Before and after pictures of a non invasive periodontal disease treatment, RPE℠ – Regenerative Periodontal Endoscopy℠

Before and after pictures of a patient treated at PerioPeak Innovations with a non-invasive treatment approach called Regenerative Periodontal Endoscopy℠, or RPE℠.

 The young female patient below came to PerioPeak with advanced stage periodontal disease, with generalized 5-13mm pockets.  This patient was very interested in a non invasive approach over traditional surgery to treat her periodontal disease.  She had undergone traditional root planing (deep cleanings) with marginal results, she continued to have deep periodontal pockets with chronic infection, bleeding, and inflammation.

This patient opted for Regenerative Periodontal Endoscopy℠, RPE℠ over periodontal surgery and extractions of her teeth.

See her before and after photos


             Before RPE℠ – 10mm pocket                                            10 months after RPE℠ – 2mm



                Before RPE℠ – 11mm pocket                                 10 months after RPE℠ – 1mm


            Before RPE℠ – 13mm pocket                                           10 months after RPE℠ – 2mm


Before RPE℠ 7-8mm  with bleeding                                      After RPE℠ 2mm – health restored


    Before RPE℠  – 8mm pocket                                             After RPE℠ 3mm – health restored


    Before RPE℠ – 8mm pocket                                 10 months after RPE℠ – 3mm health restored


Before RPE℠   9-10mm pockets                                      After RPE℠ – 2mm tight healthy gums


Before RPE℠ 8-9mm pockets                                                     After RPE℠ 2-3mm


Before RPE℠ – 7mm furcation                                      After RPE℠ – 2mm – health restored


Before 7mm                                                               After – 3mm

View the before and after x-rays and more information about this case here.

View more cases here – Real people, real results.

Watch an actual RPE℠ procedure on our You Tube Video

Regenerative Periodontal Endoscopy℠: Before and after pictures and x-rays

How Regenerative Periodontal Endoscopy℠ Works:

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 on properly prepared root surfaces 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.  Safe and effective anti-inflammatory medication is used to promote more rapid healing and stability of the gums by resetting the inflammatory response and boosting activation of regenerative cells.

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

Watch this procedure on You Tube.

More cases:   Perioscopy Case Studies, Before and After pictures,    Advanced Cases.


RPE℠ is completed in one appointment with local anesthetic, 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 treatment option which can reduce or eliminate the need for periodontal surgery and extractions.  View our long list of testimonials and request references.

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

before RPE℠  10-12mm pockets  #2, #3           6 mo’s after RPE℠ – bone fill, no pockets


before RPE℠  – 8mm  bony defect           10 months after RPE℠ – bone regenerated

very advanced bone loss 12mm      10 months after RPE℠- nice  bone fill


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      Before RPE                                                         6 months after 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,  implant, and crown.


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Advanced furcation #18 – 10mm pocket       6 months after RPE – 3mm (x-rays below)

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#18 before RPE (advanced bone loss)            6 months after – nice bone fill

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Same patient other side #31 9mm furcation    6 months after RPE – 3mm (x-rays below)

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Before RPE                                                      6 months after RPE – nice bone fill



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

(This patient is a heavy smoker)


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 RPE℠ 13mm (advanced furcation)       6 months after RPE℠ – 2mm – healthy

Before RPE℠ – 13mm advanced furcation          6 months after RPE℠ – 2mm

Before RPE℠ – 11mm  (advanced mobility)       6 months after RPE℠ – 2mm -solid

see before and after x-rays below

Before RPE℠  – 19 considered “hopeless”                Bone fill 6 months after RPE℠ (pics above)

Before RPE℠ advanced bone loss          6 months after RPE℠ – nice bone fill – see the photos for this tooth below

Before RPE℠ – 10mm                                                 6 months after RPE℠ – 2mm

before RPE℠ and root canal therapy (8-11mm)       6 months after (1-3mm) – health restored

pics are for x-rays above – before – 10mm                          6 months after RPE℠ – 2mm

Before RPE℠ – advanced bone loss #4                      6 months after RPE℠ – nice bone fill

Before RPE℠ – 9mm furcation                                  6 months after RPE℠ – 2mm – healthy

Before RPE℠ – 7mm                                                  6 months after RPE℠ – 2mm -healthy


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.



IMG_0863  IMG_4859

Before full mouth RPE -advanced case with generalized deep pockets – 3 years after RPE, complete health restored.  More photos of this case below:

IMG_0869  IMG_4862

Before RPE                                                         3 years after RPE

IMG_0873  IMG_4865

before RPE 7mm pocket                                 3 years after RPE 3mm

IMG_0876  IMG_4864

before RPE – 7mm                                              3 years after RPE – 3mm

The patient above was told due to her hopeless advanced periodontal disease she would eventually lose all of her teeth.  She was very embarrassed to smile due to shifting of the teeth from the advanced bone loss with deep pockets and was emotionally devastated before coming to PerioPeak.  She now has tight healthy tissues with no mobility and no bleeding.  This patient underwent orthodontic treatment after RPE to correct extrusions and malocclusion.  She is elated with her results!


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


Nelly LL before best x-ray Nelly LL after best x-ray

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


tongue stud damage – facing extractions       6 months after RPE℠ – health restored


Before RPE℠ – 10mm                                                   6 months after RPE℠ – 1mm

Before RPE℠ – 11mm with heavy bleeding and a periodontal abscess clearly seen – 6 months after RPE℠ 2mm very tight healthy tissue – see bone fill on x-rays below.

Before RPE℠ – class II mobility                     6 months after RPE℠ – nice bone fill


Before 11mm pockets                                          bone fill at 6 months


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


23D before 10mm 23 after 3months

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

23 before 23 after 6 wks

Before RPE℠                                       6 weeks after – good bone fill occurring

23 before lingual 23 after lingual

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


30D before 30D after

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

30 DL before 30DL after

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

da30big 30 3 mo after x-ray

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℠ – 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 strategies – 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 tendency 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 independently, 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 multi-factoral, it can typically be more effectively treated using a synergistic approach.

Contact us for a complimentary consultation

For more information about sub-antimicrobial dose doxycyline 20mg go to host modulated therapy.

For more information about  regenerative proteins (Emdogain) go to

Pancreatic Cancer and Periodontal Disease

Pancreatic Cancer linked to Gum Disease?

Scientists have recently discovered what appears to be a definitive link between pancreatic cancer and periodontal (gum) disease. Pancreatic cancer is the fourth leading cause of cancer deaths in the U.S. because it is so difficult to treat. More than 300,000 Americans are expected to die from it this year.

The study found that men with periodontal disease have a 63% greater risk of developing deadly pancreatic cancer. The research studied 51,000 professional non-smoking males from 1986 to 2002. It may be that the chronic inflammation from periodontal disease is setting off an inflammatory response which is detrimental to overall health, or that the bacteria associated with periodontal diseases are the culprit. More research is needed to determine the actual action periodontal disease has in creating a higher risk of cancer.

At PerioPeak Innovations we are committed to addressing chronic periodontal disease and the inflammation associated with it proactively and definitively.  By using a synergistic approach, involving advanced miniature fiberoptic technology and host modulated therapy, the periodontal inflammation can very effectively be put into a remissive state for the long term…lowering the overall health risks associated with all stages of periodontitis, or gum disease.

Below are recent articles about the link between periodontal disease and pancreatic cancer:

Endoscope Assisted Bone Regeneration with Emdogain

Regenerative Periodontal Endoscopy℠  (RPE℠) – Periodontal endoscopy and Emdogain

Non-surgical periodontal bone fill is finally possible thanks to a new biological technology called Emdogain, by Straumann. But what is Emdogain and how does it work? The following post will help clarify what Emdogain is and also help the reader to understand the tremendous benefits of endoscope assisted regeneration using this natural protein.

IMPORTANT: Emdogain is used non surgically at PerioPeak Innovations with an innovative technique and protocol utilizing a periodontal endoscope, soft tissue laser,  micro-piezo ultrasonics, and enzyme inhibitors. Emdogain is typically used only during some type of flap periodontal surgery procedure.  However, a recent study demonstrates histological bone regeneration with Emdogain used in a non surgical periodontal therapy approach.

So what exactly is Emdogain?

Emdogain contains Enamel Matrix Protiens, or Bioactive Molecules, called amelogenin proteins, which are harvested from the developing teeth of pigs.  What are enamel matrix proteins and how do they help humans to regenerate periodontal tissues and bone? The answer is in the unique biology of tooth development. When teeth are still developing, we can extract these “bioactive molecules” and use them in humans for the stimulation of adult stem cells to promote regeneration in periodontal defects created by chronic or acute infections of the gums.  The body responds by growing new cementum, ligament, and bone (osteogenesis) in areas where periodontal disease has damaged these important supporting structures. The damage of periodontal disease can be repaired and reversed with Emdogain.

Read easy to understand information about Emdogain

The Mechanism of Emdogain:

Attachment – the mesenchymal cells attach to the root surface covered by Emdogain.

Proliferation and Growth -the cells start to produce cementum. Cementum is the key tissue in periodontal regeneration. The recreation of alveolar bone starts from the root cementum.

Alveolar Bone – the process of mineralization starts a certain distance from the root and alveolar bone (periodontal bone around the teeth) is formed.

Note:  Efficient piezo microscopic root debridement (proper root preparation) and laser soft tissue curettage are guided by the use of a periodontal endoscope with 48X magnification.    

View non-surgical bone restoration cases using endoscope assisted RPE℠ techniques instead of surgery.

The DV2 Dental Endoscope with 48X Magnification is used to definitively access and clean all root surfaces prior to the placement of Emdogain with this non surgical technique.

Summary of the Clinical Benefits of Emdogain:

Case Report

Clinical and Histologic Evaluation of Non-Surgical
Periodontal Therapy With Enamel Matrix
Derivative: A Report of Four Cases

James T. Mellonig,* Pilar Valderrama,* Holly J. Gregory,* and David L. Cochran*  (read entire paper)

EMD stimulates fibroblast proliferation, the growth of periodontal ligament (PDL) cells, osteogenesis, and the proliferation and differentiation of osteoblasts;  it also prolongs osteoblast growth and enhances trabecular bone regeneration, promotes osteoprotegerin production, and enhances osteopontin expression and transforming growth factor-beta1 production. EMD stimulates bone sialoprotein, signal transduction of bone morphogenetic protein, release of vascular endothelial growth factor, and angiogenesis. EMD also has anti-inflammatory properties. It limits the release of proinflammatory cytokines, modulates tumor necrosis factor-alpha and prostaglandin, and inhibits caspase activation. EMD has a negative effect on the growth of periodontal pathogens and might be useful as an antiadhesive agent for breast cancer cells.

The history of Emdogain:

– 1988 Biora founded by Professor Lars Hammerstrom, Stockholm Sweden.

– 1995 CE Certification

– 1996 FDA approval- 1997 introduction into the US market.

– Since 1989 produced in Malmo Sweden

– 2004 completion of integration by Straumann.

There are numerous studies involving the safety, efficacy, and statistical clinical significance with Emdogain.  Over one million people have been treated successfully with Emdogain.  Go to for more information.