**3.2 Oral exfoliative cytology**

*Oral and Maxillofacial Surgery*

too hard to cut.

formalin solution.

biopsy specimen [3].

dure in the treatment of the patient.

*3.1.1 Precautions during transport: freezing*

*3.1.2 Adjunct techniques: electrocautery*

the fixative, bottles and the like.

unable to render diagnosis."

c.The biopsy specimen must not dry out on the bracket table while one is finding

d.Everything should be ready in advance so that the tissues can be properly fixed and a diagnosis can be rendered and to avoid the statement "improper fixation,

e.The biopsy specimen should never be submitted in normal saline or water, as

f. In an emergency, when 10% formalin cannot be obtained, 70% alcohol may be used. Alcohol causes hardening of the specimen to the degree that cutting may be difficult, so on the biopsy request form it should be noted that the specimen is submitted in alcohol. The histology technician can then transfer the specimen to 10% formalin, hopefully before 48 h, so that the tissue will not become

g.Preserving the specimen. The specimen—a tooth, piece of bone, or soft tissue—is at once placed in a bottle containing a fixing solution, such as 10% formalin, Zenker's solution, or Carnoy's solution. Most pathologists prefer 10%

other laboratory tests, as this will facilitate diagnosis in difficult cases.

i. A consultation between the pathologist and the dentist will be particularly helpful and will also give the opportunity for discussing the method of proce-

j. It is also very important that the completed history form be sent with the

During winter months in climates where the temperature drops to freezing or below, there is a danger that the biopsy specimens dropped in a mailbox may freeze. The freezing of the tissue forms ice crystals within the cells. These crystals disrupt cell membranes and cause great distortion and introduction of artifacts into the specimen. Thus interpretation of the tissue specimen becomes very tenuous.

Before mailing biopsy specimens during cold weather, one must make sure that they are fixed in 10% formalin at room temperature for at least 2 h before mailing.

Biopsy specimens can display tissue changes that might interfere with the accurate diagnosis by the use of electrocautery. The frying action of the electric current

In the case of a biopsy of an oral mucosa lesion, an eosinophilic homogenization of the fibrous tissue can be seen histologically. Thus, it is especially important not to use electrocautery for excision of small lesions. It is preferable to use a surgical scalpel to remove the biopsy specimen followed by the use of electrocautery to

generating high temperatures in the tissues results in changes.

h.It should be promptly sent to a pathologist for examination. The latter should be given all the information gained by clinical study and X-ray examination, or

the tissues become completely degenerated by autolysis.

**48**

control bleeding [3].

Oral exfoliative cytology was developed as a potential diagnostic tool for early detection of malignant lesion. It is relatively simple, easy to master and least invasive and has high patient acceptance [1]. Though it has been always used as an adjunct to oral biopsy in oral cancer diagnostics, it holds potential in diagnosis of oral dermatosis and certain microbial infections. The specimen obtained can be used for cytomorphometry, DNA cytometry and immunocytochemical studies [1].
