The Perioscope

What is it?

The perioscope at Periodontal & Implant Associates of Greater WashingtonThis revolutionary technology was developed for the treatment of Periodontal Disease. It is a relatively new, and truly ground-breaking technology. We are proud that PIAGW was the first practice on the East Coast to have this new technology, and one of only a few in the world to be familiar and working with it.

The technology is an instrument called a Perioscope. It is an endoscope specifically designed for exploration and visualization of the space under the gum of teeth involved with Periodontitis -- the periodontal pocket. The instrument produces an image, on a computer monitor, of the diseased tooth’s root surface.

The Perioscope allows the clinician to see the contents of the periodontal pocket and to analyze the root surface of the tooth for disease causing bacterial accumulations (plaque and calculus). By so doing, it guides the clinician during the process of cleaning the root surface free of its bacterial contaminations -- the treatment for Periodontitis.

Also, it allows the clinician to identify cracks, perforations and other disease-causing flaws of the tooth root’s surface that are located under the gum -- problems that used to require surgery to detect.

How does it work?

Fiber-optic strand from Perioscope at PIAGW.

The Perioscope consists of a 0.5mm diameter fiber-optic strand. The strand is inserted into a sheath. The sheath conducts a flow of water around the strand, to the strand’s end. The end of the sheath has a Sapphire lens that focuses on the tooth’s root surface and sends the image back through the fiber-optic strand to a video-sensing chip. The image is then displayed on a monitor.

Special Instruments Required

The Perioscope allows the clinician to see what could not be seen before. With the new level of vision, it has become necessary to have special instruments for removing the bacterial deposits -- deposits that conventional instruments can not remove. Thus, a new set of instruments have been, and are still being, developed for this new, more effective, therapy. Below are some examples of these instruments.

This is the instrument that carries the fiber optic strand and sheath containing the water flow and the video lens, into the periodontal pocket. It has a hollow tube through which the strand protrudes. The hollow tubes continue its length, towards its termination, with only one half of the tube present. The remaining half serves to hold the pocket wall away from the tooth and the optics. The tube conducts the water flow that flushes away blood and debris.


These are diamond abrasive files. They are just two of the special instruments used to remove calculus that is adherent to the root surface.

This is another example of a special root planing instrument. It is a slotted file. The end of the instrument is about 1.5 mm in diameter. It reaches areas of the root surface that conventional root planing instruments can not reach.

What’s So Great About The Perioscope?

Because of the ability to see the diseased root surface, the Perioscope (often, but not always) allows the clinician to treat Periodontal Disease without conventional surgical therapies.

Additionally, the Perioscope allows the clinician to see what could not be seen before during periodontal surgery. Now, surgical therapies are far more effective and reliable than in the past.

Here are some of the breakthroughs that the Periscope has made in the everyday practice of Periodontics:

  • Increased effectiveness of non-surgical treatment methods, and thus a reduction in the amount of surgical therapy required for the treatment of Periodontitis.
  • Increased diagnostic accuracy; which leads to an increased appropriateness of prescribe treatment methods.
  • Increase effectiveness of surgical therapies which were limited by visibility problems

The Perioscope has greatly increased the accuracy of periodontal diagnostics and treatment prescription. Also, it has greatly increased the effectiveness of non-surgical and surgical therapies.

The Perioscope has created a shift in the nature of periodontal care. However, it does not diminish the power of, or importance of, periodontal surgical therapies. Ultimately, periodontal therapy is about cleaning diseased tooth roots free of bacterial contamination, and keeping them free of such accumulations. Periodontal surgical therapy remains the most powerful of therapies to achieve these goals. The Perioscope contributes to the ability to achieve therapeutic results that are similar to, and sometimes better than, those achieved by surgical therapies -- without the pain, disfigurement and cost of surgical therapies. However, many periodontal disease situations cannot be adequately resolved without surgical therapy.

For more information, contact us.