Intelligent innovation for the best in periodontal care

Periowave™ is a broad spectrum anti-microbial that provides a cutting edge weapon in the dentist’s arsenal against periodontal disease. With Photo Dynamic Disinfection (PDD) you can give your patients the highest standard of treatment and results.

PDD is the application of a photosensitiser that preferentially binds with target bacteria. Non-thermal laser is applied to the treatment site at the compound specific wavelength. Reactive oxygen species kill target bacteria and inactivates virulence factors. Features of Periowave™ include:

• No known resistance, no antibiotic side effectsOraldent
• Safe and non-damaging to host tissues
• Short treatment time per periodontal site
• No patient compliance issues

Periowave™ offers this state of the art solution for the treatment of chronic periodontitis. Periowave™ PDD, in conjunction with scaling and root planing, has been shown1 to significantly:

• Increase clinical attachment level at 12 weeks
• Reduce probing depth at 12 weeks
• Decrease bleeding on probing at 6 weeks

Prove your dedication to your patients and don’t be left behind in offering the finest, technologically advanced treatment for periodontal disease. Bring Periowave™ into your practice today, and put yourself in the vanguard of modern dentistry.

The Business Case – an example

Three years ago husband and wife partners Tony and Lisa Appleton took over Church Street Dental Practice and have been working to improve the image of the practice and the treatments offered ever since. Three months ago, they introduced Periowave™.

"We looked at each of the areas of dental care we were providing and highlighted and researched those areas we felt we could improve, including Periodontal Care. Whilst researching periodontal treatments on the Internet, we came across a number of dentists using Periowave™ in Canada and they seemed to be singing its praises. Fortunately for us our research coincided with the UK launch of the product by Oraldent and we were lucky enough to secure one of the first Periowave™ machines in the country. We have now had Periowave™ for approaching three months and are delighted with it.”

Periowave™ is the only photodynamic disinfection system on the market for use in periodontic treatment. Researched and created in the UK, this painless, technological breakthrough does not attack the good bacteria and focuses solely on the killing and selective targeting of the pathogens associated with these oral infections that scaling and root planing leave behind.1

1. Loebel N, Anderson R, Hammond D, Leone S, and Leone V, Ondine Biopharma Corporation. Non-Surgical Treatment of Chronic Periodontitis Using Photoactivated Disinfection. International Association of Dental Research, March 2006.

Tony and Lisa announced the arrival of Periowave™ at Church Street Dental Practice through adverts and an editorial in the local press and have been staggered at the response it received. It has demonstrated the publics increasing awareness of the problems associated with gum disease.
Oraldent
“Patients appreciate the pro-active treatment Periowave™ offers and are happily paying for it. The ease of the treatment is a winner with both patients and practitioners alike! Although we are still in the early stages of recording our results, initial data of pocket depth reductions suggest decreases of up to 3mm at the 6-week post-op review. Patients report that mobile teeth feel tighter and their initial periodontal symptoms have improved. We are enrolling these patients in a Periodontal Programme of follow-up care and treatment and this too has increased revenue to the practice.”

Lisa Appleton said that the practice has been “delighted with the introduction of Periowave™ and our patients’ reaction to it. The uptake of Periowave™ treatment by existing and new patients has amazed us and has reassured us that many people are making gum treatments a priority at last. We are currently looking to expand our periodontal team and firmly believe that Periowave™ has given us this welcome boost to the practice."

CLINICAL STUDY – by Catherine Fairfield, RDH

New developments in Periodontal technology are making the treatment of periodontal diseases more effective. For example, the new Periowave Photodisinfection technology is a simple, two-step clinical procedure, which within 60 seconds destroys the cells of specifically targeted Gram-negative anaerobic micro organisms in a selected periodontal defect. (1)

This innovative new procedure is not only effective but also simple to use:

The first stage involves irrigation of the affected periodontal site with a photosensitising solution, which selectively binds to the periodontal pathogens while avoiding human tissue cells. (1) The second stage is illumination of the site with the light diffusing tip of a non-thermal diode laser of appropriate wavelength (670nm) for a period of one minute.

Viruses, bacteria, fungi and protozoa have all demonstrated antimicrobial sensitivity to this approach.(2,3) Periowave TM Photodisinfection, containing methylene blue, has been shown to be effective against a wide range of putative periodontal pathogens, including Porphymonas gingivalis, Prevotella intermedia, Tannerella forsythia, Fusobacterium nucleatum, and Aggregatabacter actinomycetemcomitans (1,4) Virulence factors associated with Gram-negative bacteria, including lipopolysaccarides and proteolytic enzymes, are also inactivated. (4)

In a typical case, a 69-year-old male with localized chronic periodontitis presented for a routine supportive periodontal therapy (SPT) appointment with an isolated chronic 7 mm pocket with heavy bleeding on probing (BOP) on the mesial of the maxillary right cuspid. (Figure 1.1) He was a non-smoker in good general health with no known allergies. Prior SPT at regularly scheduled 4-month intervals had delivered no improvements in the periodontal condition of this site.

Periodontal and radiographic examination revealed a chronic periodontal defect, which persisted despite routine SPT. The gingival tissue presented with localized oedema, erythema, mild cyanosis, rolled gingival margins and a ‘thickened’ soft tissue biotype with heavy BOP. The radiographic examination of the site revealed a vertical osseous defect with no evidence of a vertical fracture. The periodontist recommended full mouth SRP, followed by local photodisinfection utilizing Periowave TM. Surgical treatment options were discussed with the patient, but he preferred to continue with a nonsurgical approach.

On February 21, 2007 oral hygiene instruction and full mouth debridement were performed consisting of power-driven and manual scaling and root planing (SRP). It was recommended to schedule the photodisinfection treatment on the maxillary right cuspid one week later due to heavy bleeding in the mesial aspect. Six days post-SRP, photodisinfection treatment with Periowave TM was performed on the affected area.

Five months later the patient re-presented for routine SPT when it was noted that the PD had reduced to 5mm with only moderate BOP in the treatment site. (Figure 1.2) Clinical evaluation at this time revealed reduced oedema and erythema. Oral hygiene instruction and full mouth debridement were repeated, again consisting of power-driven and manual SRP, followed immediately by a second photodisinfection treatment.

By November 19, 2007 the PD had reduced further to 3mm with no BOP. (Figure 1.3) Clinical examination indicated a further reduction of oedema and erythema and overall improved gingival appearance. The periodontist recommended continuing with a nonsurgical regime, although without precluding possible surgical intervention in the future.

The periodontal status of this patient had previously shown no apparent improvement over time despite regularly scheduled SPT appointments. A combined treatment of SRP and photodisinfection was suggested as an attempt to reduce or eliminate residual periodontal pathogens in the affected site and so avoid the need for surgical intervention.

The patient reported no discomfort or adverse effects with Periowave TM treatment. Although the precise aetiology of this periodontal lesion remains unknown, the adjunctive photodisinfection appears to have been instrumental in reducing the PD from 7 mm to 3 mm with elimination of BOP.

For further information on this new technology please call Oraldent on 01480 862080

References:
1. Wilson M: Bactericidal effect of laser light and its potential use in the treatment of plaque-related diseases. Int Dent J. 1994; 44(2):181-189.
2. Wainright, M: Photoinactivation of viruses. Photochem Photobiol Sci. 2004;;3:406-11.
3. Wilson M: Lethal photosensitisation of oral bacteria and its potential application in the photodynamic therapy of oral infections. Photochem Photobiol Sci. 2004;3:412-8.
4. Komerik N, Wilson M, Poole S: The effect of photodynamic action on two virulence factors of Gram-negative bacteria. Photochem Photobiol Sci. 2000;72:5:676-680.

Catherine Fairfield, RDH
Biography

Catherine Fairfield RDH, graduated from the dental hygiene program at the University of Alberta in 1989. She has 19 years of experience in private periodontal practices in Calgary, Alberta and is currently practicing in both periodontal and prosthodontic disciplines. For the past 6 years, she has been a part-time clinical educator in the Graduate Periodontal program at the University of British Columbia. She provides educational seminars in non-surgical periodontal therapy, adjunctive therapies for the treatment of periodontal and peri-implant diseases, dental implant maintenance therapy, and hands-on advanced instrumentation workshops. Since 2006, Catherine has presented in Europe, the United States and across Canada at national dental and dental hygiene conferences. Catherine continues to provide consulting services and present on behalf of various companies in the dental industry and is a member of the Competence Committee for the College of Registered Dental Hygienists of Alberta.

For more information contact Oraldent on +44 (0) 1480 862080 or visit http://www.oraldent.co.uk

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