How does Perioscopy Work?

How does Perioscopy, or periodontal endoscopy, technology work?

Periodontal endoscope technology, or Perioscopy, is an important part of the PerioPeak protocol, RPE℠ – Regenerative Periodontal Endoscopy℠.  It is a crucial component to achieving excellent overall results for many reasons.  Periodontal endoscopy is a non-invasive way to view and clean root surfaces microscopically in all depths of pockets, without performing surgery, using micro-ultrasonic technology simultaneously.

Important: We prefer the term “periodontal endoscopy” rather than the commercial trademark term “perioscopy”, which over the years has become a term associated with “removing calculus only”.  We view this narrowly focused use of the periodontal endsocope as antiquated use of the technology.

The dental endoscope, or periodontal endoscope, is a fiber optic is less than 1mm in diameter, it incorporates powerful illumination with 48X magnification.  It is essentially employing the use of 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  experience to perform periodontal endoscopy procedures (diagnosis and periodontal treatment) with proficiency.  PerioPeak Innovations has provided this treatment successfully for over a decade on hundreds of clients with advanced periodontal disease.

Below are four still endoscopic pictures viewing the area between the root and gums (deep gum pocket) during a periodontal endsocopy procedure.  Click on images to enlarge

click on image to enlarge

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).

click on image to enlarge

SCI 2:  Subgingival Calculus Index 2 is calculus which cannot be felt with instruments (explorers) beneath the gum line…also known as burnished calculus (tartar).  This tartar left behind following traditional root planing because it is very smooth and can fill in the tooth depressions, furcations, and flutings in the roots.

Burnished tartar is typically left on the roots following traditional root planing. Burnished calculus cannot be seen or felt with traditional techniques beyond a depth of 4mm.   30-50% of the root may have residual calculus; infection and inflammation may persist.

click on image to enlarge

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 experienced individuals using a periodontal endoscope. Surgical microscopes and loupes (magnified glasses) 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 this detail.

click on image to enlarge

SCIO:  Sub-gingival Calculus Index Zero is what we refer to as “microscopically clean”.

The limitations of current traditional techniques, such as root planing, was unknown until the innovation of the periodontal endoscope. Using lasers beneath the gum blindly, root planing tactilely in deep pockets, or performing periodontal surgery without an endoscope, may allow toxic calculus to remain embedded in the roots, hence, periodontal inflammation and infection may continue.