Periodontics Diagnosis Short And Long Essay Question And Answers

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Diagnosis Important Notes

1. Radiographs

  • They reveal only about the amount of bone present
  • Do not give any information about the morphology of bone defects and the number of walls involved
  • Do not reveal the presence of pockets or soft tissue lesions

2. DNA probe

  • It identifies the species-specific sequences of nucleic acids that make up DNA
  • Helps in the identification of organisms

3. Dark field microscopy

  • It is used as an alternative to cultural methods
  • It has the ability to assess directly and rapidly the morphology and motility of bacteria in a plaque sample

Read And Learn More: Periodontics Question and Answers

Diagnosis Long Essays

Question 1. Define diagnosis. Describe microbiological in-investigations used. Add a note on the limitations of radiographs in periodontal diseases.
Answer:

Diagnosis Definition:

  • Diagnosis may be defined as identifying a disease from an evaluation of the history, signs and symptoms, laboratory tests, and procedures

Microbiological Investigations:

1. Direct microscopy

  • Specimens are viewed directly under a light
    1. Light microscopy
      • Gram staining is done to differentiate Gram-positive and Gram-negative organisms
    2. Darkfield microscopy
      • Fresh, unstained samples are examined by it

Periodontics Diagnosis

2. Culture methods:

  • Used for cultivation and identification of organisms
  • It determines its susceptibility or resistance to various antimicrobial agents

Specimens Obtained:

  • Blood samples
  • Mucosal surfaces
  • Periodontal pockets

Sampling Methods:

  • Nickel-plated curettes
  • Scalers
  • Paper points
  • Irrigation
  • Surgical excision

Types Of Media:

1. Supportive media:

  • Allows growth of only specific organisms

2. Enriched media:

  • Encourages the growth of organisms

3. Nonselective media:

  • Permits growth of most oral micro-organisms

4. Selective media:

  • Contains dyes, antibiotics that are inhibitory to specific organisms

Culture Techniques:

  • Jar technique
  • Pre-reduced anaerobically sterilized roll tubes
  • Anaerobic chamber techniques
  • Enzyme reduction technique

Speciation Techniques:

1. Gas-liquid chromatography

  • In it, various metabolic products of anaerobes are studied

2. DNA probes:

  • Identifies periodontal pathogens

Limitations Of Radiograph In Periodontics:

  • 30-60% of the mineral content of the bone must be lost to visualize the change
  • Lacks sensitivity
  • Actual damage is more extensive
  • It is a two-dimensional view of a three-dimensional object
  • It does not reveal current cellular activity
  • Reflects effects of past cellular experience on bone and roots

Diagnosis Short Essays

Question1. Importance of radiographs in periodontal diseases
Answer:

  • Importance Of Radiograph In Periodontics:
  • Estimates severity
  • Determines prognosis
  • Evaluates treatment outcomes
  • Demonstrates changes in calcified tissues
  • Shows visual image of bone support around tooth or implant
  • It detects
    • Periodontal bone level
    • The pattern of bone destruction
    • PDL space width
    • Radiodensity
    • Trabecular pattern
    • The marginal contour of interdental bone
  • Compares pretreatment and post-treatment results

Radiographic Features Of Periodontal Diseases:

1. Periodontitis:

  • Disruption of lamina dura
  • Widening of PDL space
  • Reduced height of interdental bone

2. Interdental craters:

  • Seen as irregular areas of reduced density

3. Furcation involvement:

  • Widening of PDL space

4. Periodontal abscess:

  • The extent of bone destruction is seen
  • Detects morphological changes in bone

5. Localized aggressive periodontitis:

  • Vertical arc-like bone destruction

6. Trauma from occlusion:

  • Thickening of lamina dura
  • Morphological changes of the alveolar crest
  • Widening of PDL space
  • Change in the density of surrounding cancellous bone

Diagnosis Short Question and Answers

Question 1. Methods of probing.
Answer:

1. Walking probing method:

  • In it, the probe is inserted at the distalmost surface of the tooth and walked or stepped towards the mesial surface. of the tooth at a 1 mm distance without taking out the probe completely from the gingival sulcus
  • Measurement is recorded at each millimeter

2. Transgingival probing:

Transgingival Probing Uses:

  • To detect alveolar bone loss
  • Confirms the extent and configuration of the infrabony component of the pocket and the furcation defects

Transgingival Probing Method:

  • Before flap reflection locally anesthetize the area
  • Next probe is walked along the tissue tooth interface

Question 2. Subtraction radiography.
Answer:

  • Subtraction radiography relies on the conversion of serial radiographs into digital images
  • These images are then superimposed and the composite is viewed on a video screen
  • Changes in bone density and volume can be seen
  • Bone gain is seen as lighter areas and bone loss as darker areas
  • Computer-assisted subtraction radiography helps in detecting changes from baseline images
  • Subtraction Radiography helps in the detection of minor changes in the bone by removing the unchanged anatomic structures from the image
  • Subtraction Radiography increases the sensitivity

Question 3. Periotemp.
Answer:

  • Periotemp are thermal probes used to measure early in-inflammatory changes in gingival tissues
  • Periotemp enables calculation of the temperature differential between the probed pocket and subgingival temperature
  • Periotemp allows consideration of differences in core temperature between individuals
  • Individual temperature differences are compared with those expected for each tooth and higher temperature pockets are signaled with a red-emitting diode

Question 4. Identification of furcation involvement.
Answer:

  • Naber’s probe is used to assess the furcation involvement clinically
  • If the pocket depth is >5 mm, there are more chances of furcation involvement
  • The probe is inserted parallel to the long axis of the tooth at the mid-buccal surface of the tooth and approximately 5 mm from the CEJ
  • It is angulated to find out the possible bone loss in the furcation area
  • If there is minimal bone loss, furcation can be felt like a groove between

Question 5. Enumerate the criteria for the ideal probe
Answer:

  • The precision of 0.1 mm
  • Range of 10 mm
  • Constant and standardized probing force
  • Non-invasive, lightweight, and easy to use
  • Easy to access any location around all teeth
  • A guidance system to ensure proper angulation
  • Complete sterilization of all portions entering the mouth
  • No biohazard from material
  • Direct electronic reading and digital output

Diagnosis Viva Voce

  1. Computer-assisted densitometer image analysis system offers an objective method for following alveolar bone density changes quantitatively
  2. Transgingival probing and visual examination by sur- gical exposure are definitive ways of knowing bone morphology
  3. Definitive diagnosis of furcation involvement, pocket depth, and periodontal abscess is made by clinical examination only
  4. In subtraction radiographs, the lighter areas indicate bone gain
  5. The disadvantage of subtraction radiography is it re- quires an identical projection in serial radiographs
  6. Periotemp probe is used to measure subgingival temperature
  7. Florida probe is an automated probe for recording pocket depth
  8. The diameter of the Florida probe tip is 0.4 mm
  9. Foster-Miller probe detects CEJ
  10. The bacterial culture technique is used to assess the antibiotic susceptibility of the microbes
  11. Evalusite is chairside membrane immunoassay
  12. Periotron is used to measure gingival crevicular fluid volume
  13. Periogard is a chairside test kit for aspartate aminotransferase
  14. Periocheck is a chairside test kit to detect neutral pro-tease in GCF

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