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  We view this narrowly focused use of the periodontal endoscope as an outdated understanding and overall use of this technology.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.

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 (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

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.

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

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.

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, cell death and infection may continue.