Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology | 2021
AVOIDING ARTIFACTS IN TISSUE SPECIMENS OF ORAL MUCOSA—IMPROVED BIOPSY METHOD
Abstract
Background Microscopic analysis is accepted as a gold standard to diagnose lesions of oral mucosa. Any technical error may result in histopathologic misidentification of the lesion. The most frequent problems can be associated with different artificial changes. Objective To develop an optimal method of incisional biopsy of the oral mucosa for prevention of artificial changes caused by forceps and dimensional deformation of material in fixative solution. Methods Technique of biopsy: the needle of an insulin syringe with an anesthetic is injected under the healthy mucosa at a distance of 5 mm to the lesion, and depth of injection is 2 to 3 mm. Infiltrative anesthesia is performed. The needle moves under the mucous membrane of the lesion for 5 mm, raising this area. Around the needle 2 semi-ovoid converging sections are made with a scalpel, and the biopsy specimen is in the shape of an ellipse. The excised part of tissue retained on the needle is transferred to a strip of filter paper. The specimen is wrapped, folded, and bound with suture nodes to hold the biopsy in the straightened position. The material is immersed in a container with formalin. Standard postoperative instructions should be provided to the patient. Results Forty-four biopsies (88.0%) were strong, correctly oriented, and informative for morphological investigation. Conclusions The presented modification for an incisional biopsy provides strong specimens, correct orientation during embedding, and exclusion of the use of forceps during biopsy.