Lesson 1Laboratory tests to request: CBC, inflammatory markers (CRP, ESR), blood glucose, liver function tests, and relevant infectious serology (TB screening when indicated)This section outlines key laboratory tests in stomatology workup, including CBC, inflammatory markers, glucose, liver function, and TB serology relevant to Botswana, explaining indications and interpretation.
CBC for anemia, infection, and bleeding riskCRP and ESR in acute and chronic inflammationBlood glucose and perioperative riskLiver function tests and drug metabolismTargeted serology and TB screening indicationsLesson 2Special stains and laboratory pathology requests: immunohistochemistry panels (p16, cytokeratins), microbial cultures, fungal stains, molecular testing where indicatedThis section covers special pathology requests that refine diagnosis, including immunohistochemistry, microbial studies, and molecular tests, with guidance on availability and influence on prognosis locally.
Selecting appropriate immunohistochemistry panelsMicrobial and fungal cultures from oral lesionsPAS, GMS, and other special histologic stainsMolecular tests for HPV and driver mutationsCommunicating clinical questions to pathologyLesson 3Ultrasound for superficial soft-tissue and lymph node assessment: technique and limitationsThis section reviews ultrasound use for superficial oral and cervical structures, describing scanning technique, lymph node characterization, and limitations like operator dependence in clinic settings.
Ultrasound equipment and probe selectionTechnique for cervical lymph node scanningSonographic criteria of malignant nodesUse of Doppler in vascular assessmentLimitations and indications for further imagingLesson 4Advanced imaging: when to order contrast-enhanced CT of the mandible, cone-beam CT (CBCT) vs medical CT, and MRI for soft-tissue extent and perineural spreadThis section explains selection of advanced imaging for jaw disease, comparing CBCT with medical CT, indications for contrast-enhanced CT, and MRI roles accessible in Botswana referral centres.
Indications for contrast‑enhanced mandibular CTCBCT vs medical CT: strengths and limitationsMRI protocols for soft‑tissue and marrow diseaseImaging signs of perineural tumor spreadRadiation dose, safety, and consent issuesLesson 5Fine-needle aspiration (FNA) and core biopsy of suspicious intraoral or cervical lymph nodes: technique and diagnostic yieldThis section details fine-needle aspiration and core biopsy of suspicious lymph nodes, covering indications, technique, complication avoidance, and integration of results into workup.
Indications for FNA vs core biopsyNeedle selection and guidance methodsStepwise FNA technique and smear preparationComplications and how to prevent themInterpreting cytology and adequacy reportsLesson 6Interpreting pathology reports: grades, margins, perineural/lymphovascular invasion, and implications for stagingThis section explains how to read oral pathology reports, clarifying terminology for grades, margins, invasion, and translating findings into staging and management decisions.
Tumor type, grade, and differentiationMargin status and clinical significancePerineural and lymphovascular invasionNodal involvement and extranodal extensionCorrelating pathology with TNM stagingLesson 7Stepwise clinical investigations: complete oral exam checklist, vital signs, focused neurological exam, dental status evaluationThis section structures complete clinical evaluation in stomatology, covering systematic examinations, vital signs, neurologic screening, and dental assessment to prioritize tests.
Pre‑visit history and red‑flag symptom screeningRecording vital signs and systemic risk assessmentStructured extraoral and cranial nerve screeningSystematic intraoral soft‑tissue inspectionDental charting, occlusion, and periodontal statusLesson 8Biopsy planning: incisional vs excisional biopsy—selection criteria for a 1.5 cm tongue lesionThis section guides biopsy planning for a 1.5 cm tongue lesion, comparing incisional and excisional approaches, considering lesion features and oncologic principles.
Clinical assessment of a 1.5 cm tongue lesionCriteria favoring incisional biopsyCriteria favoring excisional biopsyAvoiding distortion of future resection marginsPatient counseling and consent pointsLesson 9Biopsy technique for lateral tongue: surgical approach, margin selection, hemostasis, specimen handling, orientation, and submission for histopathologyThis section details lateral tongue biopsy technique, including assessment, incision planning, margin selection, anesthesia, hemostasis, and proper specimen handling for histopathology.
Pre‑biopsy assessment and contraindicationsAnesthesia, traction, and field exposureIncision design and margin selectionHemostasis, suturing, and postoperative careSpecimen orientation, labeling, and transportLesson 10Indications and timing for PET-CT or CT chest in suspected malignancy for staging and metastasis screeningThis section reviews when to request PET-CT or CT chest in suspected oral malignancy, emphasizing staging, metastasis detection, and timing relative to biopsy in available facilities.
Oncologic indications for PET‑CT referralRole of CT chest in metastasis screeningOptimal timing within staging workflowCommon pitfalls and false‑positive findingsImpact on TNM staging and treatment plansLesson 11Plain radiography: indications and interpretation of panoramic radiograph (OPG) for jaw pathologyThis section focuses on panoramic radiography for jaw assessment, reviewing indications, positioning, normal anatomy, pathology interpretation, and need for further imaging.
Indications for ordering an OPGPatient positioning and artifact avoidanceRecognizing normal panoramic anatomyRadiographic features of common jaw lesionsLimitations of OPG and need for CT or CBCT
