Oral Diagnosis and
Manifestations of Some
Dr.Usama M. Madany
B.Ch.D, M.Sc., Ph.D.
Professor, Oral Medicine Periodontology, Diagnosis and Oral
Radiology, Faculty of Dentistry, Al-Azhar Univ.
Is the art and science of collecting
data concerning the patient's chief
problem that urged him/her to
seek the dental help.
Categories of Diagnosis:
To reach a definitive diagnosis,
pretreatment evaluation of a case
should be achieved through:
- History taking
- Clinical examination
- Special Investigations
Essential elements of history taking;
History of the present illness
Past medical history
Review of systems
*Means of clinical examination:
- Biopsy: Is the technique of choice
for diagnosis of a soft-tissue lesion in
- Serological tests including PCR
If a blood disease or disorder is
suspected CBC (hemogram)
should be requested:
- R.B.Cs count
- W.B.Cs count/differential
- Platelets count
- Hemoglobin concentration
- Hematocrit value
Screening tests for a case of bleeding:
-Platelet count; normal values = 150,000-450,000 platelets/mm3
-Prothrombine time (PT); normal values = 10-13 seconds.
-Partial thromboplasine time (PTT); normal values =25-36 seconds.
-Bleeding time; normal values = < 9 minutes.
Polymerasechain reaction (PCR):
Is a technique developed by
researchers in molecular biology for
enzymatic amplification of DNA
sequence. Because of its high
sensitivity, it proved marked clinical
potential in diagnosing viral diseases
Objectives of pretreatment evaluation:
- Establishment of diagnosis.
- Determination of underlying
- Discovery of concomitant illness.
- Prevention of medical emergencies
associated with dental treatment.
Some systemic diseases and disorders may
have oral manifestations, and some oral
diseases ( lesions) may be associated with
systemic diseases or disorders. According to
oral manifestations, the systemic diseases can
be classified as those which may produce/be
*Hyperpigmentation/change in color of oral mucosa.
*Spontaneous bleeding/ with minimal touch.
*Multiple abscess formation.
Normal bleeding time
W.B.Cs count is abnormal in early stage. It varieis
from 100,000 – 500,000 in different types.
Numbers of R.B.Cs, platelets and different leukocytes
show increase or decrease according to the type
Increase in all blood elements
Increased bleeding time
Normal blood picture
Increased bleeding time
Thrombocytopenia / ThrombocytosisThrombocytopenia / Thrombocytosis
Decreased platelets count
Increased bleeding time Increased bleeding time
Increased platelets count