Técnicas Complementarias de Diagnóstico en Patología Oral

That students have an understanding of the techniques used as complementary tests in oral pathology.
That students know each of the techniques and their specific indications in oral pathology

Unit 1.- Clinical history in oral pathology and examination techniques. Photography as a complementary technique.

Unit 2. Radiological tests: Periapical / occlusal. Panoramic radiography. Waters projection .Sialography. Scintigraphy. Ultrasound. TAC. MR. PET. Practical application.

Unit 3. Biochemical tests. Blood count: Total count of erythrocytes: concentration of Hb. Hematocrit. RBC indexs: HCM: mean corpuscular hemoglobin. MCHC: mean corpuscular hemoglobin concentration. MCV: Mean corpuscular volume. Leukocyte account. Total: leukocytosis and leukopenia. Differential: in the five types of leukocytes

Unit 4.-Coagulation. Prothrombin Time (TP). TTP partial thromboplastin time: Platelet count.

Unit 5. Serum or plasma biochemistry: Blood glucose: glucose curve; Capillary blood glucose; Glycated hemoglobin. Serum iron and the total iron binding capacity. Vitamin B12 and folic acid. Calcium, phosphorus and alkaline phosphatase: hypoproteinemias and nephropathies. Uric acid. Albumin, globulin and total protein. Cholesterol and triglycerides. Bilirrubin. Renal function tests: serum creatinine and BUN and urine: microscopic examination of sediment.

Unit 6. Analysis of saliva.

Unit 7.- Immunological tests: Study of the immunoglobulins in serum and other biological fluids. Monoclonal gammopathy or paraproteinemia. Determination of serum Ig and other liquids by nephelometry in immunodeficiencies. Serum electroimmunophoresis and other liquids. Determination of total and specific IgE by RIA and ELISA.

Unit 8. Study of the complement. Diseases by immune complex deposition. Detection of circulating immune complex.

Unit 9.-Cryoglobulins. Monoclonal immunopathies

Unit 10.Aautoantibodies. Indirect immunofluorescence, hemagglutination tesT. Antinuclear antibodies (ANA): LES and disorders of connective tissue.

Unit 11.- Identification and counting of peripheral blood lymphocyte subsets: diagnosis of primary and secondary immunodeficiencies, and lymphoproliferative disorders

Unit 12.- Assessment of the cellular immunity. Testing delayed hypersensitivity. Lymphocyte proliferation to mitogens and against alloantigens

Unit 13. Ag-Typing of the HLA system. Organ compatibility.

Unit 14.Oral biopsy in oral pathology: Concept, classification indications and contraindications. Exfoliative cytology; FNA.

Unit 15. Differential gene expression in squamous cell carcinoma of the oral cavity.

Unit 16. Microbiological Testing. Fungal identification and characterization of the different species found in the mouth. Mucosa smear and culture. Antifungigram. Viral identification. Bacterial identification. Culture and antibiogram..

Unit 17.- Molecular methods. Principles. PCR. Hybridization. Flow cytometry. In situ fluorescence. Genomic hybridization.

Unit 18. immunohistochemical methods. Principles and techniques. Immunohistochemical applications. Molecular markers. Tumor markers.

Unit 19. Immunofluorescence. Principles and techniques. Preparation for IFD. Applications for diagnosis and differential diagnosis in oral diseases.

Laboratory practices and seminars:
T1.-Photography workshop. Application in oral pathology.
T2.-Management of computer programs reading TCs (Romexis)
T3.-Immunohistochemical cell count (OralImmunoanalyser and conventional microscopy)
T4.-Biopsy
T5.-Saliva recollection and measurement techniques
T6.-Application of cytology in the oral cavity.

Basic Bibliography
· Bagán Sebastián JV, Ceballos Salobreña A, Bermejo Fenol A, Aguirre Urizar JM, Peñarrocha Diago M. Medicina Oral. Barcelona: Masson. 1995.
· Bascones A, Llanes F. Medicina Bucal. 3ª ed. Madrid: Ariel, 2004.
·Blanco Carrión A. Liquen Plano Oral. Madrid: Ediciones Avances, 2000.
· Cawson RA, Odell EW. Cawson´s essentials of oral pathology and oral Medicine. 7ªed. Churchill Livingstone, 2002.
·Ceballos Salobreña A, Bullón Fernández P, Gándara Rey JM, Chimenos Kustner E, Blanco Carrión A, Martínez Sauquillo A, García García A. Medicina Bucal Práctica. Santiago de Compostela: Editorial Danú, 2000.
·Ceballos A. Medicina Bucal. Granada: Ed. Gráficas Anel, 1993.
·Chimenos E. La Historía clínica en odontología. Barcelona: Masson, 1999.
·Regezi JA, Sciubba JJ. Patología Bucal: Correlaciones clinicopatológicas. 3ª ed. México: Ed. Interamericana McGraw-Hill, 2000.
· Saap JP, Eversole LR, Wysocki GP. Patología Oral y Maxilofacial Contemporánea. 2ª ed. Madrid: Mosby, 2005.
· Wood NK, Goaz PW. Diagnóstico diferencial de las lesiones orales y maxilofaciales. 5ª ed. Madrid: Harcourt Brace, 1998.

E-books available through ClinicalKey*Student
· Abbas, Abul K., MBBS; Lichtman, Andrew H., MD, PhD; Pillai, Shiv, MBBS Inmunología celular y molecular. Novena Edición, PhD.Copyright © 2018 Elsevier España, S.L.U.
Prieto Valtueña, Jesús M.; Yuste Ara, José R. Balcells. La clínica y el laboratorio 23.a edición. Copyright ©2019 Elsevier España, S.L.U.
Swartz, Mark H., md, facp. Tratado de semiología. Séptima edición.Copyright © 2015 Elsevier España, S.L.U.
Montuenga Badía, Luis; Esteban Ruiz, Francisco J.; Calvo González, Alfonso .Técnicas en histología y biología celular. 2.ª edición.Copyright © 2014 Elsevier España, S.L.
Murray, Patrick R., PhD; Rosenthal, Ken S., PhD; Pfaller, Michael A., D.Microbiología médica.8.ª Edición.Copyright © 2017 Elsevier España, S.L.U

Especific Bibliography
Material provided by teachers thorough the virtual classroom

The subject contributes to the acquisition of the following learning outcomes

Knowledge:
Con34.-Perform basic treatments of oral and dental pathology in patients of all ages. Therapeutic procedures should be based on the concept of minimal invasion and a comprehensive and integrated approach to oral treatment.
Con36.-To take and interpret X-rays and other image-based procedures relevant to dental practice.
Con37.-Make diagnostic models, assemble them and take inter-occlusal records.
Con38.-To determine and identify the aesthetic requirements of the patient and the possibilities of satisfying their concerns.
con39.-Identify the patient who requires special care, recognizing his or her characteristics and peculiarities.
Con40.-Assess the motor and sensory function of the mouth, jaws and adnexa.
Con41.-Perform limited procedures of invasive diagnostic techniques in soft tissues (biopsies).
Appropriate prescription of drugs, knowing their contraindications, interactions, systemic effects and repercussions on other organs.
Con43.-Apply loco-regional anesthesia techniques.
Con44.-Prepare and isolate the operating field.
Con45.-Identify, assess and attend to emergencies and medical emergencies that may arise during clinical practice and apply cardio-pulmonary resuscitation techniques.
Con46.-Manage acute infections, including pharmacological prescription and simple surgical aspects.
Con47.- Identify and attend to any dental emergency.
Con48.-Perform both medical and surgical treatment of common diseases of the oral soft tissues.
Con49.-Perform simple surgical procedures: extraction of erupted temporary and permanent teeth, fractured or retained roots, and uncomplicated surgical extraction of unerupted teeth and simple pre-prosthetic surgery procedures.
Con50.-Treat dento-alveolar trauma in temporary and permanent dentitions.
Con51.-Treat both pharmacologically and surgically the inflammatory processes of the periodontal and/or peri-implant tissues, including supra and subgingival periodontal instrumentation techniques.
Con52.-Assess and treat the patient with caries or other non-carious dental pathology and be able to use all materials aimed at restoring the shape, function and aesthetics of the tooth in patients of all ages.
Con53.-Design, prepare teeth, prescribe, register, perform clinical tests and place and put into service indirect restorations: inlays, veneers or aesthetic laminated fronts and single crowns.
Con54.-Operationally treat destructive processes and traumatic dento-alveolar injuries.
Con55.-Perform endodontic treatments and apply procedures to preserve pulp vitality.
Con56.-Perform conventional aesthetic procedures from a multidisciplinary perspective.
Con57.-Treat both partial and total edentulism, including biological design (specific design characteristics), dental preparation, obtaining records, clinical tests and adaptation to patients of partial and complete removable prostheses, simple dento-supported bridges and simple prostheses on implants, both removable and fixed, including their "placement" and "commissioning".
Con58.-Prepare the prescriptions for custom-made medical devices "dental prostheses" and "orthodontic appliances and dentofacial orthopaedics".
Con59.-Perform non-surgical treatment of temporomandibular disorders and orofacial pain.

Competences:
Comp01.-Ability to analyse and synthesize.
Comp03.-Oral and written communication in one's own language.
Comp05.-Basic computer handling skills.
Comp07.-Problem solving.
Comp10.-Teamwork.
Comp11.-Interpersonal skills.
Comp17.-Ability to apply knowledge in practice.
Comp19.-Autonomous learning capacity
Comp21.-Ability to generate new ideas (creativity).
Comp24.-Ability to work autonomously.

Skills or abilities:
H/D01.-Know the essential elements of the dental profession, including ethical principles and legal responsibilities
H/D02.-Understand the importance of such principles for the benefit of the patient, society and the profession, with special attention to professional secrecy.
H/D03.-Know how to identify the patient's concerns and expectations, as well as communicate effectively and clearly, both orally and in writing, with patients, family members, the media and other professionals.
H/D04.-Understand and recognize the social and psychological aspects relevant to the treatment of patients.
H/D05.- Know how to apply the principles of anxiety and stress control to oneself, to patients and to other members of the dental team.
H/D06.-Understand the importance of developing a professional practice with respect for the patient's autonomy, beliefs and culture.
H/D07.-Promote the autonomous learning of new knowledge and techniques, as well as the motivation for quality.
H/D08.-Know how to share information with other health professionals and work in a team.
H/D09.-Understand the importance of maintaining and using records with patient information for subsequent analysis, preserving the confidentiality of the data.
H/D10.-Know and identify the psychological and physical problems derived from gender violence in order to train students in the prevention, early detection, assistance, and rehabilitation of victims of this form of violence.
H/D11.-Understand the basic biomedical sciences on which Dentistry is based to ensure correct oral and dental care.
H/D12.-Understand and recognize the normal structure and function of the stomatognathic system, at the molecular, cellular, tissue and organic levels, in the different stages of life.
H/D13.- Understand and recognize the sciences of biomaterials essential for dental practice as well as the immediate management of possible allergies to them.
H/D14.-Know about the general processes of the disease, including infection, inflammation, alterations of the immune system, degeneration, neoplasia, metabolic alterations and genetic disorders.
H/D15.- Be familiar with the general pathological characteristics of diseases and disorders that affect the organ systems, specifically those that have oral repercussions.
H/D16.- Understand the fundamentals of action, indications and efficacy of drugs and other therapeutic interventions, knowing their contraindications, interactions, systemic effects and interactions on other organs, based on the available scientific evidence.
H/D17.-Understand and recognize the principles of ergonomics and safety at work (including cross-infection control, radiation protection, and occupational and biological diseases).
H/D18.-Know, critically evaluate and know how to use sources of clinical and biomedical information to obtain, organize, interpret and communicate scientific and health information.
H/D19.-Know the scientific method and have critical capacity to evaluate established knowledge and new information. Be able to formulate hypotheses, collect and critically evaluate information for problem solving, following the scientific method.
H/D20.-Obtain and prepare a medical history containing all relevant information.
H/D21.-Know how to perform a complete oral examination, including the appropriate radiographic and complementary examination tests, as well as obtaining adequate clinical references.
H/D22.-Have the ability to make an initial diagnostic judgment and establish a reasoned diagnostic strategy, being competent in the recognition of situations that require urgent dental care.
H/D23.-Establish the diagnosis, prognosis and adequate therapeutic planning in all clinical areas of Dentistry, being competent in the diagnosis, prognosis and elaboration of the dental treatment plan of the patient who requires special care, including medically compromised patients (such as diabetics, hypertensive, immunosuppressed, anticoagulated, among others) and patients w ith disabilities.
H/D24.-Recognize life-threatening situations and know how to perform basic life support maneuvers.
H/D25.-Know and apply the basic treatment of the most common oral and dental pathology in patients of all ages. Therapeutic procedures should be based on the concept of minimal invasion and a comprehensive and integrated approach to oral treatment.
H/D26.- Know how to plan and carry out multidisciplinary, sequential and integrated dental treatments of limited complexity in patients of all ages and conditions and patients who require special care.
H/D27.-Propose and propose the appropriate preventive measures for each clinical situation.
H/D28.-Acquire clinical experience under appropriate supervision.
H/D29.-Recognize the determinants of oral health in the population, both genetic and lifestyle-dependent, demographic, environmental, social, economic, psychological, and cultural.
H/D30.-Recognize the role of the dentist in actions for the prevention and protection of oral diseases, as well as in the maintenance and promotion of health, both at the individual and community level.
H/D31.-Know the National Health System, as well as the basic aspects of health legislation, clinical management and appropriate use of health resources, understanding the importance of the role of the dentist in the field of Primary Health Care.

The theoretical part will be carried out through expository classes by the teachers of the subject and part of the material used will be provided through the virtual classroom as well as a self-assessment test for each topic.

Autonomous learning is encouraged by the performance of a project on a course topic that will be selected on the first day of class and that the student must present in PDF format and orally in front of their classmates.

Through the learning and service methodology, we will work on the contents of the subject related to potentially malignant alterations.

In clinical and laboratory practices, the knowledge acquired will be applied in a practical way.

We will use the virtual classroom to hold a forum for the discussion of clinical cases that allow the learning to be applied in daily practice.

In the tutorials, the teacher will personally attend to the students to guide them and resolve any doubts that may arise. And to lead and guide the work that has to be done to pass the subject. They will be held in person.

A continuous evaluation of the students will be carried out for their participation and attitude throughout the development of the theoretical and practical classes (20%) and participation in the APS project (5%)

Theoretical exam (60% of the total grade): test exams (PEM) will be carried out throughout the course using the virtual classroom at the end of each topic (50%) and a final exam (50%) also test (PEM).

The work presented (15%) will be evaluated using rubrics by both the teacher and the classmates.

And it is essential to meet certain requirements to pass the discipline (only those students who meet them will be positively evaluated)
-Completion of the virtual classroom evaluation tests
-Present the work that was assigned.

Class work
Expository class 20
Clinical practice 8
Laboratory practices and seminars 13
Tutorials 2
Test 2

Personal work: development work, individual study, recommended reading assistance activities recommended: 30

All students are recommended to study the subject daily. This will allow maximum performance when participating in lectures and practical classes.

For cases of fraudulent conduct of exercises or tests, the regulation for assessing students academic performance and reviewing qualifications will be applied.