Basic examination methods
Patient interview. This is done at every appointment. The doctor collects information about complaints, existing symptoms, past illnesses, medications taken, etc.
Inspection. The dentist examines the mucous membranes, teeth, evaluates the structure of the face, the closure of the dentition, the presence of swelling, edema, and other signs of inflammation. After a general examination, the condition of each of the teeth in the upper and lower jaw is assessed.
Crowns are examined using a dental mirror (allows you to see hard-to-reach areas and direct light to them). A sharp probe is used to assess the condition of the enamel. If there is a possibility of inflammation, percussion is performed, tapping the tooth (along the cutting edge or chewing surface). Normally it should be painless.
To assess the condition of the periodontium, the gums are examined, the presence of swelling, reddened, swollen, and injured areas is checked. Shallow probing may be performed to detect bleeding. If there is swelling or swelling, palpation (feeling) is performed. It is also used to assess tooth mobility.
Microscopic research methods in dentistry
This group of analyzes allows us to study the cellular structure and its changes in the oral mucosa and damaged surfaces of the dentofacial apparatus. Depending on the tasks facing the doctor, this may be a cytological sampling, biopsy or bacteriological screening.
General blood analysis.
In most cases, general clinical blood diagnostics is an additional diagnostic method. The absolute indications for using the technique are:
- Permanently appearing wounds in the oral cavity;
- Long-lasting damage to the mucous membrane;
- The appearance of necrotic tissue in the oral mucosa;
- Suspicion of problems with the functioning of the hematopoietic organs.
Very often, the first sign of a disorder in the hematopoietic processes is irritation and damage to the oral mucosa.
Biochemical diagnostics of blood and urine.
It is prescribed if a patient is suspected of having diabetes mellitus, which can manifest itself as irritation of periodontal tissue, dry mucous membranes, and the appearance of wounds and ulcers. Additionally, the doctor may decide to prescribe a gastric juice test. The main metrics in the analysis are indicators of albumin and globulins, their ratio, the amount of phosphorus and calcium in the blood serum.
Analysis for drug allergies.
The use of medications in dentistry can cause allergic reactions in the patient. This may be urticaria, blisters, tissue swelling, exanthema, anaphylactic shock. To determine the patient’s resistance, the doctor conducts a survey, studies the patient’s chart, and prescribes skin and provocative allergy tests. If necessary, indirect tests can be prescribed (injecting the patient's blood serum into the patient being studied).
Serological study.
The method consists of analyzing specific antigens and antibodies in the patient’s blood, as well as identifying certain elements of the serum through the reaction of the immune system. This method allows you to detect syphilis, brucellosis and human immunodeficiency virus.
Saliva analysis.
To make a diagnosis, in some cases of pediatric dentistry it is necessary to conduct a study of the child’s saliva. The subject of analysis may be:
- The amount and rate of saliva production in the oral cavity;
- Indicators of pro- and antioxidant systems of the body;
- Acid-base balance of saliva, an indicator of free radical oxidation;
- Mineral balance;
- Number of enzymes and buffer capacity.
Cytology.
The method is based on the study of the cellular structure and conglomerates of the analyzed surface. The cytological method is quite simple and not traumatic for the patient. It can be repeated several times. It allows you to monitor the effectiveness of prescribed therapy. And it can even be carried out on an outpatient basis, and at any stage of the inflammatory process. The analysis is taken in one of the following ways:
- Scraping from the damaged surface (ulcers, gumboils, fistulas, abscesses, erosions) and periodontal pockets;
- A smear-imprint from a damaged surface (ulcers, fluxes, fistulas, abscesses, erosions) and periodontal pockets;
- Smear reprints from the damaged surface (ulcers, gumboils, fistulas, abscesses, erosions) and periodontal pockets;
- Liquid sediment after rinsing the mouth;
- Puncture of deep periodontal tissues.
Strokes-imprints
obtained in one of two ways.
Either by applying special disinfected and degreased glass to the damaged surface (the method does not allow obtaining a print if the damage is localized deep in the mouth or access to it is difficult), or by obtaining data with a special rubber band (contact zone size 5x5 mm) and then transferring the print to the glass . Both methods are not perfect and cannot always be used. The main problem is the collection of necrotic tissue, and not the material being studied. In this case, the dentist may decide to perform a scraping
. To do this, dead areas (necrosis) are first removed from the site of damage and a smear is taken using a dental spatula (if the fistula tract is examined, the dentist uses a curettage spoon). It is important to prevent saliva, blood, and foreign objects from getting on the slide.
If catarrhal stomatitis, gingivitis or periodontitis is suspected, as well as if it is necessary to determine the reactivity of the components of the riticuloendothelial system, sediment is collected from the liquid
after several stages of rinsing the mouth (according to Yasinovsky’s method).
Collection of punctate
prescribed in case of observation of tumors, thickening of the mucous membrane and enlargement of lymph nodes. To do this, use a sterile syringe with a volume of 5 or 10 ml and a needle length of 6-8 cm. The needle is inserted into the area under study with the right hand, while fixing it with the index finger and thumb of the left hand. After the needle is inserted to a sufficient depth, I knead the area a little with the fingers of my left hand to obtain a sufficient amount of punctate. The syringe plunger is retracted while drawing. Next, the laboratory assistant disconnects the syringe and places the resulting mass on a glass slide. The procedure is carried out several times, after which the needle is removed. The procedure must be carried out quickly enough to avoid getting foreign substances or blood on the slide. Otherwise, it is difficult to prepare high-quality study drugs, which will lead to distortion of the results.
The biological material obtained as a result of the above-described manipulations is dried at room temperature (additional sources for drying are not used) and fixed in one of two mixtures - methyl alcohol or Nikiforov's solution. Additionally, the material is painted. For this, azure-eosin is used in the required concentration (depending on the urgency of the analysis).
Cytological examination allows us to determine:
- Viral diseases;
- Tuberculous ulcers;
- Some types of neoplasms;
- Acantholytic pemphigus;
- Erosion;
- Lichen planus;
- Traumatic ulcers...
It is recommended to monitor the clinical and cytological results of the study. If the data does not match, a repeat analysis or biopsy may be prescribed to eliminate diagnostic errors.
Biopsy.
It is carried out by resection of tissue for examination. The method is more accurate than cytological sampling, since there are no changes in the material that are associated with the phenomenon of autolysis. The procedure is prescribed to confirm the data of other tests or if it is impossible to establish a diagnosis using another method. For a biopsy, excision of tissue measuring 5-6 mm is sufficient. If the damaged area is small, its complete excision is recommended - the so-called total biopsy. The resulting material is also placed in a special solution and sent for histological diagnosis.
Bacterioscopy.
A bacteriological type of study in which the analyzed material is obtained from the surface of the mucous membrane to determine the cause of the disease, as well as to determine the type of bacillus. Bacterioscopy reveals:
- Syphilis;
- Gonorrhea;
- Actinomycosis;
- Infections with various fungal infections;
- Leprosy;
- Tuberculosis;
- Other.
The procedure can be carried out according to two protocols – native and fixed. In the first approach, fresh, unprocessed material is collected, placed on a glass slide and sent for research. In the second approach, the following sequence of actions is observed:
- The procedure is carried out on an empty stomach, before brushing your teeth (or 4 hours after eating and rinsing).
- The use of medications is excluded.
- The surface of the wound is cleaned with a cotton swab, and material is collected from the deep tissues.
- Cultures are carried out on various media, and the material is sent for analysis.
Radiography
An image is taken of a small area of the jaw, more often to diagnose the condition of one tooth. It allows you to evaluate the characteristics of bone tissue, the tooth itself, the tissues around it and its root (gums, bone, ligaments).
X-rays in dentistry are used to:
- diagnose hidden caries, pulpitis, inflammation or cracks of the root canals;
- collect information about the dental system before implantation, prosthetics or monitor their results;
- assess the volume of bone tissue during sinus lift;
- check the quality of root canal treatment (must be filled without voids or pores);
- assess the structure of the dental system before and after orthodontic treatment;
- perform an accurate diagnosis if the patient’s complaints correspond to several diseases.
There are several types of X-rays used in dentistry.
Intraoral, dental. Performed to obtain an image of a single tooth or small area. The picture is taken using a radiovisiograph - a digital camera that captures an x-ray signal. The technology allows you to obtain high-resolution images: the doctor can see the condition of the canals, hard tissues, etc., and identify diseases at the initial stage. Radiation exposure with digital radiovisiography is minimal, which allows the method to be used for primary and intermediate diagnostics, when assessing the results and quality of treatment. The image is taken in a few minutes: a sensor is placed in the patient’s mouth on the side of the tooth being examined, and a pulsed radiation source is placed near the face. The image is available for viewing immediately.
Panoramic. It is performed to assess the structure and condition of the jaw as a whole, allows you to identify foci of inflammation or infection, pathology or disease of the TMJ, and assess the condition of the maxillary sinus and periodontium. Panoramic photographs are needed in preparation for implantation, prosthetics, and orthodontic treatment. They are performed using a special apparatus. The radiation dose is higher, but remains safe.
CT scan. It is used in planning sinus lifting, bone grafting, implantation, and other surgical interventions, and in diagnosing periodontal diseases. The photographs are taken in certain projections and used to build a three-dimensional model of the jaw. Computed tomography is very informative. The study provides information about the localization of inflammation (including intraosseous), the presence of tumor-like formations, their structure, size, features of the location of the root canals, etc.
Comprehensive diagnostics at the Estetika clinic
Our clinic in Novosibirsk has modern German dental equipment installed. High-precision equipment allows for high-quality radiation diagnostics, which is one of the informative research methods in dentistry. We also have a modern digital device “Gendex” for three-dimensional diagnostics.
The articles published on the site are for informational purposes only, and the services described may not correspond to the list of services provided in the dental clinic. Please check with the administrator for the availability and cost of procedures.
