Case study: perioscopy-only use for a nonsurgical treatment plan

Case #1 reflects a non-surgical treatment plan and outcome utilizing only Perioscopy based on clinical findings and the patient’s low risk.

Case 1:
Female, age 47
No health issues, no social habits
Medication: Vivelle (Estradiol Transdermal) dot patch for hormone replacement therapy
PreViser Risk Analysis:
Risk 2
Disease state 9

Diagnosis and Etiology: Early to moderate periodontitis with significant sub and supragingival calculus throughout Associated occlusal traumatism and malocclusion issues Class III malocclusion with teeth #’s 14 and #19 occluding on the left side Bruxism contributing to sensitivity Generalized pocket depths of 4-5 mm, with generalized BOPTX plan: •Improved personal oral hygiene •FM Perioscopy •Orthodontic referral •3 month periodontal maintenanceUR/LR Pre Tx

Generalized 4-5mm pockets with BOP

UR/LR pre Tx (reflected in a mirror) and UR/LR radiographUL/LL Pre TX

UL/LL reflected in a mirror and UL/LL radiograph

Facials Pre-Treatment. Notice the grafting done years previously on the LA facials

LL lingual pre Tx and LR lingual pre-Tx
Treatment: FM Perioscopy completed in two, 2-hour sessions with local anesthetic and micro ultrasonics. No hand instruments are necessary during Perioscopy.
Note: When instrumenting “blindly,” the end point is unknown and debris is left behind. Visualization via the Perioscopy System ensures effective treatment is rendered because the bioburden is completely removed. Ultrasonic instrumentation is not only effective and efficient for thorough bacterial removal, but is an easier therapy to tolerate for the patient, with less sensitivity post treatment.9 months Post Treatment:

Tissue is light pink, tight and firm. All pockets are 1-3mm, no BOP

LR lingual post Tx and LL lingual post
Tissue is light pink, tight and firm. Pockets 1-3mm no BOP

Charting shows that all pockets are now generalized 1-3 mm with no BOP

Conclusion:
The patient is thrilled with her outcome and now has a stable dentition.
She is ready to move forward with orthodontia and will continue with periodontal supportive therapy every 3 months.

Suzanne Newkirk, RDH, graduated from the University of Alaska, Anchorage, in 1981 and has dedicated the last 31 years to excellence in clinical dental hygiene and periodontics. Suzanne is a periodontal therapist, dental hygiene coach and mentor. She is also a Perioscopy instructor and speaker and is listed on the Seattle Study Club Speakers Bureau List. Ms. Newkirk is a member of the American Dental Hygienists' Association and Georgia State Dental Hygienists' Association.

To read another article in RDH eVillage FOCUS from Suzanne Newkirk, go to Newkirk.

Case study: perioscopy-only use for a nonsurgical treatment plan

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