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Policy on Excised Tissue
Policy:
All tissue removed from the oral and maxillofacial
region should be submitted to a pathology laboratory for examination.
Histopathologic examination of such tissues should be performed by an oral
and maxillofacial pathologist. Tissues possibly exempt from the
requirement of submission to a laboratory include:
- extracted teeth lacking attached soft
tissue;
- extirpated dental pulp tissue;
- clinically normal tissue;
- excess donor tissue resulting from
grafting procedures.
Gross description of all removed tissues should be
entered into the patient’s dental/medical record by the attending
dentist/physician.
The pathology laboratory must prepare and transmit to
the attending doctor a written report of the diagnosis. The diagnosis
should be discussed with the patient by the attending doctor in a timely
manner, and the report should be filed with the patient’s dental/medical
record.
Rationale:
Submission of removed tissues to a pathology laboratory
offers the opportunity to:
- establish a definitive diagnosis;
- confirm a provisional clinical
diagnosis;
- provide additional information in
instances where there is no clinically evident cause for a lesion,
or when there is no resolution after appropriate, conservative
treatment;
- establish the adequacy of surgical
margins;
- provide diagnostic information to the
clinician for management of disease.
Knowledge gained through histopathologic examination is
useful in estimating clinical behavior and prognosis of disease, and in
assessing the need for any additional therapy and follow-up evaluation.
Submission of removed tissues to a pathology laboratory for diagnostic
examination constitutes a generally accepted standard of patient care.
Documentation of tissue examination and diagnosis enhances the validity of
patient management decisions, increases the likelihood of positive
clinical outcomes, and substantiates the patient record in the medicolegal
context.
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