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Periodontics is
making a significant leap forward through the use of periodontal endoscopic treatment or Perioscopy. Positioned between the traditional
scaling and root planing and periodontal surgery, this therapy can offer
patients a less invasive alternative treatment modality for some
non-responsive periodontal problems.
Perioscopy
visually enhances scaling and root planing procedures (with 24-48X
magnification) for a more thorough debridement of deep, formerly
inaccessible periodontal lesions. It may not always eliminate the need
for periodontal surgery in all disease sites; however, it will reduce
"pocket" depths in many instances, allowing those areas to be more easily
maintained.
Scaling and root
planing of the root surface under the gum line is central to the treatment
of most periodontal diseases. The inability of the clinician to
completely scale and root plane the majority of the root surface further
than 4 millimeters below the gum line is thought to be due to the
inability of the clinician to detect some root deposits (tartar) and
restricted access to these root deposits. Visualization of the root
surface during instrumentation would then improve scaling and root planing
efficiency and thus improve the patient's healing response from therapy.
Non-invasive
imaging of tissues and body structures with the aid of ultrasonics,
magnetic resonance imaging and computed tomagraphy are commonplace in
medicine and to a lesser extent in dentistry. Virtual-reality technology
can give the physician real-time three dimensional projection of structure
with non-invasive techniques of computed magnetic resonance imaging. With
the exception of computed tomagraphy none of these techniques have a
current application in dentistry and none offer non-invasive, real-time
assessment of the tissues and tooth root surface below the gum line, (i.e.
the subgingival topography). Hence the reason for the development of a
perioscopic system that allows the clinician direct visualization of the
area below the gum line.
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Perioscopy
instrumentation permits visualization for diagnostic and therapeutic
procedures. It's now possible to see, as well as, access deep below the
gum line: furcations, root deposits (tartar), caries, root fractures,
crown margins, and the soft tissues. The Perioscope can even be used as
an adjunct during periodontal surgery in hard to see areas.
The ability to
view root surfaces and to see the tartar that is present below the gum
line will significantly change the approaches that we take with patients.
We are now able to offer patients, especially those who fear or refuse
surgery, an alternative and minimally invasive procedure to help treat
their periodontal disease.
For anyone
wanting further information or an opportunity to see the Perioscope,
please feel free to contact Dr. Mark Gutt at 305-932-1887.
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