Diagnosis is made on the basis of the clinical picture by history and dental examination.
2nd order laboratory parameters – depending on the results of the history, physical examination, etc. – for differential diagnostic clarification.
- Pathogen detection – detection of periodontitis marker germs (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Bacteriodes forsythus, Treponema denticola).
- CRP (C-reactive protein), tumor necrosis factor-α and interleukin-6.
- Matrix metalloproteinase-8 (MMP-8) – used to predict, in combination with clinical parameters and subgingival microbiological analysis, whether periodontitis is stable or progressive.
Bacterial diagnostics
- Microbiological analysis (analysis of subgingival bacterial colonization): bacterial cultures, morphology of microflora, Gram classification.
- Gene probes for bacterial determination
- PCR reaction (polymerase chain reaction; molecular biological method for determining periodontal pathogenic microorganisms).
- Periotron meter – examination of the sulcular fluid or determination of the sulcular flow rate.
Immunological examinations
- Immunofluorescence microscopy
- Enzyme-linked immunosorbent assay (ELISA test).
- Enzyme test
- Latex agglutination test
- Antibody detection in blood
Molecular genetic testing
- Genetic markers (see below: DNA probe tests for periodontitis risk; interleukin-1 gene test).