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perio > diagnosis of periodontitis > Flashcards

diagnosis of periodontitis Flashcards

1
Q

what is included in the visual inspection for periodontal disease

A

Probe deapth
Bleeding on probing
Clinical attachment level
gingival inflammation(red and swelling)

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2
Q

what lab tests are done for periodontal disease

A

Biochem
Microbio
X-rays genetic

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3
Q

what are the non-invasive tooths for periodontal disease

A

NIR
OCT
ultrasound

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4
Q

what are the non-invasive tools for perio disease used for

A

More for reaserch

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5
Q

what does diagonisis of perio disease depend on

A 
Clinical manifestations
(periodontal examination and radiographs)
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6
Q

what tets are done in a perio exam

A 
checking for signs of inlfmmation
Plaque index
Gingival index
Perio probe(PD, BOP, Clinical attachment level)
Tooth mobility
Furcation involvement
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7
Q

what do we use X-rays for when diagnosing perio disease

A

Look at bone loss

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8
Q

what are the molecular methods for periodontal exams

A

host and genetic markers (saliva, and GCF)
- main focus
Micobial testing (plaque and saliva)

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9
Q

what are the types of micrbio testing

A 
Bacterial culturing
Direct Microscopy
Immunodiagnostic methods
Enzymatic methods
Molecular biology techniques
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10
Q

where do we get Biochemical analysis solution from for perio disease

A

GCF
Saliva
Serum (blood)

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11
Q

how does genetics affect periodontal disease

A

usually a genetic susceptibility to perio disease

- gene polymorphism as a risk factor

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12
Q

what does probe deapth depend on

A 
Gignival inflammation
insertion force
Placement and angulation
Size
Probing tech
Probe caliration
Presence of subgingival calculus- hard to penetrate
Overhanging restorations
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13
Q

problem with using probing for perio disease

A

Lack of sensitivity and reproducability

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14
Q

what is the problem with using clinical attachment level to diagnose perio disease

A

Poor reliability and reproducibility

Limited practical value

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15
Q

problem with radiograph for diagnosing perio disease

A

Limited sensitivity in small bone change

no value in evaluating disease activity or progression

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16
Q

what change in bone needs to occur for Radiograph to know

A

30%-50% of demineralization

-subtraction radiography is 5% change

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17
Q

problem with Subtractive radiography

A

technique sensitive

18
Q

how does an ultrasonic perio probe work

A

hollow taper tip filled with water for coupling ultrasonic beam to tissues

19
Q

are conventional radiographs specific and sensitive

A

Specific

not sensitive

20
Q

what is Cone Beam Computed Tomography used for

A

detection of periodontal disease in in vivio settings

  • intrabony defects
  • dehiscence and fenestration defects
  • periodontal cysts
  • furcation defects
  • thickness of palatal masticatory mucosa
21
Q

what is the gold standard of microbiologic testing

A

Bacterial culturinging

22
Q

what can antibiotics and bacterial culturing show

A

assess the antibiotic susceptibility of microbes

23
Q

what can be grown in bacterial culturing

A

only grow live bacteria

- w/ strict sampling and transport conditions

24
Q

what is hard to culture

A

Putative pathogens that are fastidious(need correct media)

25
Q

what is the sensitivity of bacterial culturing

A

Low

- detection limits for selective and nonselective media are 10^4 and 10^5

26
Q

what are the logistical concerns for bacterial culuting

A

Need sophisticated equipment and experienced personnel

- time consuming and expensive

27
Q

what microscopy is used to do microbiologic testing

A

Dark field

phase contract

28
Q

what does micrscopy look at in direct micrscopy to check for perio pathogens

A

Morphology and motility of bacteria in a plaque sample

29
Q

what makes identifying the main putative perio pathogens difficult with a microscope

A

most are non-motile

30
Q

how does immunodiagnostic test for perio pathogens

A

Uses Ab that target specific bacterial Ag

31
Q

what does Immunodiagnostic methods identify the most

A

identify pathogens using a plaque smear

-Aa and Pg

32
Q

how does immunodiagnostic methods prevail over bacterial culutres

A

Does not require viable bacterial cells

33
Q

what keeps people from doing Cytofluorography(flow cytometry)

A

Complexity and cost prevent

34
Q

what is Enzyme-linked immunosorbent assay(ELISA) used for

A

to detect serum antibodies to periodontal pathogens

35
Q

what is Membrane Immunoassay

A

ezyme linked immunosorbent assay for chairside use to detect Aa, Pg, and Pi

36
Q

how does Latex agglutination work

A

Binding of protein to latex beads that are coated with species specific antibody

37
Q

where is latex agglutination done

A

currently for research purpose

38
Q

how do enzymatic methods test for perio pathogens

A

Pg, Tf, Aa all have trypsin-lik enzyme

- if degradation of BANA is found, then these pathogens are present

39
Q

where can enzymatic methods be used

A

chair side

40
Q

problem with enzymatic methods

A

cannot distringuish between individual bacteria
Positive in healthy sites
negative does not rule out presence of other perio pathogens

41
Q

what are the nuclei acid probes we use

A

Synth and labeled DNA (20-30 nucleotides)
genomic DNA probe (whole strand)
16s rRNA oligonucleotide probes

42
Q

senstivity of genomic DNA probe compared to Synth and labeled DNA strands

A

genomic DNA is less sensitive and specific due to cross reactivity to non-target microorganisms

perio (8 decks)

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