Regenerative Periodontal Endoscopy - RPE

RPE is a unique synergistic periodontal treatment approach combining several advanced technologies.  What makes RPE unique is the timing and technique of each technology used.   RPE is not merely a periodontal endoscopy procedure, it is a protocol designed specifically to arrest periodontal disease and regenerate the bone which has been lost around the teeth.

The RPE Protocol:

A safe and effective enzyme inhibitor medication (sub-antimicrobial dose doxycycline) - SDD - sets the stage for success with this non-invasive approach by suppressing the destructive enzymes involved in periodontal disease.  This medication has a powerful anti-inflammatory affect on the gums.  When SDD is combined with efficient microscopic removal of calculus (perioscopy), followed by coating the roots with regenerative proteins (emdogain), the results are remarkable.  

While no formal research yet exists on this innovative synergistic approach, there is impressive research on each technology studied independantly, demonstrating efficacy and statistical significance 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.  Periodontal disease is most effectively treated using a synergistic approach.

 Before and After RPE - Case Studies:

  
Before - 12mm pocket -  advanced bone loss - this patient was advised by his periodontist he needed to have this tooth extracted and an implant placed.

 

  
10  months after RPE - normal healthy tissue 3mm- bone regeneration well underway, no mobility, and no need for an extraction and implant.  He saved thousands of dollars.

       
Before 10mm pockets           15 mo’s after RPE - bone fill- no mobility

This patient was told she needed to have this tooth extracted and an implant and crown placed.  She saved thousands of dollars in treatment costs, and did not have to undergo surgery by having non-surgical RPE instead.

     
Before and after photos for the above x-rays - very healthy tissue. 

 

    
Before -  7mm pocket           3 months after RPE- bone filled in, no longer a need for extraction of this front tooth and bridge.

   

before - 10mm pockets 

       
        3 months after RPE - 3-4mm probings - she avoided extraction of the molar tooth and bridge as well, saving thousands of dollars in treatment costs.

 

 

Before RPE - 8mm

2 weeks after RPE - 3mm - see x-rays below

 

Before x-ray #28 mesial

only 8 weeks after - rapid bone fill

 

   
Before - 7mm pockets         6 weeks after - rapid bone fill

    
Before - 8mm bony defect 19D            After RPE - 3mm probing

 

    

(above)  Before  10mm                       3 mo’s after - 4mm            

 
   6 months after

 

       
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.

 

    

before RPE - 9mm                       only 6 weeks after - 3mm with rapid bone fill

 

This protocol is very specifically designed to arrest the chronic inflammation associated with periodontal disease, allowing long term healing and regeneration to occur.  RPE goes beyond the short term affects and results of available treatment stratagies - including the overuse of oral or locally applied antibiotics, and laser periodontal therapy.

 

    

before RPE - severe chronic inflammation  

 
 3 months after - health restored

The patient above had root planing at the periodontist and was not satisfied that his periodontal disease was arrested.  He was correct.  Notice the severe floss cuts associated with “itchy” chronic inflammation.  This is due to an overactive immune response, similar to an allergy response.  This can be treated effectively using sub-antimicrobial dose doxycycline  and thoroughly cleaning the roots using perioscopy. 

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 interupt and reverse this grim outcome for millions of individuals.

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

For more information about the regenerative proteins go to www.straumann.com

before RPE - bleeding and infected 15mm pocket tooth #6

3 months after RPE - 4mm - very healthy tissue - no bleeding

Before - 9mm infected advanced periodontal pocket- tooth #8 is mobile

After RPE - 2mm, healthy, no bleeding, no mobility.

Before - severe inflammation - 7mm pocket tooth #26

After RPE - minimal inflammation - pink, healthy tissue - 3mm

Before - severe inflammation - 5mm pocket #22

After RPE - tight healthy gums - 2mm

Before - 10mm

3 weeks after RPE - 3mm tight, healthy tissue

Before - 7mm - severe inflammation

3 weeks after RPE - 2mm - very healthy tissue

Before - 11mm pockets #24 and #25

After RPE - 2mm - healthy