

Ex: a white lesion( leukoplakia), Erythroplakia, types of HPV

Surgical Diagnosis

The strength of the diagnosis comes from surgical intervention.

For example, diagnosis is made using the information gained during the surgical procedure for the traumatic bone cyst

Therapeutic Diagnosis

Nutritional deficiencies are common conditions to be diagnosed by this means.

Ex: angular cheilitis, NUG

Prescribing hydrogen peroxide rinses and observing the results without culturing the bacteria applies the principle of therapeutic diagnosis because it is based solely on clinical and historical information with confirmation by the response of the condition to therapy.

Differential diagnosis

that point in the diagnostic process when the practitioner decides which test or procedure is required to rule out the conditions originally suspected and to establish the definitive or final diagnosis.

All previously discussed components are applied to the differential diagnosis.

After arriving at a differential diagnosis, information from which one of the following categories will best establish a final or definitive diagnosis?

Microscopic

Clinical diagnosis can be used to determine the final or definitive diagnosis of all of the following except:

Unerupted supernumerary teeth

Radiographic diagnosis would contribute to the definitive diagnosis of all of the following except:

A retained deciduous tooth

When an antifungal ointment or cream is used to treat angular cheilitis, which one of the following diagnostic categories is being used?

Therapeutic

Which one of the following diagnostic categories would the dental hygienist most easily apply to the preliminary evaluation of oral lesions?

Clinical

A patient has the clinical signs of necrotizing ulcerative gingivitis. The hygienist has the patient begin hydrogen peroxide rinses without culturing the bacterial flora. This action applies to which one of the following diagnostic categories?

Therapeutic

The identification of which one of the following is not determined by clinical diagnosis?

Compound odontoma

Historical diagnosis can include the patient's:

a. Age and sex

b. Family history

c. Medical history

d. All of the above

All of the above