Perioscopy - How Does Perioscopy Work?
Perioscopy is only one part of the synergistic RPE - Regenerative Periodontal Endoscopy - protocol, but is crucial to excellent overall results for many reasons. Perioscopy is a non-invasive way to view and clean root surfaces without surgery using micro-diamond ultrasonic tips. The dental endoscope fiber optic is less than 1mm in diameter and incorporates tremendously powerful illumination and magnification. It is essentially like using a miniature microscope under the gums. The image is viewed live on a high resolution flat panel color monitor. It takes a great deal of skill and experience to perform perioscopy with proficiency. It also requires the proper pairing of technologies to achieve consistently great results.
Early perioscopy research revealed clinical results never before thought possible. The ability to treat all stages of periodontal disease without surgery was a tremendous breakthrough. The early research and numerous publications can be reviewed at www.perioscopyinc.com. However, this early research was only the beginning…at PerioPeak Innovations, regenerative periodontal techniques aimed at ensuring long term results has been our mission for nearly a decade, taking perioscopy to a much higher level with RPE - Regenerative Periodontal Endoscopy.
Why may perioscopy yield better results clinically than root planing, laser periodontal therapy, or flap/osseous gum surgery? It’s simple. None of these procedures employ the use of a sub-gingival microscope (dental endoscope). Perioscopy is highly definitive and effective when used properly. The following post will help clarify this concept.
Below are four still endoscopic pictures viewing the area between the root and gums (the sulcus) during perioscopy. Images provided by DentalView, Inc. (taken by Gayle Meyers, RDH and Roger Stambaugh, DDS)
SCI 3: Subgingival Calculus Index 3 is calculus that extends beyond the plane of the root, it can be felt and possibly seen in x-rays (radiographic calculus).
SCI 2: Subgingival Calculus Index 2 is calculus which cannot be felt with instruments (explorers) beneath the gum line…also known as burnished calculus. It is left behind following traditional root planing because it is very smooth and can fill depressions, furcations, and flutings in the roots.
Burnished calculus may be left on the roots following traditional root planing. Burnished calculus cannot be seen or felt with traditional techniques beyond a depth of 4mm, and 30-50% of the root may have residual calculus; infection and inflammation may persist.
SCI 1: Subgingival Calculus Index 1 is microscopic calculus which cannot be seen or felt, even with direct vision, as in surgery. Commonly referred to as “glitter”, SCI 1 is found in all depths of pockets and even on exposed recessed root surfaces…inflammation may persist.
The presence of microscopic calculus can be identified and removed by highly experienced individuals using a dental endoscope. Surgical microscopes and loupes do not reveal this truth because they do not incorporate 48X magnification with tremendous illumination. In addition, a surgical microscope cannot be placed beneath the gums. Note: Only a scanning electron microscope on extracted teeth will reveal the equivalent detail.
SCI 0: Subgingival Calculus Index Zero is what we refer to as “perioscopy clean”! This is the goal of non-invasive perioscopy treatment. This can only be achieved profficiently and thoroughly through many years of perioscopy experience.
The objecive truth about current traditional techniques was not known until the innovation of dental endoscopy (perioscopy). Using lasers beneath the gum blindly, root planing tactiley/blindly, or performing surgery without an endoscope, may allow toxic calculus to remain embedded in the roots, hence, periodontal inflammation and infection ensue.
Removing microscopic toxins from the roots allows the body to heal by allowing reattachment to occur. When perioscopy is combined with regenerative proteins and sub-antimicrobial dose doxycycline, regeneration and long term results are possible. RPE using perioscopy is performed in one appointment without the need for repetative treatments.
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