Test - Page One
BANA as accurate as DNA testing for periodontal pathogens
Loesche WJ. Lopatin DE. Giordano J. Alcoforado G. Hujoel P. Department of Biological and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor 48109-1078 Journal of Clinical Microbiology. 30(2):427-33, 1992 Feb.
Comparison of the benzoyl-DL-arginine-naphthylamide (BANA) test, DNA probes, and immunological reagents for ability to detect anaerobic periodontal infections due to Porphyromonas gingivalis, Treponema denticola, and Bacteroides forsythus.
Most forms of periodontal disease are associated with the presence or overgrowth of anaerobic species that could include Treponema denticola, Porphyromonas gingivalis, and Bacteroides forsythus among others. These three organisms are among the few cultivable plaque species that can hydrolyze the synthetic trypsin substrate benzoyl-DL-arginine-naphthylamide (BANA). In turn, BANAhydrolysis by the plaque can be associated with periodontal morbidity and with the presence of these three BANA-positive organisms in the plaque. In this investigation, the results of the BANA test, which simultaneously detects one or more of these organisms, were compared with the detection of these organisms by (i) highly specific antibodies to P. gingivalis, T. denticola, and B. forsythus; (ii) whole genomic DNA probes to P. gingivalis and T. denticola; and (iii) culturing or microscopic procedures. The BANA test, the DNA probes, and an enzyme-linked immunosorbent assay or an indirect immunofluorescence assay procedure exhibited high sensitivities, i.e., 90-96%, and high accuracies, Le., 83-92%, in their ability to detect combinations of these organisms in over 200 subgingival plaque samples taken from the most periodontally diseased sites in 67 patients. This indicated that if P. gingivalis, T. denticola, and B. forsythus are appropriate marker organisms for an anaerobic periodontal infection, then the three detection methods are equally accurate in their ability to diagnose this infection. The same statement could not be made for the culturing approach, where accuracies of 50 to 62% were observed.
During his years of practice, Dr. Nara offered a 'Saliva Test' which tested for the presence and levels of lacto bacillus and strep mutans - indicators of risk for dental caries (causing decay above the gumline). The test being offered today by OraMedia is called the BANA test. 'Saliva Test' would actually be a misnomer, since we are taking plaque sample rather than saliva samples.
The BANA test reveals the presence and general levels for bacteria indicated as risk factors for periodontal disease. This test can be done in the privacy of the home and results are available in 24 hours, without having to mail the kit to a lab - much quicker than the old 'Saliva Test'.
What the test is and how it works:
The test kit includes 2 enzyme-coated 5" strips. One strip is used initially, and one after 30-60 days. Each strip acommodates tests for two areas of the mouth. A package of interdental cleaners are provided and you simply move one of the cleaners in between the tooth and gum, gathering a plaque sample, smear it on the strip and wait 24 hours. Presence and levels of bacteria are indicated within 24 hours.
When you purchase a test kit, you have the ability to get a basic 'before and after' picture of bacterial activity in YOUR mouth. A protocol is provided to set up a proper hygiene routine to begin after taking the first test. After the 30-45 days, use the second set of strips to measure your success. You should either have no, or much lowered bacterial activity, thereby lowering your risk of periodontal disease. The hygiene protocol also deals with the lacto bacillus and strep mutans, thereby providing the additional benefit of lowering your risk for dental caries (cavities) in the process.
While this test is not as detailed and conclusive as a more scientific and expensive test done in the offices of the general dentist or periodontist, it provides inexpensive, worthy results and gives a much better picture of activity over waiting for severe symptoms such as pain and bleeding gums to appear.
In addition, the expense of treatment such as planing, scaling or gum surgery is greatly offset by early BANA testing and hygiene protocol - saving possibly many thousands of dollars (and your teeth!) over a lifetime.
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