iDentistry The Journal identistry_may_aug2019 | Page 6

The Journal
considered to be diseased with a colour and
bleeding score of 1 or more and radiographic
evidence of bone loss. The three healthy sites
selected for each subject had pockets <3 mm, a
colour and bleeding score of 0, and no
radiographic evidence of bone loss. Clinical
measurements were done and the diagnostic
tests were carried out at the 8 sites in the
following order: (1) probing depth (2) plaque
index (3) Periocheck diagnostic test (crevicular
fluid sample) (4) Perioscan diagnostic test
(plaque sample) (5) colour index (6) probing
attachment level (7) Bleeding index.
The initial treatment involved four visits to
dentist for oral prophylaxis like scaling,
polishing and root planing over a 4-6 week
period followed by repetition of the clinical
variables and diagnostic tests.
Colour and plaque indices
Colour index from the gingival index (Loe &
Silness 1963) was modified and was taken as; l-
slight erythema, 2- moderate erythema, 3-
marked erythema, 4-cyanosed. During
recording of the plaque score, supragingival
plaque was removed from the tooth surface with
a periodontal probe using the plaque index of
Silness & Loe (1964). Prior to the collection of
gingival crevicular fluid samples this was an
essential requirement to prevent contamination
(Griffiths et al, 1992). The residuum was
carefully removed with a sickle scaler tip which
is kept slightly above the gingival margin, in an
effort to minimise the stimulation of crevicular
fluid flow.
Diagnostic tests
Each site to be dried and isolated when
Periocheck test kit is used. At the entrance of
the gingival crevice to a depth of 1 mm, filter
paper strips were then placed. The strips were
left for 30 seconds and then incubated at 43°C
for 12 min. The amount of dye absorbed by the
filter paper strip was compared to a colour chart
6
which is provided by the kit. According to the
manufacturer's recommended procedure,
Perioscan test kit procedure was performed. To
collect subgingival plaque sample, a sterile
curette was used which was transferred to the
surface of a BANA containing strip mounted on
a plastic card. A parallel strip which contains
Evans black dye moistened with distilled water
and the card folded so that the two strips were in
contact. At 55°C for 15 min, card was then
incubated.
The card was unfolded and
examined for the presence (positive) or
absence (negative) of a blue colour on the dye
containing strip after incubation.
Periodontal examination
The interproximal probing depth was measured
with the help of UNC-15 periodontal probe.
Probing attachment level was measured to the
nearest millimetre by using an appropriate fixed
reference point on the tooth like
cementoenamel
junction (if visible) or a
restoration margin
Periocheck baseline results (n-221) compared
with clinical judgement expressed as
Sensitivity 161/185=87%. Specificity 23/40 =
58%. Ruined tests -3.
Perioscan baseline results (n-217) compared
with clinical judgement expressed
Sensitivity 175/180=97%. Specificity 20/37=
54%. Ruined tests =7
The bleeding index by Saxer & Muhleman
(1975) was taken as:
0-
no bleeding; l-pinpoint bleeding; 2-rapid
bleeding; 3-spontaneous bleeding without
probing.
Vol. 15
No. 2
May-Aug 2019