INDIAN DENTAL ACADEMYLeader in Continuing Dental Education  www.indiandentalacademy.comwww.indiandentalacademy.com
PERIODONTAL DISEASES  Estimated by signs &  symptoms of gingival  inflammation and periodontal  tissue destruction.    www...
CLINICAL     www.indiandentalacademy.com
Diagnosed by the clinicalevaluation of signs ofinflammation with orwithout periodontal tissuedestruction.     www.indiande...
PERIODONTITIS – MEASUREDBY:A. Loss of   connective tissue   attachment.B Loss of   radiographic   bone loss.    www.indian...
Provides info on the pastperiodontal destruction, itsextent and severity     www.indiandentalacademy.com
BUT DOES NOT PROVIDE INFOON :Patient’s susceptibilityDisease progression/            remissionPositive/ negative -response...
GINGIVAL INFLAMMATION –Redness of gingivaSwellingGingival bleeding    www.indiandentalacademy.com
STUDIES SAY that gingivalbleeding is a sensitive clinicalindicator of early gingivalinflammation !!      www.indiandentala...
It is also a good indicator ofthe presence ofinflammatory lesion in theconnective tissue at the baseof the sulcus.     www...
SEVERITY OF THE BLEEDINGincreases with an increase inthe size of inflammatoryinfiltrate.     www.indiandentalacademy.com
RELATION to disease progressionis unclear. healthy sites may also evoke bleeding on probing. Sothe use of gingival bleedin...
INSTRUMENTS to measuregingival temp has beendeveloped.THERMAL PROBES – measureearly inflammatory changes inthe gingival ti...
IN PERIODONTITIS, widely useddiagnostic tool is the“periodontal probe” since increasedprobing depth and loss of clinicalat...
www.indiandentalacademy.com
But use of periodontalprobes presents manyproblems in terms ofsensitivity andreproducibility ofmeasurements.      www.indi...
THE DISPARITY BETWEENMEASUREMENTSDepends on probing techniqueprobing forcesize of the probeangle of insertionprecision of...
THE MAIN PROB IN REPRODUCIBILITYvariation in probing force.studies show - forces upto 50g isnecessary for detecting period...
NIDCR CRITERIA –FLORIDA PROBE SYSTEM –consists of a probe hand piece, digitalread out, foot switch, computerinterface and ...
FLORIDA PROBE   www.indiandentalacademy.com
Electronic probing systems-Interprobe system or Peri probesystem available.Other electronic probes -Fostermiller probe, To...
RADIOLOGICAL    www.indiandentalacademy.com
For detecting destruction ofAlveolar bone, Dental x-rays are mostcommonly used since they providevaluable info on interpro...
More than 30% of the bone massat the alveolar crest should belost for a change in bone heightto be seen in dental radiogra...
DIGITAL RADIOGRAPHY – by   the use of computerized   images, which can be   stored, manipulated and   corrected for under ...
SUBTRACTION  RADIOGRAPHY –  used in periodontal diagnosis.  Relies on the conversion of  serial radiographs into digital  ...
www.indiandentalacademy.com
COMPUTER – ASSISTEDDENSITOMETRIC IMAGEANALYSIS SYSTEM – a videocamera measures the lighttransmitted through a radiograph,s...
MICROBIAL    www.indiandentalacademy.com
MICROBIAL TESTS -can also be used to monitorperiodontal therapy directed atthe suppression or eradication ofperiodontopath...
BACTERIAL CULTURING   methods are used to detect   the specific pathogens   present in plaque, by using   selective & non ...
DISADV Of the above method-   strict sampling & transport   conditions essential. Putative   pathogens like Treponema   sp...
Also requires sophisticatedequipments, experiencedpersonnel & time consuming,expensive !!      www.indiandentalacademy.com
DARK FIELD OR PHASE CONTRASTMICROSCOPY – alternative method. Directly and rapidly assesses motility and morphology of bact...
PHASE CONTRASTMICROSCOPE   www.indiandentalacademy.com
www.indiandentalacademy.com
IMMUNOLOGIC ASSAY –employs antibodies whichrecognizes specificbacterial antigens todetect target microorganisms. E.g.:Dire...
ENZYMATIC METHODS –   B. forsythus, P.gingivalis,   Treponema denticola and   Capnocytophaga- share a common   enzymatic p...
OTHER DIAGNOSTIC ADVANCED AIDS   ARE   Nucleic acid probes,   Restriction Endonuclease   Analysis and Polymerase   Chain R...
ASSESSMENT OF THE HOSTRESPONSE –study of mediators, byimmunologic or biochemicalmethods. Mediators are eitherspecifically ...
SAMPLE SOURCES –   Saliva, GCF, Gingival Crevicular   cells, blood serum, blood cells &   urine. Urine samples show little...
MORE THAN 40 COMPONENTS OF GCFHAS BEEN STUDIED WHICH CAN BEDIVIDED INTO 3 GROUPS –host derived enzymesinflammatory mediato...
SAMPLE COLLECTIONGCF-Method commonly used- Paperstrips.Strips are placed in the sulcus fora standard period of time untilt...
Fluid volume collected can bequantified by using Periotron.This device measures the changein capacitance across the stripa...
www.indiandentalacademy.com
SALIVA – EASE OF COLLECTION….contain bothlocally and systemically derivedmarkers of periodontitis..DIAGNOSTIC MARKERS in s...
www.indiandentalacademy.com
www.indiandentalacademy.com
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Advanced diagnostic aids in periodontics /certified fixed orthodontic courses by Indian dental academy

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Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

State of the art comprehensive training-Faculty of world wide repute &Very affordable.

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Transcript of "Advanced diagnostic aids in periodontics /certified fixed orthodontic courses by Indian dental academy "

  1. 1. INDIAN DENTAL ACADEMYLeader in Continuing Dental Education www.indiandentalacademy.comwww.indiandentalacademy.com
  2. 2. PERIODONTAL DISEASES Estimated by signs & symptoms of gingival inflammation and periodontal tissue destruction. www.indiandentalacademy.com
  3. 3. CLINICAL www.indiandentalacademy.com
  4. 4. Diagnosed by the clinicalevaluation of signs ofinflammation with orwithout periodontal tissuedestruction. www.indiandentalacademy.com
  5. 5. PERIODONTITIS – MEASUREDBY:A. Loss of connective tissue attachment.B Loss of radiographic bone loss. www.indiandentalacademy.com
  6. 6. Provides info on the pastperiodontal destruction, itsextent and severity www.indiandentalacademy.com
  7. 7. BUT DOES NOT PROVIDE INFOON :Patient’s susceptibilityDisease progression/ remissionPositive/ negative -response to therapy www.indiandentalacademy.com
  8. 8. GINGIVAL INFLAMMATION –Redness of gingivaSwellingGingival bleeding www.indiandentalacademy.com
  9. 9. STUDIES SAY that gingivalbleeding is a sensitive clinicalindicator of early gingivalinflammation !! www.indiandentalacademy.com
  10. 10. It is also a good indicator ofthe presence ofinflammatory lesion in theconnective tissue at the baseof the sulcus. www.indiandentalacademy.com
  11. 11. SEVERITY OF THE BLEEDINGincreases with an increase inthe size of inflammatoryinfiltrate. www.indiandentalacademy.com
  12. 12. RELATION to disease progressionis unclear. healthy sites may also evoke bleeding on probing. Sothe use of gingival bleedingcannot be totally depended upon. www.indiandentalacademy.com
  13. 13. INSTRUMENTS to measuregingival temp has beendeveloped.THERMAL PROBES – measureearly inflammatory changes inthe gingival tissues.EG : PERIOTEMP PROBE www.indiandentalacademy.com
  14. 14. IN PERIODONTITIS, widely useddiagnostic tool is the“periodontal probe” since increasedprobing depth and loss of clinicalattachment are exclusive for thisdisease. www.indiandentalacademy.com
  15. 15. www.indiandentalacademy.com
  16. 16. But use of periodontalprobes presents manyproblems in terms ofsensitivity andreproducibility ofmeasurements. www.indiandentalacademy.com
  17. 17. THE DISPARITY BETWEENMEASUREMENTSDepends on probing techniqueprobing forcesize of the probeangle of insertionprecision of probe calibration. www.indiandentalacademy.com
  18. 18. THE MAIN PROB IN REPRODUCIBILITYvariation in probing force.studies show - forces upto 50g isnecessary for detecting periodontalosseous defects! www.indiandentalacademy.com
  19. 19. NIDCR CRITERIA –FLORIDA PROBE SYSTEM –consists of a probe hand piece, digitalread out, foot switch, computerinterface and computer. tip is 0.4mmin diameter.Data is then transferred to thecomputer . www.indiandentalacademy.com
  20. 20. FLORIDA PROBE www.indiandentalacademy.com
  21. 21. Electronic probing systems-Interprobe system or Peri probesystem available.Other electronic probes -Fostermiller probe, Toronto automatedprobe, but not released yet. www.indiandentalacademy.com
  22. 22. RADIOLOGICAL www.indiandentalacademy.com
  23. 23. For detecting destruction ofAlveolar bone, Dental x-rays are mostcommonly used since they providevaluable info on interproximal boneloss. www.indiandentalacademy.com
  24. 24. More than 30% of the bone massat the alveolar crest should belost for a change in bone heightto be seen in dental radiographs. www.indiandentalacademy.com
  25. 25. DIGITAL RADIOGRAPHY – by the use of computerized images, which can be stored, manipulated and corrected for under and over exposures. advantage - diagnostic info can be enhanced. www.indiandentalacademy.com
  26. 26. SUBTRACTION RADIOGRAPHY – used in periodontal diagnosis. Relies on the conversion of serial radiographs into digital images. then they are superimposed to view on a video screen. www.indiandentalacademy.com
  27. 27. www.indiandentalacademy.com
  28. 28. COMPUTER – ASSISTEDDENSITOMETRIC IMAGEANALYSIS SYSTEM – a videocamera measures the lighttransmitted through a radiograph,signals from the cameraconverted into gray scale images.camera is fixed to an imageprocessor and a computer www.indiandentalacademy.com
  29. 29. MICROBIAL www.indiandentalacademy.com
  30. 30. MICROBIAL TESTS -can also be used to monitorperiodontal therapy directed atthe suppression or eradication ofperiodontopathic microorganisms www.indiandentalacademy.com
  31. 31. BACTERIAL CULTURING methods are used to detect the specific pathogens present in plaque, by using selective & non selective media. www.indiandentalacademy.com
  32. 32. DISADV Of the above method- strict sampling & transport conditions essential. Putative pathogens like Treponema species & B. forsythes are fastidious & difficult to culture. www.indiandentalacademy.com
  33. 33. Also requires sophisticatedequipments, experiencedpersonnel & time consuming,expensive !! www.indiandentalacademy.com
  34. 34. DARK FIELD OR PHASE CONTRASTMICROSCOPY – alternative method. Directly and rapidly assesses motility and morphology of bacteria in a plaque sample.NON MOTILE ORGANISMS CANNOT BEIDENTIFIED BY THIS METHOD. www.indiandentalacademy.com
  35. 35. PHASE CONTRASTMICROSCOPE www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37. IMMUNOLOGIC ASSAY –employs antibodies whichrecognizes specificbacterial antigens todetect target microorganisms. E.g.:Direct/Indirect IFA, ELISA,Membrane Assay, andLatex Agglutination. www.indiandentalacademy.com
  38. 38. ENZYMATIC METHODS – B. forsythus, P.gingivalis, Treponema denticola and Capnocytophaga- share a common enzymatic profile. Activity of this enzyme can be measured by using diagnostic kits like Perioscan. www.indiandentalacademy.com
  39. 39. OTHER DIAGNOSTIC ADVANCED AIDS ARE Nucleic acid probes, Restriction Endonuclease Analysis and Polymerase Chain Reaction. www.indiandentalacademy.com
  40. 40. ASSESSMENT OF THE HOSTRESPONSE –study of mediators, byimmunologic or biochemicalmethods. Mediators are eitherspecifically identified with theinfection or represent a lessspecific reaction www.indiandentalacademy.com
  41. 41. SAMPLE SOURCES – Saliva, GCF, Gingival Crevicular cells, blood serum, blood cells & urine. Urine samples show little promise except for its use in the differential diagnosis of tooth loss related to Hypophosphatasia in young children. www.indiandentalacademy.com
  42. 42. MORE THAN 40 COMPONENTS OF GCFHAS BEEN STUDIED WHICH CAN BEDIVIDED INTO 3 GROUPS –host derived enzymesinflammatory mediatorstissue breakdown products www.indiandentalacademy.com
  43. 43. SAMPLE COLLECTIONGCF-Method commonly used- Paperstrips.Strips are placed in the sulcus fora standard period of time untilthe paper gets saturated www.indiandentalacademy.com
  44. 44. Fluid volume collected can bequantified by using Periotron.This device measures the changein capacitance across the stripand this change is converted to adigital read out. www.indiandentalacademy.com
  45. 45. www.indiandentalacademy.com
  46. 46. SALIVA – EASE OF COLLECTION….contain bothlocally and systemically derivedmarkers of periodontitis..DIAGNOSTIC MARKERS in salivaproteins & enzymes of host origin,phenotypic markers, host cells,hormones, bacteria & bacterialproducts and ions. www.indiandentalacademy.com
  47. 47. www.indiandentalacademy.com
  48. 48. www.indiandentalacademy.com

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