Advanced Chairside Diagnostic Aids for Periodontal Diagnosis- A Review

Abstract

Periodontitis is an infection driven inflammatory disease caused by dental plaque accumulation that in turn causes microbial alterations which may lead to drastic consequences in the periodontium in susceptible individuals. Hence, the rationale of periodontal therapy is predominantly focused on the elimination or reduction of these periodontal pathogens. Despite following a wide range of preventive measures, controlling periodontal disease is challenging and treatment is usually initiated mostly after lesions become clinically detectable and tissues undergo irreversible damage. Microbiological diagnostic tests aid in the early detection of these lesions when they are still reversible giving an opportunity for non-invasive treatment. Microscopy, bacterial culture, immunological assays like Evalusite, Fluorescent In-Situ Hybridisation (FISH), Oraquick, enzymatic assays like Perioscan, Periogard, Pocketwatch, Periocheck, Matrix Metalloproteinase (MMP) dipstick test, Biolise, and molecular biology techniques like Polymerase Chain Reactions (PCR), Terminal Restriction Fragment Length Polymorphism (T-RFLP), 454 Pyrosequencing, Supported Oligonucleode Ligation and Detection (SOLiD) have been among the techniques employed. Some of these diagnostic aids were solely for scientific purposes, while others were adapted and updated for therapeutic use. The current paper focuses on the practical utility of the rapidly expanding plethora of microbiological diagnostic aids highlighting the concerns surrounding their applications in periodontal diagnosis.