The treatment of periodontitis is handicapped by the lack of simple, chairside diagnostic tests capable of differentiating between sites of active disease and sites which exhibit periodontal breakdown but which may currently be quiescent. In addition, many of the common, clinical diagnostic tests (radiographs, clinical examination) require subjective interpretation of data. Studies have shown that different interpretations of the same data can have dramatic effects on decisions which dictate treatment. Proteases in the extracellular matrix have been associated with periodontal disease. Many studies have associated active neutrophil collagenase with tissue destruction and have implicated polymorphonuclear leukocytes as being an important, if not the major, contributor to the acute disease process. Other studies have indicated that specific proteases may determine the outcome of surgical, bone-regenerative procedures. These data indicate that types and amounts of proteases may be an important diagnostic indicator of tissue health. The purpose of this proposal is to obtain initial funding to develop a new, objective diagnostic instrument that will allow simultaneous quantitation of multiple proteases within a single periodontal pocket using chemical fiber optic sensors. Moreover, this pilot study will be used to establish instrumentation which can be used in combination with specific substrates to measure literally hundreds of different compounds simultaneously with the same fiber optic probe. The instrumentation may, in the future, be coupled with technology for enzyme-linked immunosorbance assays (ELISA). This approach could potentially be adapted to use specific antibodies and chemiluminescence to detect and quantitate virtually any compound and compare concentrations of different compounds within the same periodontal pocket. The device could also be used to assay secretions in salivary ducts or from a variety of wounds. The applicability is, therefore, not solely limited to dentistry and the device would be important both for clinical diagnostics and as a research tool.
