Diagnostic testing as a supportive measure of treatment strategy

The bacteriological tests in periodontology have been available to clinicians since the end of the 1980s. Despite the vast and varied information that they contribute to the literature on this topic, some controversy has arisen with regard to the use of these tests. Clinicians faced with a multitude of clinical forms of periodontal disease in their patients can count on laboratory examinations to help them in the therapeutic process. These biological examinations can offer help in five areas of application: support in diagnosis and prognosis, verification of the efficiency of the treatment, indication of the correct antibiotic therapy and choice of the most appropriate molecules. The clinician's needs determine the type of bacteriological technical analysis used: bacterial culture or genetic identification using the molecular techniques. Each technique has its advantages and disadvantages. Knowing these limits allows the most appropriate choice to be made, depending on the clinical situation. The richness of information provided by culture in the antimicrobial susceptibility test and the non-targeted aspect of this test make this technique very interesting for the diagnosis of periodontitis. However, the targeted aspect of molecular techniques (PCR), their excellent sensibility and their rapidity make them prevail, particularly in the control and maintenance phases. Furthermore, despite the constant development of bacterial identification techniques, these examinations are little used by dental surgeons as these examinations are little known. They are also difficult to interpret and generate heavy additional costs.