Abstract
The performance of clinicians undertaking periodontal assessment or periodontal therapy can be improved by using optical methods as adjuncts to visual inspection and periodontal probing. Subtle changes that occur over time in periodontal tissues that are below the detection limit of visual examination or periodontal probing can be found and tracked accurately over time using 3D imaging, fluorescence spectroscopy, and optical coherence tomography. During debridement of teeth and dental implants, the effective removal of subgingival microbial biofilms and dental calculus deposits can be enhanced using magnifying loupes and operating microscopes and by novel methods based on the interactions of light with bacterial deposits, such as differential reflectometry and light-induced fluorescence. While such techniques can also be used using initial case assessment, their primary purpose is for checking debridement procedures, since the point when bacterial deposits are no longer present represents an endpoint for treatment. The concept of real-time feedback has been developed, using fluorescence readings to control the removal of deposits. Overall, optical methods can support traditional periodontal diagnosis and improve treatment planning and clinical periodontal care.
Highlights
The standard approaches that are used in periodontal diagnosis are less than perfect in terms of their clinical performance
Differential reflectometry is more accurate than tactile assessment for assessing deposits of subgingival calculus on the root surfaces of teeth than a periodontal probe [46]
As a means to detect subgingival deposits of calculus remaining after debridement, laserinduced fluorescence (LF) seems ideal, since it can provide a numerical assessment of the volume of the remaining deposits in real time, using an optical probe that is similar in shape to a periodontal probe
Summary
The standard approaches that are used in periodontal diagnosis are less than perfect in terms of their clinical performance. Tactile assessment of periodontal soft tissues and root surfaces using periodontal probes of various types provides useful information, but the results are influenced by the design of the probe, the probing force applied, and the extent of inflammation in the tissue
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