Chapter 1
Establishing a Differential Diagnosis for Periodontal Manifestations of Systemic Diseases
Aim
This chapter aims to provide the reader with a step-by-step guide to history-taking, examination and further investigation of non-plaque-induced lesions that arise withithe periodontal tissues, including the free and/or attached gingiva and associated oral mucosa, to help establish a differential diagnosis.
Outcome
Having read this chapter the reader should appreciate the need for a forensic and systematic approach to establish differential diagnoses for oral and medical conditions that manifest within the periodontal and associated tissues.
Terminology
A variety of clinical, procedural and pathological terms and descriptors are used throughout this chapter, and Table 1-1 defines these by category.
Table 1-1
Terminology Used in Periodontal and Oral Medicine/Pathology| Context | Terminology | Definition |
| Clinical presentation or procedure | Symptom | Something the patient is experiencing or complaining of as a consequence of their condition. |
| Sign | Something the clinician detects (visual, tactile or olfactory) that may help inform the diagnosis. |
| Biopsy | Acquisition of human cells or tissues to aid diagnosis. |
| Incisional biopsy | A biopsy involving partial removal of the lesion. This may be performed when malignancy is suspected and complete excision of the lesion would result in loss of key surgical landmarks. |
| Excisional biopsy | A biopsy involving complete removal of the lesion. |
