Phillip Worthington Lectureship
Morning Topic: Clinical Applications of Advanced Dental Imaging
Afternoon Topic: Fascinomas, Look Alikes, Oral Manifestations of Systemic Diseases, and Lesions that Change over Time: How Histopathology Can Aid Clinicians in Resolving Clinical Dilemmas
David Hatcher, DDS, MSc, MRCD and Dolphine Oda, BDS, MS
TUITION – price includes lunch:
CREDITS: 7 hours
* This course is eligible for a 10% tuition discount if you are a current member of the UW Dental Alumni Association.
Morning Topic: Clinical Applications of Advanced Dental Imaging
The daily dental practice encounters many diagnostic dilemmas that can benefit from appropriate imaging. This lecture will propose imaging strategies employing 3D imaging modalities to reveal the hidden anatomy of common conditions in a way that aids the clinician with diagnosis, treatment planning and treatment. The ranges of conditions that will be covered include: Implant planning, growth disturbances, jaw asymmetries, acquired changes in occlusion, incidental findings and selected lesions involving the jaws, TMJ, airway and sinuses.
Imaging and clinical goals, risks and benefits will be discussed during this presentation.
Afternoon Topic: Fascinomas, Look Alikes, Oral Manifestations of Systemic Diseases, and Lesions that Change over Time: How Histopathology can aid Clinicians in Resolving Clinical Dilemmas
Oral surgeons, periodontologists and other dental practitioners encounter a wide variety of oral pathology conditions on a daily basis. With experience, the examiner is able to diagnose some of these conditions with reasonable accuracy. Other conditions are much more difficult for even seasoned clinicians to diagnose accurately without careful light microscopic examination of biopsied material, utilizing routine staining, and yet other conditions can only be differentiated from clinical and microscopic “look alikes” by newly developed immunohistochemical and molecular techniques.
Over the past thirty years, our laboratory has amassed a treasure trove of clinical data on oral diseases affecting all tissues of the mouth, head and neck from surface epithelium to connective tissue, bone, and the salivary glands—and literally everything in between. The spectrum of oral disease encompasses infectious and reactive processes as well as benign and malignant neoplasia. Some lesions are primary to the mouth while others are oral manifestation of systemic diseases.
In this three hour course, we will review a range of conditions that present clinicians with challenging diagnostic questions. Some questions will arise because the appearance of the lesion will suggest a relatively broad differential diagnosis, and other questions will be related to the diagnoses of rare or atypical diseases. Some lesions will represent oral manifestations of systemic diseases, while still others will involve primary oral conditions that change over time. The use of histopathological techniques to arrive at accurate diagnoses in such situations will be described.
We will review the progression of oral epithelial dysplasia to squamous cell carcinoma and whether or not molecular pathology can help determine progression. We will address the often confusing concept of “lichenoid reaction”, and the question of how to determine when recurring aphthous ulcers may have their etiology in a systemic disease especially that of the GI tract. The spectrum of verrucous oral epithelial hyperplasia, verrucous carcinoma and papillary squamous cell carcinoma as part of proliferative verrucous leukoplakia will be reviewed. We will also examine some normal or benign odontogenic soft tissue changes sometimes mistaken for odontogenic myxoma, and occasional malignant neoplasms mistaken for benign entities and vice versa.
The course will provide attendees with clear and fact based fundamental principles for diagnosing oral lesions, utilizing up-to-date molecular pathology techniques and taking a look at current research which may lead to further clinical diagnostic advances.
As a result of attending the morning portion of this course, you should be able to:
- Design a case-specific 3D imaging study.
- Recognize developmental disturbance involving the TMJ and facial growth.
- Design and evaluate a radiographic study of the airway.
- Describe the risks and benefits of a 3D examination of the craniofacial region.
- Discuss the current state of implant planning.
- Generate a differential diagnosis and decision tree for selected disorders.
As a result of attending the afternoon portion of this course, you should be able to:
- Provide an up-to-date review of the progression of oral epithelial dysplasia.
- Discuss the role of HPV in oral squamous cell carcinoma.
- Provide a clear description of what a diagnosis of “lichenoid reaction” means to patient management.
- Discuss the relationship between systemic diseases and recurrent oral ulcers.
- Acknowledge that some oral conditions are very difficult to diagnose, even with the most advanced histopathologic techniques, and provide some useful approaches to such cases.
- Provide differential diagnoses for each condition discussed, together with a discussion of tools for arriving at the correct diagnosis.
- Recognize that at times normal or benign odontogenic tissue can be misdiagnosed as an aggressive neoplasm, and vice versa.
DAVID HATCHER has a private Oral and Maxillofacial Radiology practice, Interpretation Service and is a Clinical Professor in Orofacial Sciences at the School of Dentistry, University of California San Francisco. The Oral Radiology private practice entails the use of imaging technology and clinical decision strategies to solve clinical problems for the dental community.
Dr. Hatcher’s research interest include the broad areas of maxillofacial growth and development, airway, temporomandibular disorders and imaging technology. Dr. Hatcher has over 50 articles and 25 book chapters that have been published on a variety of imaging topics.
DOLPHINE ODA is a Professor of Oral Pathology in the Department of Oral and Maxillofacial Surgery. Dr. Oda is on the medical staff at University of Washington Medical Center and Harborview Medical Center. Although Dr. Oda’s main commitment is to patient care through the biopsy service in the Department of Oral and Maxillofacial Surgery, teaching is her passion. She has taught students of all ages—from elementary school kids to pathology residents—with enthusiasm and zeal. To date, she has been honored with 23 teaching awards, the latest being a highly prestigious University of Washington Distinguished Teaching Award.
Dr. Oda’s research is in the field of molecular changes in oral carcinogenesis. She has 69 papers published in refereed journals and publishes a popular monthly column called case of the month. Dr. Oda is a diplomate of the American Board of Oral and Maxillofacial Pathology and she holds Washington oral pathology and dental licenses. She is also a member of the American Academy of Oral and Maxillofacial Pathology, the International Association of Oral Pathologists, and the United States Canadian Academy of Pathology.
The University of Washington is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The University of Washington is a member of the Association for Continuing Dental Education.
University of Washington designates this activity for 7 continuing education credits.