BIOPSY Oral Surgery

BIOPSY
www.rxdentistry.blogspot.com
Biopsy:

Definition Indications Contraindications Armamenterium Points must be considered to ensure obtaining proper specimen Excisional biopsy Incisional biopsy Punch biopsy Needle biopsy Aspiration biopsy Exfoliative cytology
Types of biopsy
Definition:
Bios life Opsis vision
Removal of tissue from living beings for macroscopic examination ,microscopic analysis, bacterial analysis & combination of above is called BIOPSY.
INDICATIONS:
1.To determine the nature of lesion which does not readily respond to conservative & simple therapy. 2.To determine the nature of the lesion which is unknown. 3.To establish the diagnosis where there is suspecion of neoplasm. 4.To determine nature of any intraosseous lesion which cant be identified radiographically. 5.To determine the nature of all abnormal tissue removed from the oral cavity including cysts & granulomas.
Contraindications:
A) Relative contraindications:
1.In cases of inflammatory lesions may be due to allergy ,viral ,fungal, or bacterial lesion. e.g. candidiasis. 2.Compromised generalised health of patient. e.g. patient on anticoagulant therapy. 3.Proximity of lesions to vital , anatomic, physiologic, neural, vascular, or glandular structures.
B) Absolute contraindications: 1.Pulsatile vascular lesions. e.g. angiosarcoma. 2.Pigmented lesion should not be biopsied. e.g. Melanoma. 3.Intrabony radiolucent lesions should not be biopsied or removed without prior investigational aspiration.
ARMAMENTERIUM:
1.Mouth mirror & probe, colourless antiseptic agent. 2.LA & syringe. 3.Surgical scalpel. 4.Long pointed surgical scissors. 5.Tissue forceps 6.Biopsy punch 7.Bone burs
8.Periosteal elevator 9.Chiesel 10.Bow curette 11.Suture material 12.Needle holder 13.Sponges 14.Wide mouthed bottle with10% neutral buffered formalin
Points must be considered to ensure obtaining proper specimen:

1.Do not paint the surface of the area to be biopsied with iodine or other highly coloured antiseptic. 2.Dont inject LA into the lesion. 3.Use sharp scalpel to avoid tearing of tissue. 4.Use care not to mutilate the specimen when grasping it with forceps. 5.Fix the tissue immediately upon removal in 10% formalin or 70% alcohol. 6.If the specimen is thin, place it upon a piece of glazed paper & drop into fixative which prevents curling of tissue.
TYPES OF BIOPSY:
1.Excisional biopsy 2.Incisional biopsy 3.Scalpel biopsy 4.Punch biopsy 5.Needle/trephine/drill 6.Aspiration biopsy 7.Exfoliative cytology
EXCISIONAL BIOPSY:
*Definition: Total excision of a small lesion for microscopic study is called excisional biopsy. *Use : Lesions smaller than 1cm in meter.
Method:
Give LA which should not be closer than
2cm from the site. Stabilize the lesion via the suture. Incise mucosa around the base of the lesion in an elliptical shape. Place specimen immediately in a fixative. Close the wound using suture.
INCISIONAL BIOPSY:
Definition: Some lesions are too large to excise initially without having established diagnosis or are of such a nature that excision would be inadvisable in such instances a small section is removed for examination called incisional or diagnostic biopsy. Use : For large lesions or there is a suspicious of malignancy.
Method:
Administer LA. Identify the apparent junction between normal tissue &

the lesion select the specimen across region. Stabilize the specimen with a suture. Dissect the specimen from the edge of the lesion & include a margin of apparently normal tissue. The specimen should include representative area of the lesion. Place the specimen immediately in a prescribed specimen bottle containing 10% formalin. Close surgical site by sutures.
PUNCH BIOPSY:
A surgical instrument is used to punch out
a representative portion of tissue. Since resulting specimen is often damaged by the procedure so biopsy by scalpel is preffered.
Needle/trephine/drill biopsy:
Use : to biopsied deep-seated fibroosseous lesions. The resulting specimen is smaller may be non-representative & again often damaged by the procedures so they are not often used.
Aspiration biopsy:
Use Applicable to many cystic &
MethodClean the tissue over the proposed aspiration site. -Inject LA solution over the lesion. -Select a wide bore needle & 10 ml syringe. -Penetrate tissue & aspirate fluid. -Transfer the aspirate into a screw top specimen bottle.
fluctuant lesions
ORAL EXFOLIATIVE CYTOLOGY:

Oral epithelium is the harbour for many pathology lesions of varied origin, where the cells denude at the surface.Such cells can be used as an ADJUNCT to diagnose epithelial malignancies,viral lesions & dermatologic diseases with oral manifestations.The technic by which we study the exfoliating oral cells is termed asOral exfoliative cytology.
Collection of smear:
-A clean cotton tip applicator or a wooden spatula is used for collecting the specimen. -If the area to be scrapped is dry applicator or spatula should be moistened. -The material to be collected is obtained either by scrapping the surface of lesion or by rolling motion against the lesion. -Scrapping obtained should be smeared in the center of the previously marked slide.
Fixation of smear:
This is to maintain the almost same status as it was in the oral cavity. Fixatives used are : 1) Equal parts of ether & 95% ethyl alcohol give superstaining qualities. 2) Carbowax/Aquawax This contains -Polyethyl glycol -Distilled water -Glacial acetic acid The slide should be immersed into fixative before the smear dries out and remain it in the fixative ror 30 minutes.
Staining of the smear:

This is done by using The Modified Papnicolaou technique.-1946 utilizing Mayers haematoxylin, Orange G stain,combination of eosin & light green stains.
Screening criteria:
-Normal cells: Parabasal & immature prickle cells. Cells are spherical or cuboidal with centrally placed & EVEN CHROMATIN DISTRIBUTION. Cytoplasm stains green or bluish green. -Intermediate cells: irregularity of cytoplasmic morphology with some degree of contraction of nucleaus. Cytoplasm stains red or pink. -Mature cells: Flattened with pyknotic nucleus, may be anucleated cytoplasm stains, orange or yellow.
Criteria of malignant cells:

1.Irregular cell and nuclear borders. 2.Basal & parabasal cells. i.e in superficial part. 3.Cells with pyknotic nuclei or abscence of nuclei in an abnormal location. 4.Altered cytoplasm to nucleus ratio. 5.Epithelial giant cells. 6.Poikilocarynosis. 7.Abnormal miosis. 8.Hyperchromatism. 9.Abnormal chromatin pattern & distribution.

BIOPSY Oral Surgery

Hochgeladen von

Dokumentinformationen

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

BIOPSY Oral Surgery

Hochgeladen von

Copyright:

Verfügbare Formate

BIOPSY

Points must be considered to ensure obtaining proper specimen:

ORAL EXFOLIATIVE CYTOLOGY:

Staining of the smear:

Criteria of malignant cells:

Das könnte Ihnen auch gefallen