Dr. Sapnil., MDS Reader

1. Presented by
Dr. Sapnil, MDS
Reader

2. PRINCIPLES OF DIAGNOSIS
SPECIFICITY
Ability of test or observation to differentiate one
disease to another
SENSITIVITY
Ability of test or observation to detect the disease
whenever it is present

3. I CLINICAL DIAGNOSIS
II RADIOGRAPHIC ASSESSMENT
III MICROBIOLOGIC ANALYSIS
IV IMMUNOLOGICAL DIAGNOSIS
V BIOCHEMICAL METHODS

4. I CLINICAL DIAGNOSIS
Based on signs of gingival inflammation
A CHANGE IN COLOR
B GINGIVAL BLEEDING
C INCREASE FLOW OF GINGIVAL FLUID
D INCREASE TEMPERATURE OF GINGIVAL TISSUES

5. A CHANGE IN COLOR
NO DIAGNOSTIC TESTS
SUBJECTIVE ESTIMATION

6. B GINGIVAL BLEEDING
1. PERIODONTAL PROBES
a. CONVENTIONAL PROBES
b. ADVANCED PROBES
2. WOODEN TOOTH PICKS
3. UNWAXED DENTAL FLOSS

7. a. CONVENTIONAL PROBES
WHO / CPITN probe
WILLIAM’S probe
UNIVERSITY OF MICHIGAN “O” probe
UNC-15 probe
MARQUIS COLOR-CODED probe

8. LIMITATIONS IN CONVENTIONAL PROBES
ANGULATION PRESSURE

9. b. ADVANCED PROBES
PRESSURE SENSITIVE PROBE - 30GRAMS PRESSURE
ELECTRONIC PERIODONTAL PROBE - 25 GRAMS PRESSURE
AUTOMATED PERIODONTAL PROBE - TIP—0.5MM
COMPUTERIZED PERIODONTAL PROBE [FLORIDA]
- TIP—0.4MM
JEFFCOAT PROBE [FOSTER-MILLER ]
INTERPROBE
BIREK PROBE

10. 2. WOODEN TOOTH PICKS
INTERDENTAL BLEEDING INDEX - CATON & PALSON

11. 3.UNWAXED FLOSS
GINGIVAL BLEEDING INDEX - CARTER & BARNESS

12. C INCREASE FLOW OF GINGIVAL FLUID
1. MANUAL METHOD
NINHYDRIN PAPER -- 1.5mm - 1mm introduced into
the sulcus - for 3mnts - 0.1mg of fluid is collected
2. ELECTRONIC
PERIOTRON 2000 and 6000

13. D INCREASE TEMPERATURE OF GINGIVAL TISSUES
THERMOCOUPLE
PERIOTEMP

14. II RADIOGRAPHIC ASSESSMENT [BONE DESTRUCTION/LOSS]
OPG
IOPA
XERORADIOGRAPHY
I125 ABSORPTIOMETRY
PHOTO-DENSITOMETRIC ANALYSIS TECH
COMPUTER ASSISTED SUBSTRACTION RADIOGRAPHY
COMPUTER ASSISTED DENSITOMETRIC IMAGE ANALYSIS
NUCLEAR MEDICINE

15. LIMITATIONS IN CONVENTIONAL PERIAPICAL RADIOGRAPHY

16. RADIOGRAPHIC PARALLELING TECHNIQUE

17. RADIOGRAPHIC PARELLELING TECHNIQUE
FOR
ASSESSMENT OF ALVEOLAR BONE CHANGES
Occlusal imprint in film holder individual film holder in paralleling device
Individualized paralleling technique in place intra orally
Two radiographs obtained 6months apart showing identical projection geometry

18. DIGITAL SUBSTRACTION RADIOGRAPHY
Serial radiographs – digital images – superimposed – video screen
Changes in the density/volume of bone can be detected as
lighter areas (bone gain) or dark areas (bone loss)

19. III MICROBIOLOGICAL ANALYSIS
1. DARK FIELD /PHASE CONTRAST MICROSCOPY
2. IMMUNO FLORESCENCE MICROSCOPY
a. direct
b. indirect
3. LATEX AGGLUTINATION
4. FLOW CYTOMETRY
5. ELISA
6. BANA[ BENZYL ARGENINE NAPTHALAMIDE ]
7. DNA PROBE[Aa, Pg, Pi, Td ]
a. genomic
b. oligonucleotide
c. cloned probe

20. MICROBIAL SAMPLING OF THE SUBGINGIVAL FLORA

21. SAMPLING METHOD FOR CREVICULAR FLUID ANALYSIS
PERIOTRON SYSTEM

22. DNA PROBE
Based on the ability of DNA to hybridize or bind
to complimentary strands of DNA or RNA having
the same base
sequence
The plaque sample is collected and sent to the lab

23. A portion of DNA from specific bacterium is
isolated with the aid of enzyme called as
Restriction Endonucleoses [RE] that cut the DNA
molecule at specific location into single strands
These single strands are the probe for
complimentary sequences of specific bacterium

24. This single stranded bacterial DNA is inoculated
on a Nitrocellulose membrane
The specific labeled DNA probe is inoculated on
the membrane to allow hybridization for 15mnts
If hybridisation of 2 single strands takes place to
form a double helix, the test is + ve, if not - ve
DNA PROBES available for Aa, Pg, Pi and Td

25. IV IMMUNOLOGICAL DIAGNOSIS
Identification of defective chemotactic and
phagocytic functions of PMNL / monocytes in
diseases such as
LJP
PREPUBERTAL
RPP
ANUG
by blood examination

26. V BIOCHEMICAL
enzymes present in severe periodontitis such as
PPP, LJP, RPP are
Lysozymes
Collagenase
Alkaline phosphate/acid
Beta glucoronidase
Cathepsin - D
Elastase
Arlysulphatase
Prostaglandins
Myloperoxidase[MPO]

27. identified by tests such as
PERIOSCAN
PROGNOSTIC
PERIOGAURD
PERIOCHECK