Perio Protect Method™Scanning Electron Microscope

Bacterial Count Results

D.C. Keller, Perio Protect LLC, St. Louis, MO, USA; J.W. Costerton, USC School of Dentistry, Los Angeles, CA, USA; C. Schaudinn, USC School of Dentistry, Los

Angeles, CA, USA; P. Sedghizadeh, USC School of Dentistry, Los Angeles, CA, USA; G.S. Keller, Keller Professional Group P.C., St. Louis, MO, USA

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Perio Protect Method™

The Perio Protect Method™ uses an appropriately formed, customized dental tray fabricated in a licensed dental lab to

place prescribed solutions into periodontal pockets.

Localized Medication Delivery System

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Perio Protect Method™ Localized Medication Delivery System

Flexible polycarbonate carriers were inserted into periodontal pockets and worn in vivo for two day intervals during treatment with the Perio Protect Method™.

The pictures in this presentation show beginning bacterial biofilm and subsequent SEM pictures taken after 2 days, 7 days, 12 days, and 17 days of treatment.

Flexible Polycarbonate Carriers

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19 mb, before Perio Protect® Treatment

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19 mb, before Perio Protect® TreatmentThe magnified biofilm has formed on the carrier and consists of those bacteria present in the 6mm periodontal pocket.  These can be virulent strains, such as Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Treponema, etc.

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19 mb, 2 days after Perio Protect® Treatment

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19 mb, 2 days after Perio Protect® Treatment

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19 mb, 2 days after Perio Protect® Treatment

This slide demonstrates a much modified oral bacterial environment after 2 days of treatment.  The colonization of fusiform-like bacteria and long rods has been affected by the patient delivered medications and some of the cocci-like bacteria also demonstrate modifications in form.

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19 mb 7 days after Perio Protect® Treatment

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These results after using the medications for 7 days demonstrate a dramatic change in the bacterial colonization.  The bacterial population is decreased in this study by 98% and there are no rods observed in these scans.  The remaining biofilm bacteria demonstrate significant modifications.

19 mb, 7 days after Perio Protect® Treatment

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19 mb, 12 days after Perio Protect® Treatment

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The periodontal pocket is significantly changed by 12 days.  There are almost no bacteria observed and the pellicle is observed to be incompletely formed on the carrier through the action of the medications where hyaluronic acid is cleaved and histadine is converted to alanine and asparagine is converted to aspartate and the protein chains are disrupted.

19 mb, 12 days after Perio Protect® Treatment

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19 mb, 17 days after Perio Protect® Treatment

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99.98% of the bacteria are missing from the carriers at 17 days.  Those having the form of Actinomyces-type of bacteria and a few cocci-like bacteria are all that can be found and we know these from the normal aerobic microflora of healthy gums.

19 mb, 17 days after Perio Protect® Treatment

104

105

106

20 127days

17

~2x10E6

~4x10E3 ~5x10E3

~2x10E6

~4x10E2bact

eria

cel

ls

short rods

Fusiform-like

Selenomonas-like

Cocci-like

Actinomyces-like

100%

0.2% 0.25%

0.02%

100%

11

2222 33

223333

4444 44

33

55

Probing Changes after 12 days

103

Perio Protect Method™ effect on subgingival biofilms (graph) tooth 19 mesial buccal

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100%

0.2% 0.25%0.02%

2200 121277 1717

~2x10E6

~4x10E3 ~5x10E3

100%

daysdays

19mb19mb

~6x10E5

~7x10E2

~3x10E7

carr

ier

lost

carr

ier

lost

2%

1% 1%

0.05%0%

2x10E5 2x10E5

1x10E4

2x10E7

0x10E0

~2x10E6

~4x10E2

0.002%

14mb14mb

14db14db

short rods

Fusiform-like

Selenomonas-like

Cocci-like

Actinomyces-like

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© Perio Protect

End of Presentation

Cell analysis before treatment with the Perio Protect Method™ determined the pocket ecosystem consisted of large numbers of fusiform-like bacteria, cocci, short rods and in one pocket, treponema. After two days of using the Perio Tray™ for minutes each day according to the Perio Protect™ protocol most of the fusiform bacteria and treponema had disappeared. After 17 days there were less than 0.02% (99.98% Kill) of the periopathogenic bacteria and what remained were some cocci and pleomorphic rods that were visible next to a large number of eukaryotic cells.

After 17 days the few remaining bacteria, cocci- and actinomyces-like, are known as normal aerobic microflora of healthy gums.