Methods for diagnosis of periodontal diseases

Chemistry: analytical and immunological testing – Involving diffusion or migration of antigen or antibody

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436 63, 436811, 435 11, 435 71, 435 792, 435 793, 435 794, 435 795, 435 23, A01N 102, C12Q 137, G01N 3348

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active

058664327

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BRIEF SUMMARY
THE FIELD OF THE INVENTION

The present invention relates to methods for rapid, reliable, specific and sensitive chair-side diagnosis of different forms of periodontal diseases as well as peri-implantitis and HIV(+)-associated periodontal diseases and especially for predicting the risks for progression of said diseases by using test kits with which neutrophil gelatinase-associated lipocalin (NGAL) can be measured.


THE BACKGROUND OF THE INVENTION

The traditional method for determining the progression of periodontitis is to assess the degree of damage which has occurred to the periodontal tissues over a given period of time by probing. Unfortunately, as a measurement technique, periodontal probing has several sources of error which make it inexact.
Radiographs have long been used to assess the level and loss of alveolar bone around teeth. However, it is impossible to visually detect minor changes in bone. Hence, the amount of bone destruction/loss tends to be underestimated when radiographs are read in a routine fashion.
In the past decade there has been increased interest in developing, testing and refining diagnostic aids for the early detection of the presence and progression of periodontitis. It is evident that any diagnostic and/or prognostic test for progressing periodontal lesions should provide information that offers some advantage over the conventional indicators of disease.
Data from epidermiological studies have confirmed that periodontal diseases are multifactorial in nature (Armitage, G. C., CDA Journal 36: 35-41, 1993). This data indicates that periodontal diseases are caused by an infection with one or more of a handful of periodontopathogenic microbes. These organisms include Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Bacteroides forsythus (Bf), Actinobacillus actinomycetemcomitans (Aa), Campylobacter rectus, Fusobacterium nucleatum and spirochetes.
Much work, without giving definitive and clear resolution, has been done to determine the specific groups of subgingival microorganisms which are most strongly associated with progressing lesions (Armitage, G. C., CDA Journal 36: 35-41, 1993). The target microorganisms have been assessed by enzyme tests, culture analysis, microscopic analysis and DNA-probes.
Gingival crevicular fluid (GCF) is an inflammatory exudate that flows into the oral cavity from periodontal pockets. It contains subgingival bacteria, inflammatory cells and a lot of different substances produced by bacteria as well as host cells present. It is an inflammatory exudate with several inflammatory reactions occuring in the adjacent periodontal tissues (Birkedal-Hansen, H., J. Periodontol. 64: 474-484, 1993). In clinical practice, GCF is easy to collect by placing filter paper strips at the pocket orifice. These features have made GCF an attractive source of potential markers for the progression of periodontitis. These markers include: 1) products associated with tissue remodeling and breakdown, 2) inflammatory mediators and 3) host cell-derived enzymes (Birkedal-Hansen, H., J. Periodontol. 64: 474-484. 1993).
One of the major features of periodontitis is the destruction of connective tissue and bone. Abundant amounts of tissue breakdown products from these tissues are released during the periodontal disease process. In cross-sectional studies, GCF collected from sites with periodontitis have been shown to contain elevated levels of hydroxyproline from e.g. collagen degradation (Talonpoika, I., Changes in the composition of gingival crevicular fluid after periodontal treatment, Thesis, Ann. Univ. Turku 142, 1994). However, longitudinal studies have not been done to determine if the presence of these substances is strongly associated with progressive lesions. It is not yet known if these products are associated with the actual periodontal tissue destruction or remodeling.
Many different inflammatory mediators are produced by periodontal tissues affected by gingivitis and periodontitis. Some of these mediators appear to play a central role in the destructive proce

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Periocheck information package.

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