Periodontal Infection Management by Risk Assessment - PIMBRA
The acronym PIMBRA stands for Periodontal Infection Management by Risk Assessment. PIMBRA is a method for assessing an individual’s risk for periodontal disease and making treatment and restorative decisions based on that information.
In medicine, for example, a similar assessment is used when evaluating an individual’s risk for heart disease. During a physical examination, a physician will evaluate your vital signs clinically such as blood pressure and pulse. As well, an interview regarding diet and exercise and family history is performed. From this information along with past medical history the physician and the patient can decide on the appropriate treatment based on this evidence.
In dentistry, this approach to manage risk for periodontal disease is similar. The dentist performs a physical examination of your mouth, takes measurements of gum heights, and checks for signs of bleeding, infection or inflammation. The dentist reviews the medical history, evaluates effects of any medications that may be involved and asks about the family history for early tooth loss due to periodontal disease. Screening the patient for habits such as smoking, bruxism, and alcohol or drug use is performed. Dental x-rays are taken to check bone levels and for the presence of tartar hidden under the gum tissue.
Family history –Genetics - play an important role in whether or not one is at increased risk for periodontal disease. Genetic screening for that risk is an important part of an individual’s strategy for managing their health. Genetic testing
tells an individual how their immune system responds to infection. A PIMBRA-1 test is completed.
In the presence of a periodontal infection, identifying the periodontal pathogens involved is an important part of an individual’s strategy for managing and treating the periodontal disease successfully. A PIMBRA-2 test is completed before and after therapy.
The dentist together with the patient can make treatment recommendations based on this strategic Information Rx. High risk patients may want to employ more aggressive protocols in treating an infection or managing their periodontal health with more frequent visits and consideration of therapies such as systemic antibiotics. Together, both dentist and patient armed with this information will be less likely to fail in their treatment and disease intervention therapy.
Many dental journals have been dedicated to the subject of periodontal disease, the role inflammation plays and managing periodontal infections successfully through testing.
Journal Links
Inflammation and Factors That May Regulate Inflammatory Response Thomas E. Van Dyke, Kenneth S. Kornman
Journal of Periodontology Online publication date: July 2, 2008: 1503-1507.
Rethinking Periodontal Inflammation
Steven Offenbacher, Silvana P. Barros, James D. Beck
Journal of Periodontology August 2008, Vol. 79, No. 8s: 1577-1584.
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PIMBRA-1 Test Kit
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PIMBRA-2 Test Kit
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