The Perio Protect Method proves itself over and over.
By lowering the barriers to treatment and raising the likelihood of success, we have witnessed proven results from controlled studies, third party research and in-depth reviews.
Clinical Trials
A 6-month clinical investigation of custom tray application of peroxide gel with or without doxycycline as adjuncts to scaling and root planning for treatment of periodontitis.
Putt M, Mallatt M, Messmann L, and Proskin H. American Journal of Dentistry. 2014;27:273-284.
This study evaluates the 6-month clinical effects of one scaling and root planing (SRP) procedure alone or combined with local administration of hydrogen peroxide gel (with or without inclusion of doxycycline for 2 weeks) via Perio Trays® for treatment of subjects with chronic periodontitis. In the test groups, Perio Tray delivery started at baseline, SRP followed three weeks later, and daily Perio Tray usage continued throughout the trial. The control group received SRP at the same time as the test groups. BI and PPD data were collected one week before SRP, two weeks after SRP, and at 3 and 6 months. Results indicate that mean BI dropped significantly only for test groups before SRP. Two weeks post-SRP, BI reductions for test groups were significantly greater than the control, and remained so for most comparisons. Analysis of pockets >5mm at baseline showed that mean PPD for both test groups significantly decreased from baseline before SRP. By 26 weeks, mean PPD decreased > 1.10 mm for both test groups compared to 0.38 mm for the SRP-only control (P< 0.001 for test versus control at all post-SRP comparisons). Analysis of pockets ≤ 5 mm at baseline showed the same relationship between groups (P< 0.001 for test versus control).
Custom Tray Application of Peroxide Gel as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis: Results of a Randomized, Controlled Trial after 6 Months.
Putt M and Proskin H. The Journal of Clinical Dentistry. 2013;24:100-107.
When compared with SRP alone, clinical improvements in PPD (e.g. ~1.0 mm for pockets >5 mm at baseline) were maintained for up to 6 months after SRP with adjunctive use of 1.7% hydrogen peroxide gel, locally administered using prescription, customized trays in the treatment of subjects with moderate to advanced periodontitis.
Custom Tray Application of Peroxide Gel as an Adjunct to Scaling and Root Planing in the Treatment of Periodontitis: A Randomized, Controlled Three-Month Clinical Trial. The Journal of Clinical Dentistry.
Putt M and Proskin H. The Journal of Clinical Dentistry. 2012;23(2):48-56.
A three-month clinical trial comparing scaling and root planing (SRP) alone to custom tray application of peroxide gel in conjunction with SRP shows that the adjunctive use of 1.7% hydrogen peroxide gel in the treatment of subjects with moderate to advanced periodontitis demonstrated statistically significant clinical improvements in pocket depths and bleeding when compared with SRP alone.
Refractory Maintenance Study
Case Series Report of 66 Refractory Maintenance Patients Evaluating the Effectiveness of Topical Oxidizing Agents.
Cochrane RB and Sindelar B. The Journal of Clinical Dentistry 2015;26:109-114.
Case series data were analyzed from 66 failing periodontal maintenance patients who had exhausted treatment options before using prescription trays with a 1.7% hydrogen peroxide gel once or twice daily for two-and-a-half to five years. Data included pocket probing depths (PPD), bleeding on probing (BOP), smoking status, and compliance with tray usage. Data were collected prior to tray usage and after tray delivery at six months, one year, and annual intervals. A clinical and statistical reduction in BOP was maintained over the length of the study (p ≤ 0.01). No differences were seen in patients who used trays two times or one time a day or in patients who smoked or did not smoke.
Independent Reviews
Perio Protect-A Conservative Periodontal Therapy Adjunct.
Clinicians Report. March 2009:2(3)1,3-4.
Independent evaluation of the Perio Protect Method® documents 98% of doctors surveyed reported reduced bleeding for patients following the Perio Protect Method®. 95% also reported reduced inflammation, and 90% reported decreased pocket depths. In the majority of cases, these results were apparent in 2 weeks time.
Treating periodontal disease with Perio Protect: Catapult Education members evaluate this gum disease treatment device.
Fraser G. DPR. (2018)May:90-91.
Independent evaluation of the Perio Protect Method® documents 98% of doctors surveyed reported reduced bleeding for patients following the Perio Protect Method®. 95% also reported reduced inflammation, and 90% reported decreased pocket depths. In the majority of cases, these results were apparent in 2 weeks time.
"...In a generation, trays are going to change the face of dentistry." One clinician's view on the Perio Protect Method and Perio Trays.
Cochrane B. DPR. (2013)July.
One periodontist's view on how Perio the Perio Protect Method is customizable to fit the needs of individual patients who are working to battle biofilm.
Minimally Invasive, State of the Art Treatment Patients Love.
Wood C. Dentistry Today
An interview with Charissa Wood, RDH who practices at Atlanta Dental Spa with Dr. Peter Boulden, a Perio Protect Provider. Charissa gives her insights on the secrets of her office's success.
Dental Product Shopper's 2020 Buyer's guide - "BEST PRODUCT" - The Perio Tray
DPS Released January 2020
Dr. Lou Graham and other clinicians share the benefits of being a Perio Protect provider, while patients talk about the amazing results.
Customizing Treatment for Long-Term Health
DPS Released September 2021
Dr. Lou Graham shares a case demonstrating the importance of stabilizing the periodontium before placing implants, as well as the important role the Perio Tray plays in a successful maintenance routine.
Clinical Practice
Customizing Treatment for Long-Term Health
Graham L, (2021) 3:10,103-116.
Research plays a role almost every day as we create treatment plans and make care recommendations to our patients. However, sometimes we need to see proof of that research manifested in our practices for it to really hit home. This particular case, which combines many variables, is an excellent example of that.
Managing Peri-Implantitis and Peri-Mucositis with Direct Medication Delivery.
Keller D, Buechel M, Sawyer G, Goldstein J. Int J Dent & Oral Heal. (2017) 3:10,103-116.
Direct medication delivery of hydrogen peroxide gel and doxycycline using custom formed medical devices are effective in treating periodontal disease, peri-implantitis and perimucositis. Direct medication delivery demonstrates a significant modification in the biofilm by decreasing the number and virulence of bacteria, improving tissue responses and decreasing pocket probing depth and bleeding upon probing.
Systemic Lp-PLA-2 cardiovascular marker response to direct medication delivery periodontal treatment.
Keller D. Cardiovascular System 2014;2(8):15 November 2014
Inflammatory markers such as lipoprotein-associated phospholipase A2 (Lp-PLA-2) demonstrate an increased risk of heart attack and ischemic stroke. This case report discussed treating patients’ periodontal conditions with the Perio Protect Method (PPM) and evaluating systemic Lp-PLA-2 levels, before, during and after periodontal treatment. Treating the patient’s periodontal conditions results in decreasing the periodontal markers and lowering the Lp-PLA-2 levels and these findings may be important as an adjunct of cardiovascular treatment.
How to Manage Oral Biofilm Using Perio Protect as a minimally invasive method for lasting oral health.
Keller, D. DPR 2010 July;44(7):54-55.
This case study follows one patient with advanced periodontal disease for four years. Photos, radiographs, and charting indicate significantly improved heath with significant bone gains and pocket depth reductions.
Managing Periodontal Disease In A Patient Suffering From Renal Failure.
Keller, D.C. Dentistry Today. July 2008:27(7)144-47.
This case study report examines the results of the Perio Protect Method® to help successfully manage the periodontal conditions of a patient during renal failure, when systemic calcium levels are often related to an increased incidence of periodontal disease.
Management of Periodontitis for HIV-AIDS Patients.
Keller, D.C. Dentistry Today. June 2006;25(6):110-3.
Patients with HIV-AIDS are reported to have higher incidences and severity of periodontal disease. This case study report demonstrates that a patient with HIV-AIDS and severe periodontal problem successfully managed the disease for more than 4 years with Rx Perio Trays®.
Biofilm, Hydrogen Peroxide & Proof of Concept
Direct medication delivery modifies the periodontal biofilm.
Keller DC and Buechel M., Oral Biol Dent. 2017; 5:1.
This study indicates that direct medication delivery of medicaments with a custom formed tray modifies the biofilm from a more virulent anaerobic to a less virulent aerobic composition and reduces the number of pathogens. Fewer bacteria that are less virulent should provide better treatment results.
Prescribing Hydrogen Peroxide in the Treatment of Periodontal Disease.
Dunlap T. Oral Health 2016;Dec:64-68.
Hydrogen peroxide has a long and safe track record in dentistry and has been used in tray delivery for more than 10 years to treat periodontal disease. Classified as an oral debriding agent and an oral wound cleanser, peroxide is an effective antimicrobial for chronic oral wounds inducing periodontal disease.
Subgingival Delivery of Oral Debriding Agents: A Proof of Concept.
Dunlap T, Keller D, Marshall M, Costerton J, Schaudinn C, Sindelar B, and Cotton J. The Journal of Clinical Dentistry. 2011 Nov;XXII(5):149-158.
A demonstration that the prescription Perio Tray® effectively places medication subgingivally. Mathematical modeling indicates Perio Tray® placement of hydrogen peroxide gel in periodontal pockets with depths up to 9 mm. Pathology reports reveal reductions in subgingival bacterial loads and improvements in pretreatment pocket depths of up to 8 mm after 1.7% hydrogen peroxide and Vibramycin syrup were prescribed for use with the Perio Tray®.
Hydrogen Peroxide: A Review of Its Use in Dentistry.
Marshall MV, Cancro LP, Fischman SL. J Periodontol. 1995 Sept;66(9):786-96.
Adverse irritant effects from exposure to ≤3% hydrogen peroxide were rare in studies in which ≤3% hydrogen peroxide were used daily for up to 6 years. Use of solutions of ≤3% hydrogen peroxide in the oral cavity, even for prolonged periods of time should prove safe and beneficial in reducing plaque and supragingival microflora. For periodontal disease, therapeutic delivery of hydrogen peroxide requires mechanical access to subgingival pockets.
White Papers
Peroxide and Viruses
Milton V. Marshall, PhD, DABT, RQAP-GLP, CCRP
Significant eveidence exists for the antiviral activity of hydrogen perioxide toward coronaviruses. The US Environmental Protection Agency regulates disinfectants, and 0.5% hydrogen peroxide and other products are registered as a disinfectant for human coronaviruses.
Antibiotics vs Peroxide in a Post-Antibiotic Age
Tanya Dunlap, PhD.
The Centers for Disease Control and Prevention (CDC) published a report at the end of 2019 that has been overshadowed by COVID-19. Antibiotic Resistance Threats in the United States 2019 is a wake-up call to health care providers.
Could Periodontitis Be an Overlooked Co-Infection in the Fight Against COVID-19?
Casey Hein, BSDH, RDH, MBA
The overwhelming threat we face from COVID-19 conveys to us responsibility to find ways to prevent and combat this deadly disease.
