Advances in Detecting And Monitoring periodontal disease Flashcards
How to recognize severity ?
visual inspection
probing depths
CAL
Radiographs
For intital determination of need for periodontal therapy
Describe the characteristics of diagnostic methods
- Adjunctive or combined with clinical examination
- Help to identify periodontal isease activity
- Help to identify patients at risk for an episode of active disease.
- Help determine appropriate mode of treatment
- Evaluate disease progression or risk of future periodontal breakdown.
State the 3 groups of adjunctive tests
Gingival Crevicular Fluid assays
Microbial tests
Genetic assays
State the characteristics of gingival crevicular fluid assays
- originates from connective tissue (lamina Propria)
- Flows into gingival crevice
- Formed by fluid leak from dilated blood vessels
- Fluid collects tissue breakdown products, enzymes etc associated with immune response
- Inflammatory soup: subgingival plaque biofilm, inflammatory cells, enzymes, PGE2 and inflammatory mediators.
- This is a source of potential markers for periodontal disease
What makes up the oral epithelium?
Top: Parakeratinized epithelium
Second top: Startum spinosum
Third: Stratum germinativum/basale layer
Rete. pegs
bottom: Lamina propria
State how GCF is collected
Placing paper strips into selected pockets
Discuss GCF assays use host-derived enzymes and PGE
Assoicated with increased risk of clinical attachment loss and bone loss
Markers for periodontitis
Most evident 6 months before disease occurrence
What are the different types of GCF host derived enzymes?
Aspartate aminotransferase (AST)
B- glucronidase
Elastase
Collagenase
Prostaglandin E2
What does the b glucuronidase and elastase do?
Predict clincial attachment loss and bone loss
What does the aspartate aminotransferease do?
- intracellular enzyme ( present extracellularly= cell death)
- Predict CAL ( 3 months in advance)
- Detectable sooner than b glucuronidase and Elastase
- No test avalible commerically
What does the collagenase do?
- Normal collagen remodeling through breakdown
- Excessive amounts= tissue destruction
- Produced by collagen and fibroblasts
- No test available commercially
Give the characteristics of host-derived enzymes and PGE
- Associated with bone loss
- PGE2 levels significantlyu higher in patients with CAL > 3mm than patients without level of CAL
- High levels indicate increased risk of periodontal disease 6 months prior to appearance
- No test avalible commerically in US
State the use of microbial tests and the four types
- Bacterial plaque biofilm
- Identification allows for faster and better treatment
aimed at eliminating or reducing bacterial levels
Types:
* Microbiologic culturing analysis
Microscopic techniques
Nucleic Acid Probe analysis
Immunological assays / methods
Give the characteristics of the four types of microbial tests
Microbiologic culturing- Allows for growth of certain micoorganisms. Determines the lack of respond from conventional therapy, and type of antibitoic therapy.
Oral DNA- Alert2: oral pathogens that cause gum disease (MyPerioPath)
with inherited genetic risk (MyPerioID)
Microscopic Techniques- phase-contrast microscopy
Categories bacteria by mobility (motile), Dark-field microscopy
Identifies bacteria by morphology or shape (cocci, rods)
Used for Patient education
Nucleic Acid Probe Analysis- identifies DNA sequence specific for certain subgingival periodontal pathogens
State the collection of culturing, microscopic, and nucleic acid probe analysis
State the use of genetic assays
Discuss the use of GCF, microbial tests, and genetic assays with the detection and monitoring of periodontal disease
What are the differnet types of periodontal pathogens associated with disease?
AA
Porphyromonas gingivalis
Treponema denticola
Tannerella forsythia
