Feature Of The Week 3/21/10: An Update on Novel Non-Invasive Approaches for Periodontal Diagnosis
Feature Of The Week 3/21/10: Periodontitis is currently diagnosed almost entirely on the basis of its clinical manifestations: signs of gingival inflammation (e.g., redness and swelling), probing depth (PD), and level of periodontal attachment or amount of alveolar bone loss. In fact, alveolar bone and periodontal attachment loss represent the results of the destructive aspects of the host defense mechanisms responding to opportunistic infections by bacteria present in the gingival sulcus as well as the direct effects of virulence factors of periodontal pathogens. Alveolar bone and periodontal attachment loss cannot be used to predict the susceptibility to future disease progression or to dictate appropriate treatment plans. Therefore, the drawback of traditionally used diagnostic procedures (clinical signs) is that they cannot reliably identify susceptible individuals or distinguish between disease-active and -inactive sites.
The search for clinically acceptable methods for the accurate, non-invasive diagnosis and prognosis of periodontitis continues. The newly emerging diagnostic approaches, namely, infrared spectroscopy, optical coherence tomography (OCT), and ultrasound are particularly attractive to dental community as these methods are non-invasive, do not impose any discomforts to the patients during the procedure, and require no tissue to be extracted. OCT uses broadband low-coherent NIR light that provide considerable penetration into tissue with no known detrimental biologic effects to create high-resolution cross-sectional images of biologic structures.
Researchers from the National Research Council in Canada show here preliminary data showed that OCT imaging can offer three-dimensional imaging of periodontal soft tissues and bone at an exquisitely high resolution. Because OCT reveals microstructural details of the periodontal soft tissues, it offers the potential for identifying active periodontitis before significant alveolar bone loss occurs. OCT may prove to be a more reproducible and reliable method of determining attachment level than traditional probing methods.