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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
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4. Diagnosed by the clinical
evaluation of signs of
inflammation with or
without periodontal tissue
destruction.
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5. PERIODONTITIS – MEASURED
BY:
A. Loss of
connective tissue
attachment.
B Loss of
radiographic
bone loss.
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6. Provides info on the past
periodontal destruction, its
extent and severity
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7. BUT DOES NOT PROVIDE INFO
ON :
Patient’s susceptibility
Disease progression/
remission
Positive/ negative -
response to therapy
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9. STUDIES SAY that gingival
bleeding is a sensitive clinical
indicator of early gingival
inflammation !!
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10. It is also a good indicator of
the presence of
inflammatory lesion in the
connective tissue at the base
of the sulcus.
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11. SEVERITY OF THE BLEEDING
increases with an increase in
the size of inflammatory
infiltrate.
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12. RELATION to disease progression
is unclear. healthy sites may also
evoke bleeding on probing. So
the use of gingival bleeding
cannot be totally depended upon.
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13. INSTRUMENTS to measure
gingival temp has been
developed.
THERMAL PROBES – measure
early inflammatory changes in
the gingival tissues.
EG : PERIOTEMP PROBE
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14. IN PERIODONTITIS, widely used
diagnostic tool is the
“periodontal probe” since increased
probing depth and loss of clinical
attachment are exclusive for this
disease.
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16. But use of periodontal
probes presents many
problems in terms of
sensitivity and
reproducibility of
measurements.
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17. THE DISPARITY BETWEEN
MEASUREMENTS
Depends on probing technique
probing force
size of the probe
angle of insertion
precision of probe calibration.
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18. THE MAIN PROB IN REPRODUCIBILITY
variation in probing force.
studies show - forces upto 50g is
necessary for detecting periodontal
osseous defects!
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19. NIDCR CRITERIA –
FLORIDA PROBE SYSTEM –
consists of a probe hand piece, digital
read out, foot switch, computer
interface and computer. tip is 0.4mm
in diameter.
Data is then transferred to the
computer .
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21. Electronic probing systems-
Interprobe system or Peri probe
system available.
Other electronic probes -Foster
miller probe, Toronto automated
probe, but not released yet.
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23. For detecting destruction of
Alveolar bone, Dental x-rays are most
commonly used since they provide
valuable info on interproximal bone
loss.
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24. More than 30% of the bone mass
at the alveolar crest should be
lost for a change in bone height
to be seen in dental radiographs.
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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.
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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.
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28. COMPUTER – ASSISTED
DENSITOMETRIC IMAGE
ANALYSIS SYSTEM – a video
camera measures the light
transmitted through a radiograph,
signals from the camera
converted into gray scale images.
camera is fixed to an image
processor and a computer
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30. MICROBIAL TESTS -
can also be used to monitor
periodontal therapy directed at
the suppression or eradication of
periodontopathic microorganisms
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31. BACTERIAL CULTURING
methods are used to detect
the specific pathogens
present in plaque, by using
selective & non selective
media.
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32. DISADV Of the above method-
strict sampling & transport
conditions essential. Putative
pathogens like Treponema
species & B. forsythes are
fastidious & difficult to
culture.
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34. DARK FIELD OR PHASE CONTRAST
MICROSCOPY –
alternative method.
Directly and rapidly
assesses motility and
morphology of bacteria in
a plaque sample.
NON MOTILE ORGANISMS CANNOT BE
IDENTIFIED BY THIS METHOD.
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37. IMMUNOLOGIC ASSAY –
employs antibodies which
recognizes specific
bacterial antigens to
detect target micro
organisms. E.g.:
Direct/Indirect IFA, ELISA,
Membrane Assay, and
Latex Agglutination.
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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.
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39. OTHER DIAGNOSTIC ADVANCED AIDS
ARE
Nucleic acid probes,
Restriction Endonuclease
Analysis and Polymerase
Chain Reaction.
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40. ASSESSMENT OF THE HOST
RESPONSE –
study of mediators, by
immunologic or biochemical
methods. Mediators are either
specifically identified with the
infection or represent a less
specific reaction
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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.
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42. MORE THAN 40 COMPONENTS OF GCF
HAS BEEN STUDIED WHICH CAN BE
DIVIDED INTO 3 GROUPS –
host derived enzymes
inflammatory mediators
tissue breakdown products
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43. SAMPLE COLLECTION
GCF-
Method commonly used- Paper
strips.
Strips are placed in the sulcus for
a standard period of time until
the paper gets saturated
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44. Fluid volume collected can be
quantified by using Periotron.
This device measures the change
in capacitance across the strip
and this change is converted to a
digital read out.
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