ADVANCED DIAGNOSTIC TECHNIQUES

ADVANCED DIAGNOSTIC TECHNIQUES

Introduction

Periodontal diagnostic procedures are essential in managing periodontal diseases. Periodontal diseases affect areas around the teeth, for example, gum, periodontal ligament, and alveolar bone. Signs and symptoms alone are not sufficient in planning and executing appropriate, individualized treatment without investigating pathology behind periodontal diseases. Advanced diagnostic procedures can determine the stage of the disease, that is whether the condition is an inactive stage. These procedures determine the progress of the disease and its prognosis with or without treatment.

Diagnostic Procedures

The following diagnostic procedures are used in periodontal diseases; microbiological investigations, biochemical investigations, radiological studies.

• Biochemical test

Biochemical diagnostic tests include the use of an oral fluid nanosensor test. This new device can detect oral cancer by the use of electrochemical detection of several saliva proteins and nucleic acids. It is highly sensitive and specific to these proteins and nucleic acids. Therefore used as a screening device for detecting oral cancers.

Another biochemical test is an electronic taste chip. They simultaneously monitor several biomarkers for various periodontal diseases. These differentiate between a healthy tooth and a periodontal disease because of both healthy and those affected releases biomarkers. This system measures oral fluids in the solution phase (Kinane Stathopoulou & Papapanou,  2017). Coupled device after an immunological reaction, it visualizes and captures optical signals generated on the microspheres.

Integrated microfluidic platform for diagnosis help in the rapid quantification of salivary biomarkers. Its main advantage is that it promotes a hand free saliva analysis. This biochemical test is used for the fast measurement of collagen cleaving enzyme MMP-8 for health and periodontally affected teeth (Kinane Stathopoulou & Papapanou,  2017). Inflammatory molecules are used as a predictive diagnostic for periodontal diseases.

• Microbiological tests

Omnigene diagnostic procedures use different DNA probes to identify eight pathogens that cause periodontal diseases. These bacterias include Treponema denticola and Campylobacter species. This test is advantageous as results take less time, and an individualized plan can de be initiated. Immediately after effects .my Perio Path is another diagnostic procedure that detects microbe in saliva samples. The test employs a DNA polymerase chain reaction to identify the type and concentration of bacteria in a saliva sample (Grover et al., 2014). Plague samples taken are cultured in the lab, and the causative agent determined for treatment.

• Immunological Diagnosis

Applies the immunofluorescent method to identify particular bacteria present in the bacterial smear. According to Reddy (2017), both direct and indirect immunofluorescent purposes use an antiserum to identify the bacteria present in the smear sample. Latex agglutination makes use of antibody molecules in latex to increase the amount of antigen-binding sites. Antigen produced by the specimen attaches to the antibody, creating crosslinked aggregates. ELISA measures immobilized antigens on a sample and determine the number of antigens spectrophotometric analysis.

• Radiological Diagnosis

In radiological studies to identify periodontal diseases, one should be keen on; normal bone position, any reduction in bone height, progressive bone loss, crown root ratio, periodontal ligament space, periapical pathology and, any pattern of bone loss. Various radiographic techniques include xeroradiography. (Reddy,  2017) explains that this method uses amorphous selenium material to copy images. It does not involve the use of darkrooms or wet chemical processing .when exposed to X rays, a real image on an opaque paper is produced. In orthopantomography tends to overlook minor bone changes, their major disadvantage is lack of clarity and image distortion.

Advanced diagnostic methods include nuclear medicine bone scan, computed tomography, absorptiometry for analyzing bone mass change. Others being digital radiography, and subtraction radiography. The main advantage of radiography is that a visual image of bone supporting the teeth can be visualized.

Conclusion

Advancement in periodontal diagnosis procedures translates into an improvement of periodontal therapy offered by health care professionals. It also eases planning of care and individualized treatment program. This was of great essence in reducing mortality and morbidity caused by complications of periodontal diseases.

References

Grover, V., Kapoor, A., Malhotra, R., and Kaur, G., 2014. Clinical Relevance of the Advanced Microbiologic and Biochemical Investigations in Periodontal Diagnosis: A Critical Analysis. Journal of Oral Diseases, 2014.

Kinane, D.F., Stathopoulou, P.G., and Papapanou, P.N., 2017. Periodontal diseases. Nature Reviews Disease Primers, 3(1), pp.1-14. [Accessed 03 April 2020].

Reddy, S., 2017. Essentials of Clinical Periodontology & Periodontics. JP Medical Ltd