Advanced periodontal diagnostic techniques provide more precise information about periodontal disease beyond conventional methods like probing. New tools include digital radiography, subtraction radiography, cone-beam CT, and microbiological assays. Periodontal probes also improved from early generations that lacked standardization to current automated probes that control probing force and directly capture data. These advanced techniques enhance detection of bone loss, monitor disease activity, and identify pathogens involved.

1. ADVANCED PERIODONTAL DIAGNOSTIC
TECHNIQUES
Dr MIDHUN KISHOR S
I

2. DIAGNOSIS
Diagnosis is defined as; correct determination, discriminative estimation and logical appraisal of
conditions found during examination by distinctive marks, signs and characteristics of diseases
Diagnosis can be defined as the art of identifying a condition or disease and differentiating it from
other entities
Text book of Carranza's clinical periodontology, Second southAsia Edition
Diagnosis is defined as an utilisation of scientific knowledge for identifying a disease process and to
differentiate it from other diseased process

3. Types of diagnosis
Provisional Therapeutic Differential Comprehensive Emergency
DIAGNOSTIC AIDS IN PERIODONTICS
CONVENTIONAL
ADVANCED

4. Current conventional techniques
Clinical diagnosis is made
by measuring either
clinical attachment loss
(CAL) or radiographically
by loss of alveolar bone
This kind of evaluation
identify and quantify
current clinical signs of
inflammation
Provides historical
evidence of damage with
its extent and severity

5. STATUS of current conventional methods
POSITIVES
They can be performed swiftly with
minimum equipment and effort and are
in expensive
Epidemiologic surveys can be carried out easily
and the results are usually a true representation
of the periodontal status of population
Diagnostic techniques in periodontology: a historical review STEVENI. GOLD Periodontology 2000,Vol. 7, 1995, 9-21

6. NEGATIVES
• Does not provide cause of the condition, EXACT etiology cannot be
determined
• No info. on patient’s susceptibility to the disease
• Cannot identify sites with ongoing periodontal destruction or sites in
remission
• No reliable markers of current diseases activity
• Difficult to determine the prognosis accurately and to perform an
appropriate treatment
Diagnostic techniques in periodontology: a historical review STEVENI GOLD Periodontology 2000,Vol. 7, 1995, 9-21

7. Advanced periodontal diagnostic techniques
Text book of Carranza's clinical periodontology, Second south Asia Edition

8. Advances in clinical diagnosis
GINGIVAL BLEEDING
• Indicator of inflammatory lesion
• Relation to disease activity is unclear.
• Normal probing force is 0.25N
• Presence is not an indicator but absence indicates health.

9. Gingival temperature
• Kung et al (1990) claim that thermal probes are sensitive diagnostic devices
for measuring early inflammatory changes in gingival tissue.
• Subgingival temperature at diseased sites is increased as compared to
normal healthy sites
• Commercially available system PerioTemp probe enables the calculation of
temperature differential (with sensitivity of 0.10C) between the probed
pocket and subgingival temperature
Kung RT, Ochs B, Goodson JM:Temperature as a periodontal diagnostic. J Clin Periodontol 1990; 17:557

10. • Possible explanation for increase temperature with increasing probing
depth is an increase in cellular and molecular activity caused by increased
periodontal inflammation
• Haffajee et al. (1992): found that elevated subgingival site temperature is
related to attachment loss in shallow pockets and elevated proportions of
Pg, Pi,Tf, Aa
• Smokers have differences in sub gingival temperature and sublingual
temperature

11. Periodontal probing
• Most widely used diagnostic tool
• Probing depth is measured from the free gingival margin to the depth of the
probeble crevice.
• Longitudinal measurement of CAL or probing depth is a ‘gold standard’ for
recording changes in periodontal status

12. Limitation of conventional probing
Lack of
sensitivity and
reproducibility.
Disparity
between
measurement
depends on:
probing
technique,
probing force,
angle of
insertion of
probe, size of
probe, precision
of calibration,
presence of
inflammation.
Readings of
clinical pocket
depth measured
with probe does
not coincide with
the histologic
pocket depth.
All these variable
contribute to the
large standard
deviations (0.5-
1.3 mm) in clinical
probing results

13. Classification of periodontal probes
depending on generation
1.First generation probes: (conventional probes)
Conventional manual probes that do not control probing force or pressure and that are
not suited for automatic data collection.
 Williams periodontal probe
 CPITN probe
 UNC-15 probe
 Goldman Fox probe
Comparison of a Conventional ProbeWith Electronic and Manual Pressure Regulated Probes. DorothyA. Perry," Edward J.Taggart/
Angela Leung/ and Ernest Newbrurt J Periodontol 1994; 65:908-913

15. 2.Second generation probes: (Constant force probes)
• Study done by Tupta et. Al ,Hunter (1994) has shown that
• force to probe pocket: 30g
• force to probe osseous defect: 50g
• Introduction of constant force or pressure sensitive probes allowed for
improved standardization of probing.
e.g.: Pressure sensitive probe
Constant pressure probe
• Limitation: data readout and storage is inaccurate

16. • 3.Third generation probe:(Automated probes)
• Computer assisted direct data capture was an important step in reducing
examiner bias and also allowed for generation of probe precision. (according
to NIDCR criteria)
• Toronto probe
• Florida probe
• Inter probe
• Foster Miller probe.

17. FLORIDA PROBE
• Tip is 0.4mm
• Sleeve- edge provides reference to make measurements
• Coil Spring; provides constant probing force
• Computer for data storage
Comparison of a Conventional ProbeWith Electronic and Manual Pressure Regulated
Probes. Dorothy A. Perry," Edward J.Taggart/ Angela Leung/ and Ernest Newbrurt J Periodontol 1994; 65:908-913
.

18. FP Hand piece tip 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 (3.0 mm).
FP Handpiece tip as it enters the sulcus

19. • Clark andYang (1992): trained operators and performing the ‘double pass’
method, the measurements taken with Florida probe system shows lower
standard deviation than those obtained with conventional probing.
• Mean Standard Deviation forCAL of about 0.3mm, which is superior to an
average of 0.82mm reported by Haffajee et al. For conventional probing.
Disadvantages of Florida probe.
Lack of tactile sensitivity
Fixed probing force
Underestimation of deep periodontal pockets
Description and clinical evaluation of a new computerized periodontal probe-the Florida Probe –journal of clinical
periodontology Volume 15, Issue 2 February 1988 Pages 137–144

20. • 4.Fourth generation probes: (Three dimensional probes) (WATTS 2000)
• Currently under development, these are aimed at recording sequential
probe positions along a gingival sulcus.
• An attempt to extend linear probing in a serial manner to take account of
the continuous and three dimensional pocket that is being examined.
• 5.Fifth generation probe: (3D + Noninvasive)
• Basically these will add an ultrasound to a fourth generation probes.
• If the fourth generation can be made, it will aim in addition to identify the
attachment level without penetrating it.
• e.g.: Ultra sono graphic probe.

21. Advances in Radiographic Assessment
• Dental Radiographs are traditional method to assess destruction of alveolar bone.
• “Conventional radiographs are very specific but lack sensitivity”
• Primary criterion for bone loss is the distance from CEJ to the alveolar crest and
distance more than 2 mm is considered as the bone loss.
• But variability affecting conventional radiographic technique are,
Variation in projection geometry
Variation in contrast and density
Masking by other anatomic structures.
Radiographic diagnosis in Periodontics MARJORIKE. JEFFCOAT, I.-CHUNGW ANG& MICHAELS. REDDY
Periodontology 2000,Vol. 7, 1995, 54-68

22. Digital radiography
• Capturing radiographic image using a sensor
• The first direct digital imaging system, RadioVisioGraphy (RVG), was
invented by Dr. Frances Mouyens.
• Advantages
Elimination of chemical processing
Increased efficiency and speed of viewing
Diagnostic information can be enhanced
Computerized storage of radiographs
Reduced exposure to the radiation
Fundamentals of periodontics-WILSON and KORMAN

23. Uses a Charge Couple Device (CCD) or CMOS sensor linked with fiber optic
or other wires to computer system
CCD receptor is placed intra orally as traditional films ,images appear on a
computer screen which can be printed or stored
Text book of Carranza's clinical periodontology, Second south Asia Edition

25. Subtraction radiography
• Subtraction radiography was introduced to dentistry in 1980 by Ruttimann,
Webber et & Grondahl HG
• 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
Fundamentals of periodontics-WILSON and KORMAN

26. • This technique requires a paralleling technique to obtain a standardize
geometry and accurate super imposable radiographs
• This technique facilitates both quantitative and qualitative visualization of
even minor density changes in the bone
• Bone gain appears as light areas and bone loss appears as dark areas
• Rethman et al.(1985): increased detectability of small osseous lesions by
substraction method compared with conventional radiography

27. Recent image
subtraction:“diagnostic
subtraction radiography” (DSR)
Modification
Use of a positioning device
during film exposure
Image analysis software system
applies an algorithm to correct
angular alignment discrepancies.

28. Ortmann (1994)- 5% of bone loss
can be detected.
Diagnostic subtraction
radiography (DSR) can be used
for enhanced detection of crestal
or periapical bone density
changes and to evaluate caries
progression

29. Computer Assisted Densitometric Image Analysis
(CADIA)
• Video camera measures the light transmitted through radiograph and the
signals form the camera is converted to gray scale image.
• Camera is interfaced with an image processor
• Advantage
• Measures quantitative changes in bone density longitudinally.
• Higher sensitivity, reproducibility and accuracy as compared to DSR.

30. Computed tomography (CT)
• In 1972, Godfrey Hounsfield announced the invention of a revolutionary imaging
technique, which he referred to as “computerized axial transverse scanning”
• Fan shaped X-ray source is used
• The computed tomographic image is reconstructed by computer, which
mathematically manipulates data obtained from multiple projections.
• Computed tomography is a specialized radiographic technique that allows
visualization of planes or slices of interest
Textbook Of Dental & Maxillofacial Radiology 2nd Edition by Karjodkar

31. Advantages over conventional radiography
• eliminates the super imposition of images of structures superficial or deep
to the area of interest.
• Because of inherent high contrast resolution, differences may be
distinguished between tissues that differ in physical density by less than 1%.
• multiple scans of a patient may be viewed as images in the axial, coronal, or
sagittal planes depending on the diagnostic task, referred to as multi planar
imaging.

32. Application of CT
• Used when accurate information regarding the topography of osseous
structure is needed
• Soft tissue contour and dimension
• To check continuity and density of the cortical plates
• vertical height of the residual alveolar ridges
• density of the medullary space and basilar bone
• when determining how much space is available above the mandibular canal
or amount of bone below maxillary sinus to receive a dental implant or
whether there is a space occupying lesion in the maxillofacial region.
Textbook Of Dental & Maxillofacial Radiology 2nd Edition by Karjodkar

33. Disadvantages of ComputedTomography
• specialized equipment and setting.
• Radiologists andTechnicians need to be knowledgeable of the anatomy,
anatomic variants and pathology of the jaws
• higher radiation
• Metallic Restorations can cause ring artifacts that impair the diagnostic
quality of the image

34. HELICAL CT
Introduced in 1989
The gantry containing x ray tube and detectors continuously revolve
around the patient ,where as patients table advances through the gantry.
Result is acquisition of a continuous helix of data.

35. Cone-beam ComputedTomography
• Routine use of CT in dentistry is not accepted due to its cost, excessive
radiation, and general practicality.
• In recent years, a new technology of cone-beam CT (CBCT) for acquiring 3D
images of oral structures is now available to the dental clinics and hospitals.
• It is cheaper than CT, less bulky and generates low dosages of X-radiations.
• The innovative CBCT machine designed for head and neck imaging are
comparable in size with an ortho pantomogram.
Textbook Of Dental & Maxillofacial Radiology 2nd Edition by Karjodkar

36. ADVANTAGES
• It gives complete 3D reconstruction
• CBCT units reconstruct the projection data to provide inter relational
images in three orthogonal planes (axial, sagittal, and coronal).
• Its beam collimation enables limitation of X-radiation to the area of interest.
• Patient radiation dose is five times lower than normal CT, as the
exposure time is approximately 18 seconds, that is, one-seventh the
amount compared with the conventional medical CT.
• Reduced image artefacts

37. Indications of CBCT
Evaluation of the jaw bones which
includes the following:
Bony and soft tissue lesions
Periodontal assessment
Soft tissueCBCT for the measurement of gingival tissue and the
dimensions of the dentogingival unit
Alveolar bone density measurement
Temporomandibular joint evaluation
Implant placement and evaluation
Whenever there is need for 3D
reconstructions

38. INTERFACE CONE-BEAM CT MANAGEMENT SOFTWARE

39. CT vs CBCT
ConventionalCT scanners make use of a
fan-beam and Provides a set of consecutive
slices of image
ConventionalCT makes use of a lie-down
machine with a large gantry.
Greater contrast resolution &
More discrimination between different
tissue types (i.e. bone, teeth, and soft
tissue)
Utilize a cone beam, which radiates from the x-ray source in a
cone shape, encompassing a large volume with a single
rotation.
a sitting-up machine of smaller dimensions
Commonly used for hard tissue
Ease of operation
Dedicated to dental
Both jaws can be imaged at the same time
Lower radiation burden

40. OTHER NEWERTECHNIQUES
• Micro ComputedTomography
• Denta scan -pre-operative planning of endosseous dental implants and
subperiosteal implants
• SIMPLANTS-Computer program for assessing oral implant site
• TACT-tuned aperture CT
• BONE SCANNING or RADIONUCLIDE IMAGING-technique assesses biochemical
alteration in body , It Is a nuclear scanning test that identifies new areas of bone
growth or breakdown.

42. Advances In Microbiologic Analysis
Uses of microbiologic analysis
1. support diagnosis of various Periodontal disease
2. Can tell about initiation & progression
3. To determine which periodontal sites are at high risk for active destruction
4. Can also be used to monitor Periodontal therapy
Diagnosis of periodontal disease based on analysis of the host Response B. LAMSTER & JOHNT. GRBIC Periodontology 2000,Vol. 7,
1995, 83-99C

43. Advances In Microbiologic Analysis includes:
1. Immunohistodiagnostic methods
2. Enzymatic methods
3. Molecular biology techniques
• Nucleic acid probes
• Checkerboard DNA-DNA hybridization
• PCR

44. Sample collection
• It is a common need of all the microbiologic analysis to collect an
appropriate subgingival plaque sample
• Mombelli et al. (2002) have shown that four individual subgingival
specimens, each from the deepest periodontal pocket in each quadrant,
should be pooled to be able to detect the highest amount of pathogens.
• Transport the specimen in an anaerobic environment

45. 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
Page RC: Host response tests for diagnosing periodontal diseases. J Periodontol 1992; 63:356.

46. Immunofluorescent assays
• Direct IFA: AB conjugated with Fluorescein marker + Bacteria ( Antigen) =
Immuno complex
• Indirect IFA: Primary AB + Bacteria= Immune Complex+ Secondary Fl
conjugated AB

49. Flow cytometry
• Rapid identification
• Laser or impedence type
• Principle is labelling bacterial cells with both species-specific antibody and a
second fluorescein-conjugated antibody
• This suspension is introduced into flowcytometer, which separates bacterial
cells into an almost single cell suspension
• Limitation is sophistication and cost involved with this procedure
Text book of Carranza's clinical periodontology, Second south Asia Edition

50. ELISA= Enzyme Linked Immunosorbent Assay
ELISA has been used
primarily to detect serum
antibodies to periodontal
pathogens.
In research studies to
quantify specific
pathogens in
subgingival samples
A novel chair side ELISA commercially
known as “Evalusite” has been marketed
in Europe and Canada for the chair side
detection of 3 periodontal pathogens. Aa,
Pg and Pi

52. Latex agglutination
Test
+ve

53. MERITS
Quantitative estimate of target species
Not requiring stringent sampling and transport methodology
Higher sensitivity and specificity
DEMERITS
Limited to number of antibodies tested
Not amenable for antibiotic susceptibility

54. Enzymatic Methods
• Bacteria release specific enzymes. Certain group of species share common
enzymatic profile.
• e.g.Tf, PG,Td, and Capnocytophagea species release trypsin like enzyme
Trypsin like
enzyme BANA hydrolysis
β-naphthylamide
(chromophore)

55. PERIOSCAN uses this reaction
for the identification of this
bacterial profile in plaque
isolates
Loesh et al. (1986) detection of these
periodontal pathogens by BANA reaction
serves as a marker of disease activity
He also showed that 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

56. ADVANTAGES
• May be positive in clinically healthy site
• Can not detect sites undergoing periodontal destruction
• Limited organisms detected
• So that, negative results does not rule out the presence of other important
periodontal pathogens.

57. Molecular BiologyTechniques
• 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 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
Socransky SS, Haffajee AD, SmithC, Martin L, Haffajee JA, Uzel NG, Goodson JM. Use of checkerboard DNA-DNA hybridization to study complex
microbial ecosystems.Oral Microbiol Immunol 2004;19:352-362

58. 1. Nucleic acid probes
• A probe is a known, single stranded nucleic acid molecule (DNA or RNA)
from a specific pathogen synthesized and labelled with an enzyme of a radio
isotope
• Hybridization: Pairing of complimentary strands of DNA to produce a
double stranded DNA.
Socransky SS, Haffajee AD, SmithC, Martin L, Haffajee JA, Uzel NG, Goodson JM. Use of checkerboard DNA-DNA hybridization
to study complex microbial ecosystems.Oral Microbiol Immunol 2004;19:352-362

59. Hybridization
Probe DNA

60. • DMDx and Omnigene are commercially available genomic probes for the
detection of Aa, Pg, Pi andTd.
• Van Steenberghe et al. (1999) reported a sensitivity of 96% and specificity
of 86% forAa., and 60% and 82% respectively for Pg in pure lab isolates.
• In clinical specimens, both sensitivity and specificity were reduced
significantly, suggestive of cross reactivity with non target bacteria in
plaque sample because of the presence of homologues sequences between
different bacterial species

61. Checkerboard DNA-DNA hybridization technology
• Developed by Socransky et.al in 1994
• 40 bacterial species can be detected using whole genomic digoxigenin-
labeled DNA probes.
• Applicable for epidemiologic research and ecological studies
Socransky SS, Haffajee AD, Smith C, Martin L, Haffajee JA, Uzel NG, Goodson JM. Use of checkerboard DNA-DNA hybridization
to study complex microbial ecosystems. Oral Microbiol Immunol 2004;19:352-362

62. Polymerase chain reaction (PCR)
• Repeated cycles of oligonucleotide (primer)–directed DNA synthesis of
“target sequences” are carried out in vitro.
• The PCR method is considered the fastest and most sensitive method
available for detecting the presence of bacterial DNA sequences
• A modification of the original PCR technology, "real-time" PCR, permits not
only detection of specific microorganisms in plaque, but also its
quantification.

63. • Advantages
• High detection limit. As less as 5- 10 cells can be amplified and detected.
• Less cross reactivity under optimal conditions
• Many species can be detected simultaneously
• Disadvantage
• Small quantity needed for reaction may not contain the necessary target DNA
• Plaque may contain enzymes which may inhibit these reactions.

64. Biochemical test kits
• Biochemical test kits used in periodontics analyze the gingival crevicular
fluid (GCF).
• Since this fluid is derived from periodontal tissues, evaluating its
constituents such as host-derived enzymes, inflammation mediators and
extracellular matrix components may provide early signs of alterations.
CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3

65. PERIO 2000
This test kit was
released in the year
1993.
It detects elevated
levels of MMPs in
the gingival
crevicular fluid such
as the elastases.
The GCF is
collected onto the
filter paper strip
impregnated with
a known amount
of buffered
elastase substrate
labeled with a
fluorescent
indicator.
Elastase on the
test strip cleaves
the substrate
during the
reaction time of
4-6 minutes and
releases the
indicator, visible
under fluorescent
light.
Elastase is released
from the lysosomes
of
polymorphonuclear
leucocytes which
accumulate at sites
of gingival
inflammation.
The levels of
these enzymes in
GCF have been
noted to increase
with the
development of
gingivitis as well
as sites of
established
periodontitis
CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3

66. PERIOGARD
PerioGard is based on the detection
of an enzyme called aspartate
aminotransferase(AST).AST is a
soluble intracellular cytoplasmic
enzyme that is released from within
the cell upon its death. Since cell
death is an important part of
periodontal pathogenesis,
AST levels in GCF have great potential
as markers of early periodontal tissue
destruction. Elevated total AST levels
in a 30-second sample have been
positively associated with disease-
active sites in contrast to inactive sites
CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3

67. The test involves collection of
GCF with the filter paper strip
which is then placed in
trimethamine hydrochloride
buffer.
A substrate reaction mixture
containing 1-aspartic and α-keto-
gluteric acid is added to the sample
and allowed to react for ten
minutes. In the presence of AST, the
Aspartate and α-keto-gluteric acid
are catalyzed to oxaloacetate and
glutamate.
The addition of a dye such as
fast red results in a color
product,the intensity of
which is proportional to the
AST activity in the GCF
sample

68. POCKET WATCH
• The PocketWatch was developed as a simple method of analyzingAST at the chairside .
• The principle of this test is that, in the presence of pyridoxal phosphate,AST catalyzes the
transfer of an amino group of cysteine sulfuric acid by α- keto- glutericacid to yield β-sulfinyl
pyruvate.
• Glutamate β-sulfinyl pyruvate spontaneously and rapidly decomposes
• The sulphite ion instantaneously reacts with malachite green (MG), simultaneously causing MG
to convert from a green dye to its colorless form, thereby allowing the pink–colored rhodamine
B dye to show through.
• The rate of conversion of MG is directly proportional to AST concentration. However,
components of the extracellular matrix and its dissolved products are present in GCF of
destructive pockets, and they may release sulfide ions.
CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3

69. • PST® genetic susceptibility test
• Periodontal susceptibility test (PST®) is the first and only genetic test that
analyzes two interleukins (IL-1α and IL-1β) genes for variations.
• IL-1 genetic susceptibility may not initiate or cause the disease but rather
may lead to earlier or more severe disease.
• The IL-1 genetic test can be used to differentiate certain IL-1 genotypes
associated with varying inflammatory responses to identify individuals at
risk for severe periodontal disease even before the age of 60.
CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3

70. • Clinically, PST is used in
• New periodontal patients to assist in developing treatment plans.
• Patients requiring extensive periodontal and/or implant therapy to
determine prognosis, improve patient acceptance and optimize treatment
outcomes.
• Smoking patients as an additional incentive for smoking cessation.

71. • This discussion directly translates into improved periodontal therapy by
offering the clinician, the radiographic & laboratory measure of periodontal
infection as an adjunct to traditional clinical indices of periodontal disease.
• Future application of advanced diagnostic techniques will be of value in
documenting disease activity and treatment options
• But, despite excellent progress in diagnostic methodology,conventional
efforts evaluating inflammation and past evidence of tissue breakdown
remain the standard for disease evaluation

72. COMMON COMMERCIAL DIAGNOSTIC AIDS ANDTHEIR USES
PERIOTEMP - GINGIVALTEMPERATURE
PERIOTEST - TOOTH AND IMPLANT MOBILITY
OSSTELLAPPARATUS - IMPLANT MOBILITY
PERIOSCOPY - DETECTION OF CALCULUS
KEYLASER3 - DETECTION AND REMOVAL OF CALCULUS
PERIOSCAN - DETECTION OF BANA ORGANISMS
HALIMETER - HALITOSIS
DIGORA - DIGITAL RADIOGRAPHY
NEWTOM QR-DVT - CBCT

73. ULTRADENT - ULTRASONIC IMAGING
PERIOCHECK - NEUTRAL PROTEINASE
PROGNOSTIK ,BIOLISE - ELASTASE
PERIOGUARD - AST
POCKET WATCH - AST
TOPAS - BACTRIALTOXINS AND PROTEASES
MICRODENTTEST - PCR for Pg,Aa,Tf,Td
My PERIO PATH - RT-PCR
My Perio ID - Genetic susceptibility test
OMNI GENE - NUCLEIC ACID PROBE

84. REFERENCES
• Socransky SS, Haffajee AD, Smith C, Martin L, Haffajee JA, Uzel NG, Goodson JM. Use of checkerboard DNA-
DNA hybridization to study complex microbial ecosystems. Oral Microbiol Immunol 2004;19:352-362
• Periodontology 2000. Vol. 7, 1995
• CHAIRSIDE DIAGNOSTICTEST KITS IN PERIODONTICS - A REVIEW by Sachin Malagi ,IAJD ,Vol 3
• Text book of Carranza's clinical periodontology, Second south Asia Edition
• Kung RT, Ochs B, Goodson JM:Temperature as a periodontal diagnostic. J Clin Periodontol 1990; 17:557
• Host response tests for diagnosing periodontal diseases. J Periodontol 1992; 63:356.

85. Host response tests for diagnosing periodontal diseases. J Periodontol 1992; 63:356.
Description and clinical evaluation of a new computerized periodontal probe-the Florida Probe –
journal of clinical periodontology Volume 15, Issue 2 February 1988 Pages 137–144
Loesche WJ:The identification of bacteria associated with periodontal disease and dental caries by
enzymatic methods. Oral Microbiol Immunol 1986; 1:65.
Comparison of a Conventional ProbeWith Electronic and Manual Pressure Regulated
Probes. Dorothy A. Perry," Edward J.Taggart/ Angela Leung/ and Ernest Newbrurt
J Periodontol 1994; 65:908-913
Fundamentals of periodontics-WILSON and KORMAN
Textbook Of Dental & Maxillofacial Radiology 2nd Edition by Karjodkar

86. THANKYOU