Industry
Periodontal Care
Challenge
Patient with generalized severe gingival inflammation and bleeding, heavy plaque and calculus accumulation, and multiple sites exhibiting probing depths of 8mm.
Results
A significant reduction in bleeding on probing, and the probing depths had improved considerably, with many sites reducing by 2mm or more in just 3 weeks.
Product Used
PerioDT
"The patient was visibly pleased and reported feeling 'so much better,' noting a significant reduction in gum pain and no longer experiencing spontaneous bleeding during brushing or eating."
Patient History
The patient, a middle-aged male, presented to our office with the chief complaint: “My gums bleed and hurt sometimes.” Upon initial examination, it was evident that the patient had not received a professional dental cleaning in many years.
Clinical signs included generalized severe gingival inflammation, heavy plaque and calculus accumulation, and multiple sites exhibiting probing depths of 8mm. Bleeding on probing (BOP) was widespread. Based on the clinical findings and patient history, he was diagnosed with generalized stage III, grade B periodontitis.
Probing Depths & Bleeding Before TreatmentIncorporation of PerioDT
Abstract
Background: Fixed lingual retainers can hinder biofilm control and instrumentation on mandibular anterior lingual surfaces, predisposing to persistent inflammation and calculus accumulation.
Case: A healthy 27-year-old female on a 3-month periodontal maintenance schedule presented overdue, with persistent bleeding and calculus beneath a bonded lingual retainer spanning teeth 33–43. Baseline indices at the visit (2025-05-31) were plaque 22%, calculus 22%, bleeding 42%, suppuration 0%. Several sites exhibited probing depths ≥4 mm (notably 25, 17, 47, 46, 37, 36).
Intervention: After isolation and drying, a desiccant agent (PerioDT, sulfonated phenolics + sulfuric acid) was applied per instructions, then removed with high-volume suction and water rinse before hand/ultrasonic instrumentation, piezoelectric debridement, sub and supragingival air polishing, and expandable floss under the retainer.
Outcomes: Tenacious sub-retainer calculus detached with minimal pressure; hemostasis improved visualization; immediate post-care photographs showed cleaner subgingival surfaces and reduced bleeding. The patient reported the retainer region “felt the cleanest it has in years.”
Conclusion: In areas with compromised access around fixed retainers, pre-procedural desiccation with PerioDT can facilitate efficient biofilm/calculus disruption and improve debridement visibility as an adjunct to mechanical therapy. Literature supports desiccant technology as a useful adjunct to SRP and maintenance care in disrupting biofilm matrices.
Bonded lingual retainers are widely used for long-term stabilization of mandibular anterior alignment. However, their presence can increase plaque/calculus retention and gingival inflammation because the wire and bonding composite impede effective home care and professional instrument access. Studies have documented higher plaque and calculus accumulation adjacent to fixed retainers with corresponding gingival inflammation. https://pmc.ncbi.nlm.nih.gov/articles/PMC6605884/
Adjunctive chemical desiccants, combinations of sulfonated phenolics and sulfuric acid—rapidly dehydrate biofilm, denature proteins, and collapse the extracellular polymeric substance (EPS) matrix, facilitating mechanical removal. The PerioDT formulation applies this desiccation technology for efficient debridement in restricted-access sites. https://pmc.ncbi.nlm.nih.gov/articles/PMC10024107/
Case Presentation
Patient: Healthy, medication-free female, 27 years old.
Orthodontic history: Bonded lingual retainer 3.3–4.3; floss passes freely between centrals and laterals.
Chief complaint: “Persistent inflammation and calculus beneath my lower front wire.”
Treatment date: May 31, 2025
Clinical and Periodontal Findings (05/31/2025)
• Plaque index = 22%
• Calculus index = 22%
• Bleeding = 42%
• Suppuration = 0 %
• Probing depths ≥ 4 mm: 25, 17, 47, 46, 37, 36
• No furcations ≥ class I; no mobility > 0
Intervention (Chairside Protocol)
Adjunctive product: PerioDT (Young Specialties), a desiccant agent with sulfonated phenolics + sulfuric acid.germiphene.com
After Treatment
Probing Depths & Bleeding After Treatment
• Debridement: Calculus under the retainer detached effortlessly post-PerioDT.
• Hemostasis: Bleeding significantly reduced, improving visibility.
• Post-treatment tissue appearance: Margins tighter, papillae pinker.
• Patient feedback: Reported the site “felt the cleanest it has in years.”
Figure 5. Sequential clinical images showing the progression of treatment for the mandibular anterior region (33–43).
(A) Baseline image illustrating inflamed gingival tissues and heavy sub-retainer calculus accumulation. Embrasure spaces fulled with biofilm and calculus.
(B) At placement of PerioDT (Young Specialties), showing gel coverage beneath and around the fixed lingual wire.
(C) After initial debridement using expandable floss, partial removal of denatured biofilm with visible hemostasis and improved access.
(D) Immediate post-debridement following completion of hand, ultrasonic, piezoelectric, and air polishing instrumentation, demonstrating clean subgingival surfaces, reduced erythema, and recontoured gingival margins.
Discussion
Fixed lingual retainers foster a protected microenvironment conducive to biofilm maturation and mineralization. Desiccation with sulfonated phenolics + sulfuric acid works by collapsing hydrated EPS, denaturing bacterial proteins, and weakening adhesion between calculus and enamel.
PerioDT’s hemostatic and dehydrating effect improves visualization, critical when access is limited by bonded orthodontic components. Combined with ultrasonic, piezoelectric, and air-polishing instrumentation, this adjunctive step can enhance debridement efficiency without systemic antibiotics.
Studies of similar desiccant technologies have demonstrated improved bleeding-on-probing and probing-depth reductions when used adjunctively with SRP compared to
SRP alone.
In a periodontal maintenance patient with a mandibular lingual retainer, pre-procedural desiccation with PerioDT improved hemostasis and visualization, facilitated easy removal of otherwise tenacious sub-retainer calculus with minimal pressure, and produced immediate clinical and patient-reported benefits. Given the access challenges imposed by fixed retainers, desiccation technology represents a practical, non-antibiotic adjunct to optimize efficiency and outcomes during maintenance care. Controlled follow-up measures (PD, BOP) are encouraged to quantify response over time. germiphene.com+1
Clinical Significance
• Fixed lingual retainers create plaque-retentive niches; special strategies are needed to disrupt mature biofilm/calculus efficiently. pmc.ncbi.nlm.nih.gov
• PerioDT desiccates and denatures the EPS-rich biofilm matrix in ≤30 s, improving access and visibility for subsequent instrumentation—particularly useful under wires and around prosthetics. germiphene.com+1
• Combining desiccation with hand/ultrasonic/piezo instrumentation and subgingival air polishing aligns with contemporary maintenance protocols and is supported by adjunctive-therapy evidence. PubMed+1
Product and Application Notes
• Agent: PerioDT (Young Specialties); sulfonated phenolics + sulfuric acid; liquid or gel.
• Indication: Adjunctive decontamination and smear-layer/necrotic debris removal during debridement; non-systemic, non-antibiotic; compatible with enamel, dentin, cementum, porcelain, titanium, and other metals. germiphene.com
• Protocol: Isolate/dry → apply thin film (≤30 s) → high-volume suction + water rinse → instrument (hand/ultrasonic/piezo/air polish) → optional reapplication for residuals. (Matches your technique and manufacturer guidance.) germiphene.com+1
References
1. Kartal Y, Kaya B. Fixed Orthodontic Retainers: A Review. Turk J Orthod. 2019. (“Increased plaque/calculus or gingival inflammation”). pmc.ncbi.nlm.nih.gov
2. Juloski J, et al. Long-term influence of fixed lingual retainers on periodontal health. Eur J Orthod. 2017. (“More pronounced plaque and calculus”). pmc.ncbi.nlm.nih.gov
3. Fudalej PS, et al. Periodontal implications of fixed retainers. Semin Orthod. 2024. (“Retainers promote accumulation”). ScienceDirect
4. Khalil B, et al. Effects of adjunctive desiccant agent in periodontal therapy: review. Clin Cosmet Investig Dent. 2023. (Adjunct to SRP). pmc.ncbi.nlm.nih.gov
5. Isola G, et al. Desiccant agent + SRP reduces PD vs SRP alone (12-mo). Clin Oral Investig. 2017. TRATAMENT PARODONTOZA HYBENX OZOSAN
6. De Nale M, et al. In-vitro: HYBENX denatures biofilm matrix via sulfuric acid + sulfonated phenols. Sci Rep. 2025. Nature
7. Martins O, et al. Efficacy of air polishing in supportive periodontal therapy: systematic review. J Clin Periodontol. 2023. PubMed
8. Gheorghe DN, et al. Subgingival use of air-polishing powders: systematic review. Appl Sci. 2023. pmc.ncbi.nlm.nih.gov
9. Young Specialties. PerioDT product information; desiccation technology; material compatibility. (Accessed 2025). germiphene.com+1
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