Tag Archives: Case Studies

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.

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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

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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

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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

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

(This patient is a heavy smoker)

  excellent-bone-fill-6-mo

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)

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

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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

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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.

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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:

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Before RPE                                                         3 years after RPE

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before RPE 7mm pocket                                 3 years after RPE 3mm

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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!

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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.

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(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.

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

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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

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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

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

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

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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

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Before 11mm pockets                                          bone fill at 6 months

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

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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

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30D before 30D after

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

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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

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

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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 http://periopeak.com/blog/category/bone-regeneration/

Advanced Periodontal Disease Pictures – Successful Treatment Without Surgery – Implant Alternative

Pictures of Advanced Gum Disease Treatment  – pictures taken by PerioPeak Innovations


Above:  Before non surgical Regenerative Periodontal Endoscopy℠ (RPE℠) -bleeding and infected 15mm pocket tooth #6.  This patient was advised by three different periodontists that due to the advanced nature of his periodontal disease he needed all of his teeth extracted.


Above:  3 months after RPE℠ – 4mm – very healthy tissue – no bleeding.  This patient has remained stable and healthy for many years.   See more pics below, or  Learn more about this unique protocol.

 


Above:  Before RPE℠ – 9mm infected advanced periodontal pocket- tooth #8 is very loose


Above:  After RPE℠ – 2mm, healthy, no bleeding, no mobility.

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Before RPE℠ – severe inflammation – 7mm pocket tooth #26.  This patient was also told she needed full mouth extractions due to the advanced periodontal disease on all the teeth. (she had generalized 5-12mm pockets).


After Regenerative Periodontal Endoscopy℠ -RPE℠:   minimal inflammation – pink, healthy tissue – 3mm measurements – health restored to all her gum tissues.  No longer a need for full mouth extractions.


Before – 10mm – this patient was treament planned for extractions by her periodontist.


3 weeks after RPE℠ – 3mm tight, healthy tissue – no need for extractions.


Before – 7mm – severe inflammation


3 weeks after RPE℠ – 2mm – very healthy tissue


Before – 11mm pockets #24 and #25


After RPE℠ – 2mm – healthy

Read how Regenerative Periondontal Endoscopy works

or watch our You Tube Video 

 

Comparison Pictures of Periodontal Surgery vs. RPE℠ Below:   

Left: This patient underwent periodontal surgery (osseous surgery) for her advanced periodontal disease (she had 5-9mm pockets generalized) – this picture is 6 months after undergoing periodontal surgery.

Above: This patient had 5-9mm pockets generalized but instead of having the periodontal surgery recommended by her periodontist, she had non-surgical RPE℠.  This picture is 6 months after RPE℠.  No tissue and bone is removed as in the periodontal surgery picture.  A superior cosmetic outcome is the result – with no gaps between the teeth and no recession of the gums.

RPE℠ is a conservative treatment approach which does not cause the disfigurement often associated with aggressive periodontal surgery.  The two cases presented above had identical pocket depths.  One patient underwent traditional osseous periodontal surgery, the other chose RPE℠.  The difference in results is obvious.  Unfortunately for many patients who have undergone periodontal surgery, the gum and bone is removed (cut out) to reduce periodontal pockets –  in doing so the roots are exposed causing disfigurement of the gums (black triangles and recession).

Periodontal surgery picture below (warning – this photo may be disturbing):

Below:  Regenerative Periodontal Endoscopy℠ Procedure – RPE℠.

The miniature fiber optic used in this picture enables our highly skilled clinicians to clean all root surfaces without the need for flap/osseous periodontal surgery.  There is no need for bone and tissue removal as in osseous periodontal surgery.  Instead, all infected gum tissue in deep pockets is gently removed with micro-ultrasonics,  regenerative proteins are then placed on the roots to stimulate adult stem cells – promoting closure of periodontal pockets.  Healing is accelerated due to the conservative nature of the procedure and the addition of host modulated therapy.  Since there is no trauma to the tissue, the disfigurement and recession often associated with traditional periodontal surgery does not occur with RPE℠.