Optimization of periodontal disease diagnosis by the results of clinical laboratory tests

Abstract

Relevance. The authors have established that the microbiological and local risk factors prevail in changing the clinical condition of the periodontium. Aim – сlinical and diagnosis argumentation of the gingival tissue condition according to the criteria of the New International Classification of Periodontal and Peri-implant Diseases and Conditions and Proceedings of the 2017 World Workshop jointly held together by the American Association of Periodontology (AAP) and the European Federation of Periodontology (EFP).

Materials and methods. Clinical and laboratory assessment of 105 young patients was conducted. Three patient groups were formed according to the detected risk factor and according to the data of the New International Classification of Periodontal and Peri-implant Diseases and Conditions. The main group consisted of 70 (66.6%) patients with diagnosed chronic plaque-induced gingivitis (33.3%) and initial periodontitis (33.3%) (mild chronic periodontitis). The control group comprised 35 patients with clinically healthy gingiva on an intact periodontium (71.1%) and reduced periodontium (22.9%). Periodontal pathogens as a risk factor were assessed by PCR using DNA-express commercial sets (Liteh, LLC, scientific manufacturing company, Russia). Cytology of the gingival crevicular fluid impression smears stained by Romanovsky-Giemsa method was performed.

Results. Changes in the hygiene and periodontal indices were revealed on full dental examination. PCR detected low or critical number of periodontal pathogens in the studied samples. Neutrophilic leukocytes, histiocytes and epithelial cells were present in the impression smears, polymorphonyclear neutrophils significantly increased and macrophages, histiocytes, epithelial cells appeared; macrophages decreased.

Conclusion. Full dental examination and laboratory tests revealed the following clinical conditions: clinically healthy gingiva on an intact periodontium, clinically healthy gingiva on a reduced periodontium, plaque-induced gingivitis, stage I periodontitis – initial periodontitis, which corresponded to the New International Classification of Periodontal and Peri-Implant Diseases and Conditions and Proceedings of the 2017 World Workshop held by the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP).