Since we are revamping the PerioPeak website this blog is currently under construction. As soon as everything is in place the old posts will be back! In the meantime I encourage you to explore the website. Use the navigation to on top to find out more about non-surgical periodontal treatment in Seattle WA.
Regenerative Periodontal Endoscopy - RPE
RPE is a unique non-surgical, synergistic periodontal therapy regeneration approach combining several advanced technologies. What makes RPE unique is the timing and technique of each technology used. RPE is not merely a perioscopy procedure, it is a protocol designed specifically to arrest periodontal disease and regenerate lost bone.
The RPE Protocol:
A safe and effective enzyme inhibitor medication (www.periostat.com) sets the stage for success with this non-invasive approach by addressing the destructive enzymes involved in periodontal disease. This medication has a powerful anti-inflammatory effect on the gums. When this medication is combined with the 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.
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 mo’s after - rapid bone fill occuring
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 vertical defect 18 mesial
only 6 weeks after - 3mm with rapid bone fill
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 low dose doxycycline 20mg taken twice daily, 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. Low dose doxycycline and RPE can effectively interupt and reverse this grim outcome for millions of individuals.
For more information on low dose doxycycline, also known as sub-antimicrobial dose doxycyline, or PerioStat, go to host modulated therapy.
For more information about regenerative proteins go to www.straumann.com or www.osteohealth.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
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 ending chronic periodontal disease and the inflammation associated with it. By using an innovative approach involving advanced miniature fiberoptic technology and host modulated therapy, the periodontal inflammation and infection can be very effectively 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:
http://abcnews.go.com/GMA/OnCall/story?id=2813658&CMP=OTC-RSSFeeds0312
http://www.medicalnewstoday.com/medicalnews.php?newsid=60977&nfid=rssfeeds
http://www.healthcentral.com/newsdetail/408/601047.html
Perioscopy is a non-invasive way to view and clean root surfaces using micro-diamond ultrasonic tips and a dental endoscope fiber less than 1mm in diameter with tremendously powerful illumination and magnification. 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 takes 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.perioscopy.com. This early research was only the beginning…at PerioPeak Innovations, regenerative periodontal techniques aimed at ensuring long term results has been a labor of love, taking perioscopy to a 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 individuals using a dental endoscope. Surgical microscopes and loupes do not reveal this truth because they do not have 48X magnification with tremendous illumination as well. In addition, a surgical microscope cannot be placed beneath the gums. Note: Only a scanning electron microscope on extracted teeth will reveal this detail.
SCI 0: Subgingival Calculus Index Zero is what we refer to as “perioscopy clean”! This is the goal of non-invasive perioscopy treatment.
We did not discover the objecive truth about our current traditional techniques until the innovation of dental endoscopy (perioscopy). Using lasers beneath the gum blindly, root planing tactiley, 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 combined with regenerative proteins and low dose doxycycline, regeneration and long term results are possible. Perioscopy and RPE is performed in one appointment without the need for repetative treatments.
