Rationale of Oral Diagnosis and Maxillofacial Imaging

Author(s): Tim Peter Thermadam

Oral diagnosis of the maxillofacial lesions has always been a challenging puzzle from its inception. The lesion which varies from mere dental pulpal infections to carcinomas provides a broad spectrum of diagnostic challenge. It is extremely important to follow a systematic approach towards the diagnosis of the soft and hard tissue lesions. The approach must not be too short to miss the defining features of the lesions; or too long to consume the extended clinical time for the patients.A categorical approach of accurate clinical questioning pertaining to a lesion is mandatory for proceeding further. A systematic working clinical classification of the lesions pertaining to the soft and hard tissue lesions has to be made available for the clinician. The experience of the clinician and the knowledge of the variety of lesions present an overriding role in the entire process of diagnosis.Rationale of investigations is another pivotal area in confirming the provisional diagnosis. It is unethical for sending all the patients for a predefined set of investigations regardless of the clinical evaluation. An accurate flowchart of rationale of investigations for the hard tissue lesions has to be worked out ready from the plain film conventional radiograph to the cone beam computed tomography imaging (CBCT). Similarly for the soft tissue lesions, a look up guide for the selection of investigation mode has to be prepared and made available. It can vary from  Ultrasonography (USG) , Magnetic Resonance Imaging (MRI)  leading to biopsy. The concern and least invasive, but most efficient measures for diagnosis and treatment for the patient has to be the overruling theme in the entire procedure.This paper aims to summarize on the righteous ways to be followed in clinical scenario in the diagnosis and investigations of the lesions affecting oral soft and hard tissues.