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
