diagnosis of periodontitis

Question 1

what is included in the visual inspection for periodontal disease

Answer 1

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

Question 2

what lab tests are done for periodontal disease

Answer 2

Biochem
Microbio
X-rays genetic

Question 3

what are the non-invasive tooths for periodontal disease

Answer 3

NIR
OCT
ultrasound

Question 4

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

Answer 4

More for reaserch

Question 5

what does diagonisis of perio disease depend on

Answer 5

Clinical manifestations
(periodontal examination and radiographs)

Question 6

what tets are done in a perio exam

Answer 6

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

Question 7

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

Answer 7

Look at bone loss

Question 8

what are the molecular methods for periodontal exams

Answer 8

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

Question 9

what are the types of micrbio testing

Answer 9

Bacterial culturing
Direct Microscopy
Immunodiagnostic methods
Enzymatic methods
Molecular biology techniques

Question 10

where do we get Biochemical analysis solution from for perio disease

Answer 10

GCF
Saliva
Serum (blood)

Question 11

how does genetics affect periodontal disease

Answer 11

usually a genetic susceptibility to perio disease

- gene polymorphism as a risk factor

Question 12

what does probe deapth depend on

Answer 12

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

Question 13

problem with using probing for perio disease

Answer 13

Lack of sensitivity and reproducability

Question 14

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

Answer 14

Poor reliability and reproducibility

Limited practical value

Question 15

problem with radiograph for diagnosing perio disease

Answer 15

Limited sensitivity in small bone change

no value in evaluating disease activity or progression

Question 16

what change in bone needs to occur for Radiograph to know

Answer 16

30%-50% of demineralization

-subtraction radiography is 5% change

Question 17

problem with Subtractive radiography

Answer 17

technique sensitive

Question 18

how does an ultrasonic perio probe work

Answer 18

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

Question 19

are conventional radiographs specific and sensitive

Answer 19

Specific

not sensitive

Question 20

what is Cone Beam Computed Tomography used for

Answer 20

detection of periodontal disease in in vivio settings

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

Question 21

what is the gold standard of microbiologic testing

Answer 21

Bacterial culturinging

Question 22

what can antibiotics and bacterial culturing show

Answer 22

assess the antibiotic susceptibility of microbes

Question 23

what can be grown in bacterial culturing

Answer 23

only grow live bacteria

- w/ strict sampling and transport conditions

Question 24

what is hard to culture

Answer 24

Putative pathogens that are fastidious(need correct media)

Question 25

what is the sensitivity of bacterial culturing

Answer 25

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

Question 26

what are the logistical concerns for bacterial culuting

Answer 26

Need sophisticated equipment and experienced personnel | - time consuming and expensive

Question 27

what microscopy is used to do microbiologic testing

Answer 27

Dark field | phase contract

Question 28

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

Answer 28

Morphology and motility of bacteria in a plaque sample

Question 29

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

Answer 29

most are non-motile

Question 30

how does immunodiagnostic test for perio pathogens

Answer 30

Uses Ab that target specific bacterial Ag

Question 31

what does Immunodiagnostic methods identify the most

Answer 31

identify pathogens using a plaque smear | -Aa and Pg

Question 32

how does immunodiagnostic methods prevail over bacterial culutres

Answer 32

Does not require viable bacterial cells

Question 33

what keeps people from doing Cytofluorography(flow cytometry)

Answer 33

Complexity and cost prevent

Question 34

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

Answer 34

to detect serum antibodies to periodontal pathogens

Question 35

what is Membrane Immunoassay

Answer 35

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

Question 36

how does Latex agglutination work

Answer 36

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

Question 37

where is latex agglutination done

Answer 37

currently for research purpose

Question 38

how do enzymatic methods test for perio pathogens

Answer 38

Pg, Tf, Aa all have trypsin-lik enzyme | - if degradation of BANA is found, then these pathogens are present

Question 39

where can enzymatic methods be used

Answer 39

chair side

Question 40

problem with enzymatic methods

Answer 40

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

Question 41

what are the nuclei acid probes we use

Answer 41

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

Question 42

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

Answer 42

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