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1. Screening
2. Diagnosis of specific periodontal disease
3. Identification of sites or subjects at an increased risk of experiencing the progression of
periodontal destruction
4. Treatment planning and
5. Monitoring of therapy.
I) GINGIVAL TEMPERATURE : Kung et al (1990) claim that thermal probes are sensitive
diagnostic devices for measuring early inflammatory changes in gingival tissue.
i) Florida probe:
Tip is 0.4mm
Sleeve- edge provides reference to make measurements
Coil Spring; provides constant probing force
Computer for data storage.
Probe Handpiece tip enters the sulcus with constant force in use (tip at bottom of sulcus) and
sleeve properly positioned at the top of the gingival margin allowing the computer to measure
the difference.
Limitations :
1) Digital radiography
Capturing radiographic image using a sensor
Advantages
1. Elimination of chemical processing
2. Increased efficiency and speed of viewing
3. Diagnostic information can be enhanced
4. Computerized storage of radiographs
5. Reduced exposure to the radiation
2) Subtraction radiography
This is a technique by which images not of diagnostic value in a radiograph, are
eliminated so that changes in the radiograph can be precisely detected
Serial radiographs converted to digital images superimposed
This technique requires a paralleling technique to obtain a standardize geometry
and accurate superimposable radiographs
This technique facilitates both quantitative and qualitative visualization of even
minor density changes in the bone
Increased detectability of small osseous lesions by subtraction method compared
with conventional radiography
Recent image subtraction:“diagnostic subtraction radiography” (DSR) Modification
Use of a positioning device during film exposure
MICROBIOLOGICAL ANALYSIS
Immunodiagnostic methods
Immunological assays use fluorescent conjugated antibodies that recognize specific
bacterial antigens, and the identification of these specific antigen-antibody reactions
allows the detection of target microorganisms.
This reaction can be visualized using a variety of techniques and reactions:
1. Direct (DFA) and indirect (IFA) immunofluorescent assays
2. Flow cytometry
3. Enzyme-linked immunosorbent assay (ELISA)
4. Latex agglutination
1) Immunofluorescent assay
2) Enzymatic methods
Some periodontal pathogens release a trypsin like enzyme which when reacted
with BANA (N-benzoyl-d L-arginine-2-naphthylamide) undergoes hydrolysis
Beta- naphthylamide (chromophore) is the end product
Perioscan uses this reaction for the identification of the bacterial profile in plaque
sample
Detection of these pariodontal pathogens by BANA reaction serves as a marker of
disease activity
shallow pockets exhibited 10% positive BANA reaction, whereas deep pockets
(7mm) exhibited 80%-90% +ve BANA reaction
Beck et al. (1995) used BANA test as a risk indicator for periodontal attachment loss
Disadvantage includes:
May be positive in clinically healthy site
Can not detect sites undergoing periodontal destruction
Limited organisms detected
3) Flow cytometry
Rapid identification
Principle is labelling bacterial cells with both species-specific antibody and a second
fluorescein-conjugated antibody
This suspension is introduced into flow cytometer, which separates bacterial cells
into an almost single cell suspension
Limitation is sophistication and cost involved with this procedure
4) ELISA
To detect serum antibodies to periodontal pathogens.
In research studies to quantify specific pathogens in subgingival sample
Quantitative analysis
The principles of molecular biology technique reside in the analysis of DNA, RNA and the
structure and function of proteins
Diagnostic assays require specific DNA fragment (DNA Probe) that recognize complementary-
specific DNA sequences from target microorganisms
This technology requires bacterial DNA extracted from the plaque sample and amplification of
the specific DNA sequence of the target pathogen