diagnosis of periodontitis Flashcards
what is included in the visual inspection for periodontal disease
Probe deapth
Bleeding on probing
Clinical attachment level
gingival inflammation(red and swelling)
what lab tests are done for periodontal disease
Biochem
Microbio
X-rays genetic
what are the non-invasive tooths for periodontal disease
NIR
OCT
ultrasound
what are the non-invasive tools for perio disease used for
More for reaserch
what does diagonisis of perio disease depend on
Clinical manifestations (periodontal examination and radiographs)
what tets are done in a perio exam
checking for signs of inlfmmation Plaque index Gingival index Perio probe(PD, BOP, Clinical attachment level) Tooth mobility Furcation involvement
what do we use X-rays for when diagnosing perio disease
Look at bone loss
what are the molecular methods for periodontal exams
host and genetic markers (saliva, and GCF)
- main focus
Micobial testing (plaque and saliva)
what are the types of micrbio testing
Bacterial culturing Direct Microscopy Immunodiagnostic methods Enzymatic methods Molecular biology techniques
where do we get Biochemical analysis solution from for perio disease
GCF
Saliva
Serum (blood)
how does genetics affect periodontal disease
usually a genetic susceptibility to perio disease
- gene polymorphism as a risk factor
what does probe deapth depend on
Gignival inflammation insertion force Placement and angulation Size Probing tech Probe caliration Presence of subgingival calculus- hard to penetrate Overhanging restorations
problem with using probing for perio disease
Lack of sensitivity and reproducability
what is the problem with using clinical attachment level to diagnose perio disease
Poor reliability and reproducibility
Limited practical value
problem with radiograph for diagnosing perio disease
Limited sensitivity in small bone change
no value in evaluating disease activity or progression
what change in bone needs to occur for Radiograph to know
30%-50% of demineralization
-subtraction radiography is 5% change
problem with Subtractive radiography
technique sensitive
how does an ultrasonic perio probe work
hollow taper tip filled with water for coupling ultrasonic beam to tissues
are conventional radiographs specific and sensitive
Specific
not sensitive
what is Cone Beam Computed Tomography used for
detection of periodontal disease in in vivio settings
- intrabony defects
- dehiscence and fenestration defects
- periodontal cysts
- furcation defects
- thickness of palatal masticatory mucosa
what is the gold standard of microbiologic testing
Bacterial culturinging
what can antibiotics and bacterial culturing show
assess the antibiotic susceptibility of microbes
what can be grown in bacterial culturing
only grow live bacteria
- w/ strict sampling and transport conditions
what is hard to culture
Putative pathogens that are fastidious(need correct media)
what is the sensitivity of bacterial culturing
Low
- detection limits for selective and nonselective media are 10^4 and 10^5
what are the logistical concerns for bacterial culuting
Need sophisticated equipment and experienced personnel
- time consuming and expensive
what microscopy is used to do microbiologic testing
Dark field
phase contract
what does micrscopy look at in direct micrscopy to check for perio pathogens
Morphology and motility of bacteria in a plaque sample
what makes identifying the main putative perio pathogens difficult with a microscope
most are non-motile
how does immunodiagnostic test for perio pathogens
Uses Ab that target specific bacterial Ag
what does Immunodiagnostic methods identify the most
identify pathogens using a plaque smear
-Aa and Pg
how does immunodiagnostic methods prevail over bacterial culutres
Does not require viable bacterial cells
what keeps people from doing Cytofluorography(flow cytometry)
Complexity and cost prevent
what is Enzyme-linked immunosorbent assay(ELISA) used for
to detect serum antibodies to periodontal pathogens
what is Membrane Immunoassay
ezyme linked immunosorbent assay for chairside use to detect Aa, Pg, and Pi
how does Latex agglutination work
Binding of protein to latex beads that are coated with species specific antibody
where is latex agglutination done
currently for research purpose
how do enzymatic methods test for perio pathogens
Pg, Tf, Aa all have trypsin-lik enzyme
- if degradation of BANA is found, then these pathogens are present
where can enzymatic methods be used
chair side
problem with enzymatic methods
cannot distringuish between individual bacteria
Positive in healthy sites
negative does not rule out presence of other perio pathogens
what are the nuclei acid probes we use
Synth and labeled DNA (20-30 nucleotides)
genomic DNA probe (whole strand)
16s rRNA oligonucleotide probes
senstivity of genomic DNA probe compared to Synth and labeled DNA strands
genomic DNA is less sensitive and specific due to cross reactivity to non-target microorganisms
