However, the host response factors, such as the immune and inflammatory responses, are critical to the pathogenesis of periodontal disease. 5 Investigations into the pathogenesis of periodontal disease are often based on the role of bacterial infection.
Therefore, uniform criteria have not yet been established in periodontal disease diagnosis.
Even though the trained physician’s eye is a powerful tool, such evaluations are subjective and semiquantitative. Accepted diagnostic practices include intraoral periapical (IOPA) X ray to estimate bone loss and clinical assessments, such as bleeding on probing (BOP) and gingival index (GI), to detect the presence of inflammation. At present, clinical diagnosis of periodontal inflammation is based almost entirely on the visual perception of tissue color and clinical probing. Successful treatment of periodontal diseases depends on accurate diagnosis of sites with periodontal inflammation. Recent studies have revealed the association of periodontal disease with adverse pregnancy outcomes, 1 cardiovascular disease, stroke, pulmonary disease, 2, 3 and diabetes. The American Academy of Periodontology acknowledged recently that the development of enhanced surveillance and prognostic tools is essential for the control of periodontal diseases. Periodontal diseases are infectious diseases that destroy the periodontal attachment apparatus, resulting in the loss of tooth support. The high diagnostic accuracy is utilized to detect underlying inflammation in six patients with a previous history of periodontitis. The DR image ratio values at each site are compared with clinical diagnosis to estimate the specificity and sensitivity of the DR imaging technique in inflammation mapping. The DR image ratio R620/R575 computed for each pixel (8-µm resolution) from the monochrome images is pseudo-color-mapped to identify gingival inflammation sites. An experienced periodontist assesses the level of gingival inflammation at each site through periodontal probing and assigns diagnosis as healthy, mild, moderate, or severe inflammation. A multispectral imaging system is utilized to record narrow-band DR images at 575 and 620 nm from the anterior sextant of the gingivia of 15 healthy volunteers and 25 patients ( N=40 ). Diffuse reflectance (DR) spectra recorded with white light illumination is utilized to detect periodontal inflammation from the oxygenated hemoglobin absorption ratio R620/R575. Since conventional techniques using periodontal probes have inherent drawbacks in the diagnosis of different grades of gingival inflammation, development of noninvasive screening devices becomes significant.
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