Oral Diagnosis II Forth Year

1. Differential diagnosis of
the oro-facial swellings
Aiman A. Ali DDS, PhD.
1

2.  Chief complaint
 History of chief complaint
 Medical history
 Review of systems
 Medications
 Hospitalizations
 Family history
 Psycho-social history
 Dental history
 Clinical examination
 Extra-oral
 Intra-oral
 Differential diagnosis
 Special investigations
 Final diagnosis 2
Aiman A. Ali , DDS, PhD. 2009

3. Chief complaint
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 Swelling
 Difficulties during eating
 Psychology [male, female]
 Pain
Aiman A. Ali , DDS, PhD. 2009

4. History of chief complaint
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 Onset and duration
Associated factors
Aiman A. Ali , DDS, PhD. 2009

5. History of chief complaint
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 Onset and duration
Associated factors
Aiman A. Ali , DDS, PhD. 2009

6. Medical history
• Review of systems
• Medications
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Leukemia
Dilantin hyperplasia
Aiman A. Ali , DDS, PhD. 2009

7. Psychosocial history
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Aiman A. Ali , DDS, PhD. 2009

8. Dental history
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Aiman A. Ali , DDS, PhD. 2009

9. Clinical examination
 Extra-oral “lymph nodes”
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Aiman A. Ali , DDS, PhD. 2009

10. Clinical examination
 Extra-oral: Salivary glands
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Aiman A. Ali , DDS, PhD. 2009

11. Clinical examination
 Extra-oral: Infections & Neoplasm
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Aiman A. Ali , DDS, PhD. 2009
Lipoma BCC
Periapical abscess Mumps

12. Clinical examination
 Color
 Normal
 White
 Red
 Blue
 Melanotic
 Yellow
 Café-au-lait
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Aiman A. Ali , DDS, PhD. 2009

13. Clinical examination
 Consistency:
 Hard
• Stony
• Bony
 Soft
 Mixed
 Fluctuant
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Aiman A. Ali , DDS, PhD. 2009

14. Clinical examination
 Site:
 Localized
 Generalized
 Gingiva
 Tongue
 Lip …etc.
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Aiman A. Ali , DDS, PhD. 2009

15. Clinical examination
 It’s relationship with adjacent teeth
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Aiman A. Ali , DDS, PhD. 2009

16. Special investigations
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Aiman A. Ali , DDS, PhD. 2009

17. Special investigations
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Imaging
Aiman A. Ali , DDS, PhD. 2009
CT scan MRI
U-Sound X-Ray

18. Special investigations
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Aiman A. Ali , DDS, PhD. 2009

19. Building the final
diagnosis
Inv.
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Aiman A. Ali , DDS, PhD. 2009
Text
Fam
.
Int.
S.I.
Med.
clin
Ext.history
Final
diagnosis

20. Anatomical classification of
Swelling
 Swelling of the gingiva
 Swelling of lip
 Swelling of the palate
 Swelling of the tongue
 Swelling of the floor of the mouth
 Facial swelling
 Swelling of salivary glands
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Aiman A. Ali , DDS, PhD. 2009

21. Swelling of the gingiva
 Gingival fibromatosis.
 Leukemia.
 Medications: Phenytoin, cyclosporine,
calcium channel blockers.
 Vitamin C deficiency
 Epulis: Pregnancy, fibrous, giant cells
 Tumors
 Granulomatous disorders: Crohn's,
sarcoidosis, orofacial graulomatosis
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Aiman A. Ali , DDS, PhD. 2009

22. Swelling of lip
 Edema: trauma, infection, insect bite
 Angioedema
 Granulomatous disorders: Crohn's,
sarcoidosis
 Mucoceles
 Cysts
 Tumors
 Abscess
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Aiman A. Ali , DDS, PhD. 2009

23. 23

24. Swelling of the palate
 Dental causes: impacted tooth, odontogenic
cyst, dental abscess
 Turus palatinus
 Tumors
 Developmental Cysts
 Fibroosseous lesions: fibrous dysplasia, Paget's
disease
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Aiman A. Ali , DDS, PhD. 2009

25. 25
Developmental cyst Inflammatory cyst

26. Swelling of the tongue
 Macroglossia
 Congenital: Lingual thyroid nodule,
hemangioma, lymphangioma,
 Abscess
 Edema: inflammatory, angioedema
 Hematoma
 Cysts
 Tumors
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Aiman A. Ali , DDS, PhD. 2009

27. 27
AngioedemaPyogenic granuloma
Hemangiomas

28. Swelling of the floor of the
mouth
 Fibrous hyperplasia
 Dental cause: abscess
 Tumors
 Cysts: dermoid, mucoseles, retention
cyst
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Aiman A. Ali , DDS, PhD. 2009

29. 29
Lipoma Dermoid Cyst
Ranula

30. Facial swelling
 Inflammation and infection
 Trauma
 Post operative emphysema
 Insect bite
 Angioedema
 Endocrine/metabolic causes (corticosteroids)
 Cysts
 Neoplasms
 Granulomatous disorders: Crohn's disease,
sarcoidosis, Melkersson-rosenthal syndrome,
orofacial granulomatusis
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Aiman A. Ali , DDS, PhD. 2009

31. 31

32. Swelling of salivary glands
 Inflammatory: mumps, AIDS, CMV
infections, Sjogren's syndrome, non
specific infections
 Obstructions: calculi or neoplasm
 Tumors
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Aiman A. Ali , DDS, PhD. 2009

33. 33
suppurative parotitis
Mumps Pleomorphic adenoma

34. Aiman A. Ali , DDS, PhD. 2007
34