From manual periodontal probing to digital 3‐D imaging to endoscopic capillaroscopy: Recent advances in periodontal disease diagnosis

Abstract

Deepened periodontal pockets exert a significant pathological burden on the host and its immune system, particularly in a patient with generalized moderate to severe periodontitis. This burden is extensive and longitudinal, occurring over decades of disease development. Considerable diagnostic and prognostic successes in this regard have come from efforts to measure the depths of the pockets and their contents, including level of inflammatory mediators, cellular exudates and microbes; however, the current standard of care for measuring these pockets, periodontal probing, is an analog technology in a digital age. Measurements obtained by probing are variable, operator dependent and influenced by site-specific factors. Despite these limitations, manual probing is still the standard of care for periodontal diagnostics globally. However, it is becoming increasingly clear that this technology needs to be updated to be compatible with the digital technologies currently being used to image other orofacial structures, such as maxillary sinuses, alveolar bone, nerve foramina and endodontic canals in 3 dimensions. This review aims to summarize the existing technology, as well as new imaging strategies that could be utilized for accurate evaluation of periodontal pocket dimensions.

Magnetic resonance imaging as a diagnostic tool for periodontal disease: A prospective study with correlation to standard clinical findings—Is there added value?

“…The diagnosis of periodontitis is so far based on clinical and radiographic findings, that is pocket depth, clinical bone loss or radiographic bone loss (Elashiry et al, 2019). The strategy and the success of periodontal treatment is inevitably bound to the individual severity of the disease, that is the loss of periodontal attachment (Pretzl et al, 2019; Sanz‐Sanchez et al, 2020).…”

Periodontal evaluation using a non-invasive imaging method (ultrasonography)

“…The missing link, a soft tissue 3D scanner Motivation: The current standard of care for measuring periodontal pockets is periodontal probing, an analogue technology in a digital age [34]. For intraoral scanners it can be difficult to detect deep margin lines in prepared teeth and/or in case of bleeding [35].…”

Melatonin and Hyaluronic Acid in Periodontal Disease

“…Periodontal disease is considered a multifactorial inflammatory condition, caused by the interaction between oral bacteria organized in complex communities that form biofilms [1], adhering to the dental structures and infecting the tooth supporting tissues, and the local host defense response [2]. Consequently, the junctional epithelium migrates apically with the destruction of connective tissue collagen fibers attachment and alveolar bone loss.…”