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AU 15- Periodontology Exam 2 > Efficacy of Diagnostic Techniques for Periodontal Diseases > Flashcards

Efficacy of Diagnostic Techniques for Periodontal Diseases Flashcards

1
Q

Periodontal disease is currently diagnosed almost entirely on the basis of _______.

A

clinical manifestation

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2
Q

What are the traditionally used diagnostic procedures (2) for adults over 50 years old?

A
  1. periodontal examination

2. Radiographs

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3
Q

Clinical examination of periodontal disease include which five methods?

A
  1. signs of gingival inflammation
  2. Periodontal probing
  3. tooth mobility
  4. furcation involvement
  5. Radiographs
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4
Q

True or False: Microbiologic testing, Assessment of the host response, and genetic analysis are routine measures for evaluating periodontal disease in practice.

A

False

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5
Q

What are the 5 methods of microbiologic testing?

A
  1. Bacterial culturing (gold standard)
  2. Direct microscopy
  3. Immunodiagnostic methods
  4. Enzymatic methods
  5. Molecular biology techniques
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6
Q

What are the tissue sources that are used for assessing the host response?

A 
gingival crevicular fluid***
saliva
blood serum
blood cells
urine
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7
Q

True or False: Gene polymorphism is a risk marker for periodontitis.

A

True

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8
Q

What is the main limitation of traditional diagnostic techniques (Probe penetration, CAL, and radiographs)?

A

they lack sensitivity and reproducibility; they don’t catch all the problems

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9
Q

Periapical radiographs will identify bone change only after 30-50% has been lost. What is a more sensitive radiography method?

A

Subtraction Radiography: use subsequent, overlapping radiographs and subtract bone heights. Detection can be found as low as 5% bone loss

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10
Q

Ultrasonic Periodontal Probing is “non-invasive.” Describe how it works.

A

a hollow, tapered tip is filled with water for coupling of the ultrasonic beam into the tissues

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11
Q

What is Cone-beam Computed Tomography and how is it used in periodontology?

A

a new method of radiography that is better at detecting intrabony defects, periodontal cysts, furcation defects, and thickness of palatal masticatory mucosa

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12
Q

The sensitivity of a diagnostic test refers to the probability of the test being ______ when the disease is _______.

A

positive

present

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13
Q

The specificity of a diagnostic test refers to the probability of the test being ______ when the disease is _______.

A

negative

absent

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14
Q

What are the downsides of bacterial culturing?

A
  • low sensitivity

- can only grow particular kinds/live bacteria

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15
Q

Direct microscopy relies on which characteristic of bacteria for identification?

A

motility

Most of the main bacteria are non-motile (except spirochetes)

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16
Q

True or False: Immunodiagnostic methods do not require viable bacterial cells.

A

True

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17
Q

Which two species of bacteria are commonly detected by using immunodiagnostics?

A

A.a and P.g

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18
Q

What are the four type of immunodiagnostic methods?

A
  1. Direct or Indirect IFA (immunofluro. assay)
  2. Flow cytometry
  3. Enzyme-Linked Immunosorbent Assay (ELISA)
  4. Latex Agglutination
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19
Q

Enzymatic methods of microbiologic testing are unable to _________.

A

distinguish between individual bacteria

20
Q

Molecular biology techniques analyze _____, _____, and __________ from target microorganisms.

A

DNA, RNA, Proteins (structure and function)

21
Q

Of the molecular biology techniques, which one has high sensitivity and specificity for the identification of target pathogens?

A

PCR

22
Q

What are three important components of the GCF?

A
  1. Host-derived enzymes and their inhibitors
  2. Byproducts of tissue breakdown
  3. Inflammatory mediators and host-response modifiers
23
Q

Host derived enzymes are of what two types?

A
  1. intracellular destruction enzymes

2. extracellular destruction enzymes

24
Q

_______ destruction enzymes are possible markers of active periodontal destruction and are released from dead or dying PMNs.

A

Intracellular

25
Q

What type of host derived enzymes is associated with the activity of matrix metalloproteinases?

A

extracellular

26
Q

What type of cells will produce extracellular destruction enzymes?

A

inflammatory, epithelial, and connective tissue cells

27
Q

____ is released during tissue cell death and its concentration is markedly increased in sites of severe gingival inflammation.

A

Aspartate Aminotransferase (AST)

28
Q

Which enzyme is a membrane-bound glycoprotein involved in maintenance of alveolar bone and exists in high numbers in disease sites?

A

Alkaline Phosphatase

29
Q

______ is a lysosomal enzyme that degrades proteoglycans and ground substance and is a good indicator of future periodontal breakdown.

A

beta-glucuronidase

30
Q

Which enzyme is found in lysosomal granules of neutrophils and is associated with the chair-side PerioCheck test kit?

A

Elastase

31
Q

Aspartate Aminotransferase, Alkaline phosphatase, beta-glucaronidase, and elastase are all examples of ______ destruction enzymes.

A

intracellular

32
Q

What two cell types secrete matrix metalloproteinases?

A

Fibroblasts

Macrophages

33
Q

What is the purpose of matrix metalloproteinases?

A

remodeling and degradation of extracellular matrix components

34
Q

The ECM of the periodontium is composed of _____ (predominantly), proteoglycan, and _________ proteins (elastin, fibronectin, laminin, etc).

A

collagen

non-collagen

35
Q

GCF from sites with periodontitis contain elevated levels of _______, ________, ______, and ______.

A

hydroxyproline
glycosaminoglycans
osteocalcin
type I collagen

“GOtCH”

36
Q

What are the common inflammatory mediators (cytokines)?

A 
TNFalpha
IL-1alpha
IL-1beta
IL-6
IL-8
PGE
37
Q

Traditional immunoassays analyze for a single cytokine at a time. What is special about the Bio-Plex Cytokine Assay?

A

it uses color-coded beads to permit the simultaneous detection of up to 100 cytokines in a single well
“Bio-Plex is complex”

38
Q

What is the basis for Infrared Spectroscopy (how does it work)?

A

vibrating covalent bonds of organic molecules absorb a characteristic wavelength of IR light, so the absorption depends on the nature of the bond and this establishes a fingerprint

39
Q

What is the basis for Near Infrared Spectroscopy (NIR)?

A

measures the oxygen saturation of tissues, the wavelength 500-600nm is dominated by absorption from oxygenated and deoxygenated hemoglobin, oxygenation at perio sites is SIGNIFICANTLY LOWER

“i think about the Egyptian king Nero…NIR-O…oxygen”

40
Q

Tissue _______ reflects increased oxygen consumption that occurs with persistent inflammation.

A

hypoxia

41
Q

Why is saliva used as a means to test for periodontal disease?

A
  • abundant fluid and easy to collect/store

- highly enriched content of disease biomarkers

42
Q

In order to identify specific periodontal pathogens and concentration, which salivary diagnostic test should you use?

A

DNA PCR

43
Q

When testing saliva for genetic susceptibility to perio, which molecules would you be looking for to be over-expressed?

A

IL-1alpha and IL-1beta

44
Q

True or False: Genetic susceptibility tests will help to identify when destruction may occur.

A

False: they identify general risk factors for the development of perio but do NOT determine when destruction will occur

45
Q

What is the Salivary Occult Blood Test (SOBT)? What is the specificity and sensitivity?

A

a test that is available in Japan to test for perio status; good sensitivity but low specificity (overdiagnose)

46
Q

Future diagnostic methods for periodontal disease would probably involve salivary _______ analysis because it is cost effective for studying large populations.

A

proteome

AU 15- Periodontology Exam 2 (14 decks)

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