Final; Efficacy of Diagnostic Techniques for Periodontal Disease Flashcards
Periodontal disease is currently diagnosed almost entirely on the basis of what
its clinical manifestations; gingival inflammation, periodontal probing, tooth mobility, furcation involvement, radiographs for bone loss
What are the two traditionally used diagnostic procedures for diagnosing periodontal disease
periodontal examination and radiographs
What three tests are not routinely used in clinical practice
microbiologic testing
assessment of the host response
genetic analysis
What are some limitations of probe penetration
lack of sensitivity and reproducibility
probing depth; inflammation, technique, subgingival calculus
What are some limitations of diagnosing CAL
poor reliability and reproducibility
limited practical value
What are some limitations of radiographic examinations
limited sensitivity in small bone change; can only be identified by eye after 30% to 50% of the bone mineral has been lost
no value in evaluating disease activity or progression
What is the mechanism of ultrasonic periodontal probing
it uses a hollow tapered tip that is filled with water for coupling of the ultrasonic beam into the tissues (non-invasive)
This has been introduced for the detection of periodontal defects in in-vitro settings, especially for bony defects, periodontal cysts, furcation defects, and thickness of palatal masticatory mucosa
CBCT
This quality of a diagnostic test refers to the probability of the test being positive when the disease is truly present
sensitivity
This quality of a diagnostic test refers to the probability of the test being negative when the disease is not present
specificity
This type of microbiologic testing is the “gold standard” method which assess for antibiotic susceptibility of microbes but has low sensitivity
bacterial culturing
This type of microbiologic testing depicts the morphology and motility of bacteria in a plaque sample
direct microscopy
This type of microbiologic testing uses Abs that target specific bacterial Ag, flow cytomerty, ELISA, and latex agglutination
immunodiagnositc methods
This type of microbiologic testing identifies common tyrpsin-like enzymes that hydrolyze BANA in periodontal pathogens
enzymatic methods
This type of microbiologic testing analyzes DNA, RNA, and structure and function or proteins from target microorganisms
molecular biology techniques
What are five sources of a sample used to asses the host response
saliva GCF (most commonly used) blood serum blood cells urine
How would you collect GCF
paper strips are placed within the crevice for 30 seconds - No blood on strip
What three things can be found within the GCF
- host-derived enzymes and their inhibitors
- byproducts of tissue breakdown
- inflammatory mediators and host-response modifiers
These are possible markers of active periodontal destruction, released from dead or dying PMNs
intracellular destruction enzymes
What are four examples of intracellular destruction enzymes
- aspartate amino-transferase
- alkaline phosphatase
- beta-glucuronidase
- elastase
These are associated with the activity of matrix metalloproteinases (MMPs), produced by inflammatory, epithelial, and connective tissue cells
extracellular destruction enzymes
The ECM of the periodontium is composed of what
collagen, proteoglycans, and non-collagen proteins
Elevated levels of what three things can be found in the GCF from sites with periodontitis
- hydroxyproline (collagen breakdown)
- glycosaminoglyans (from matrix degradation)
- osteocalcin and type I collagen (from alveolar bone destruction)
Why test saliva for periodontal disease
its abundant, easy to collect, and store
high enriched content of disease biomarkers
What two tests can be done via saliva testing
- type and concentration of specific periodontal pathogens
- genetic susceptibility based upon over-expression of IL-1 a
Whats the main issue with salivary diagnostic testing
not being able to specifically predict periods of disease activity
What are the inflammatory mediators from GCF (Cytokines):
TNFa IL-1a IL-1b IL-6 IL-8 PGE2
There are two optical spectroscopy techniques, what are they?
- Infrared spectroscopy
- Near infrared spectroscopy
How does IR spectroscopy work?
Absorbing a wavelength that is characteristics of a certain covalent bond. Each bond has a certain wavelength
How does NIR spectroscopy work?
Measures the oxygen saturation of tissues
- Low O = periodontitis
