September 2009, Volume 5, Issue 8
Published by AEGIS Communications
Dissolving Oral Biofilm With Perio Protect®
Perio Protect® is a method to treat gingivitis and periodontitis. It incorporates into your existing treatment protocols a medical device called a Perio Tray® to place antimicrobial agents into gingival crevices or periodontal pockets. The non-invasive Perio Tray® has been shown to deliver oxidizing antimicrobials subgingivally and interproximally, and these agents were capable of dissolving the biofilm matrix and eliminating the bacteria causing periodontal disease. The Perio Protect Method® allows the doctor to select the appropriate antimicrobial and is able to overcome the problems of crevicular fluid flow.
The patented Perio Tray® is prescribed by a dentist and fabricated with a special seal and extension customized according to the diseased condition of the gingiva around each tooth. Dentists send periodontal probing evaluations and models to a registered dental laboratory. The dental laboratory customizes each tray according to the probing evaluations and produces the most effective seal to deliver and maintain medications in the sulcus.
The frequency and duration of Perio Tray® usage depend on the severity of disease, but for most patients it amounts to minutes each day. Daily use of the Perio Tray® allows patients to overcome crevicular fluid flow and deliver the medicaments to the source of the infection. Patients return to their dentist according to a recall system for evaluation and revised wearing instructions. As healing occurs, Perio Tray® antimicrobial delivery decreases.
Although the medication used with the Perio Tray® is determined by the doctor, the primary antimicrobial used by many practitioners is not an antibiotic but a low concentration of hydrogen peroxide. The importance of hydrogen peroxide as an oxidizing agent is explained by biofilm expert Dr. Bill Costerton: “When delivered deep into the sulcus with the Perio Tray®, this oxidizing agent kills planktonic cells very effectively and also kills the most exposed of the bacterial cells in the biofilms—the ones near the edges of the biofilm communities—until the communities themselves are eliminated. As the biofilm communities that cause periodontitis decrease, inflammation begins to subside, and the host has new opportunity to heal.”
One of the world’s leading dental microbiologists, Dr. Christoph Schaudinn, used the Biofilm Potential technique with a scanning electron microscopy (SEM) to complete cellular evaluations and determine the effects of the Perio Protect Method® on subgingival biofilm. Carriers were inserted in a patient’s periodontal pockets and the results were evaluated with SEM analysis. The results are observed in Figure 1. Note the pretreatment type of bacteria as well as the number of bacteria (6x10E6 equates to 6,000,000 bacteria/grid unit area). Each pocket has a different consistency of the biofilm and no two pockets are identical.
This patient was treated with the Perio Protect Method® for 12 weeks (no scaling or root planing was performed). The posttreatment SEM results indicate management of the biofilm community with de-creased bacterial populations, marked pocket depth reduction, and absence of bleeding on probing, indicating a decreased localized inflammatory response.
Many doctors using Perio Tray® delivery of oxidizing agents choose to scale and root plane first. Others prescribe antimicrobial delivery with the Perio Tray® to address the infection before mechanical intervention to dissolve the biofilm and modify the calculus, making scaling and root planing easier and more effective when it is necessary. One benefit of starting Perio Protect® treatment first is the reduction of bacteria before periopathogens may be introduced into the bloodstream with mechanical intervention.
The research results show that the direct application of oxidative agents using the Perio Tray® radically modified the microbial ecosystem. This has significant implications for long-term care. Costerton compares the changes in the microbial ecology of the sulcus with Perio Protect® therapy to the changes in the ecology of the whole mouth after brushing and flossing.
Because the ecology of the sulcus is changed, the Perio Protect Method® gives patients an effective treatment option for long-term health, especially for those patients who have struggled to maintain their oral health between office visits. For patients whose disease conditions are so serious that surgery is unavoidable, Perio Protect® maintains surgical gains and helps prevent the disease from recurring.
Doctors and patients report that this method is easy to follow, comfortable, and works quickly to stop bleeding and decrease inflammation. All of these positive aspects of treatment help explain a history of excellent patient compliance. Compliance may also be encouraged by the positive side effects that patients report, including fresh breath and whiter teeth.
For more information, contact:
Perio Protect, LLC
The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, orthe Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products orservices or their effectiveness, quality, orsafety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibilityfor any injury to persons or property resulting from any ideas or productsreferred to in the precedingmaterial.