Regenerative Periodontal Endoscopy, or RPE, is an advanced non surgical endoscope procedure pioneered and offered by PerioPeak Innovations.  The skilled use of a periodontal endoscope, micro-ultrasonic piezo technology, and regenerative proteins can eliminate the need for aggressive surgery.   When used properly, endoscope technology allows for pinpoint precision and the complete removal of gum infection and tartar in deep pockets without surgery.   Emdogain, a natural regenerative protein,  is then placed in all deep gum pockets to stimulate the body’s own regenerative stem cells, reduce inflammation, inhibit growth of bacteria, aid in the reattachment of the gums, and promote bone fill.  Enzyme inhibitors are used to promote rapid healing and stability of the gums. 

To understand more about the research and science behind this advanced protocol click here.

Watch this procedure on You Tube. 

To view our extensive library of case studies throughout this site: 

Perioscopy Case Studies,   Before and After pictures, Advanced Cases. 

RPE is completed in one appointment with local anesthetic only, there is no need for repetitive visits as with other periodontal treatment modalitites.  There is no pain and no down time following RPE, making it very convenient for our many clients traveling in from out of state.  Our clients do not need to alter their diet and they do not experience root sensitivity following RPE.  Remarkable clinical results are achieved without surgery, including closure of deep gum pockets and bone fill.   RPE is a definitive and affordable first phase treatment option over root planing, periodontal surgery, and extractions.  View our long list of testimonials and request references.

 Before and after pictures and x-rays of actual RPE:

  
Above – Before RPE - 12mm pocket -  advanced bone loss – this patient was advised by his periodontist he needed to have this tooth extracted and an implant placed.  He chose RPE as a less invasive, more affordable option- see result below.

  
3  months after RPE – normal healthy tissue 3mm- bone fill well underway, no mobility, and no need for an extraction and implant.  This tooth was treated in 2006 and is still healthy.  This patient saved thousands of dollars in treatment costs by avoiding an extraction, bone graft,  impant, and crown.

Before RPE – 10mm pocket (x-ray below)             after RPE – 1-2mm (x-ray below)

Before RPE - very advanced bone loss        6 mo’s after RPE – remarkable bone fill

Before RPE-  10mm pocket (x-ray above)                        After RPE – 1mm (x-ray above)

Before RPE  - advanced bone loss                    4 months after – complete bone fill

                          
Before – 10mm pockets tooth#10              15 mo’s after RPE – 3mm- no mobility

The patient above was told she needed to have this tooth extracted and an implant and crown placed.  She was also treatment planned for full mouth osseous periodontal surgery for multiple infections and deep pockets.   Instead, she chose the option of RPE.  She was able to avoid spending $12,000 for the full mouth surgery and the added expense of having an implant placed.  Her total cost for full mouth RPE treatment was only $3000.

     
Before 10mm                                    after 3mm

The above result has been maintained since 2006.

    
Before -  7mm pocket                3 months after RPE- bone filled in

The patient above was facing the loss of her entire bridge due to advanced periodontal bone loss, 3 months after RPE she no longer had to worry.  Health restored to the gums with nice bone fill on the x-ray.

(above) before – 10mm pockets                                (above) 3 months after RPE – 3-4mm

 the patient above was able to avoid extraction of the molar tooth, thus saving the bridge.  She was able to avoid having an implant placed, followed by a new bridge for this area.    

  before RPE – extraction of 18 imminent          1 year after RPE – her dentist sent us this x-ray with nice bone fill

 Before RPE – 10mm (19 & 20)                               1 yr after RPE – bone filled in -health restored

 The case study below demonstrates well the speed at which healing occurs with RPE.

       (above) Before – 8mm                                     2 weeks after RPE – 3mm – x-rays below

Before x-ray #28 mesial                                             8 weeks after RPE - rapid bone fill is evident

Before – painful abscess 7mm                                  2 weeks after – 1mm – health restored

   
 Before – 7mm pockets – tongue stud damage      Bone fill 6 weeks later

Before 11mm pockets                                          bone fill at 6 months

Before – 10mm pocket 19 mesial                                        6 months after, nice bone fill, 4mm.

     Before RPE - 10mm                             3 months after – 3mm (see x-rays below)

     Before RPE                                       6 weeks after - good bone fill occuring

before RPE – 10mm                                               3 months after RPE – 2mm

    Before RPE – 10mm                                                                3 mo’s after RPE – 3mm

Before RPE – 12mm                                                    3 mo’s after RPE – 4mm (see x-rays below)

Before RPE (is tooth fractured?)                   3 mo’s after, slight bone fill – no fracture detected

Before RPE - 10mm                                      6 months after – nice bone fill occuring – 3mm  

Before RPE  – 12mm pocket tooth #11               3 months after - nice  bone fill – 3mm

       
Before RPE – 10mm             7 months after RPE – no mobility – 3mm

The above tooth was treatment planned for extraction by the periodontist.  #31 presented with a 10mm distal defect, a 10mm furcation on the buccal, and mobility.  Only 7 months after RPE, all periodontal probings are normal, there is no mobility, and the tissue is tight and healthy.

The RPE protocol is very specifically designed to arrest the chronic inflammation associated with periodontal disease, allowing long term healing and restoration of the gums to occur.  RPE goes beyond the short term results seen with traditional non surgical treatment stratagies – including the overuse of oral or locally applied antibiotics, and/or traditional laser periodontal therapy.   View more case pictures.

One third of the population has a genetic tendancy to develop periodontal disease, one half of those individuals will develop advanced periodontal disease, resulting in tooth loss.  RPE can effectively interrupt and reverse this grim outcome for millions of individuals. 

While no formal research yet exists on this innovative approach, there is impressive research on each technology studied independantly, demonstrating efficacy in the treatment of periodontal disease.  Pairing these technologies properly promotes “synergy” – the phenomenon in which the combined action of two or more things is greater than the sum of their effects individually.  Because periodontal disease is multifactoral, it can typically be more effectively treated using a synergistic approach.

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For more information about sub-antimicrobial dose doxycyline go to host modulated therapy.

For more information about  regenerative proteins (Emdogain) go to http://periopeak.com/blog/category/bone-regeneration/