Pennsylvania Dentist Receives Orkos Award

Posted: July 16, 2015
Edited by Dentaltown staff

ST. LOUIS—Infections around dental implants are an increasingly common challenge with few good non-surgical treatment options. One solution to help manage periodontal bacteria involves prescription tray delivery of hydrogen peroxide gel.

Dr. Jeffrey Goldstein offers this tray therapy and his treatment results have awarded him an Orkos Award for excellence in case study of periodontal therapy. Dr. Goldstein also was honored for his efforts to help patients understand the importance of periodontal health and its relationship with diabetes and other inflammatory diseases.

The patient in this case study initially presented with signs of periodontitis in 2001 and was referred to a local periodontist. He refused to follow up with the specialist or to maintain regular visits. By 2004, his periodontal disease was advanced and three teeth in the upper right quadrant were no longer salvageable. Implants were placed in 2007 and the patient’s periodontal status remained stable for several years.

In 2014, however, he exhibited 4mm to 7mm deep periodontal pockets, bleeding on probing at 36 sites and moderate subgingival calculus. Conditions were worst around the three implants. At this point he was desperate to save his implants and teeth, and he specifically wanted to avoid more surgery.

A salivary diagnostic test confirmed the presence of eight bacteria associated with periodontal disease. To help with effective biofilm management, Dr. Goldstein prescribed Perio Trays to place a 1.7% hydrogen peroxide gel deep into the pockets before and after nonsurgical periodontal debridement and laser therapy.

Perio Trays are customized based on the patient’s probing depths and designed to seal around the periodontal tissues. This helps drive the gel deep into the pockets and keep it in contact with exposed implant and root surfaces.
Perio Tray delivery began on August 21, 2014 and continued throughout the course of treatment, dropping from the initial four daily 15-minute increments to two daily 15-minute increments. Four rounds of periodontal debridement, laser therapy and subgingival irrigation were completed between September 9 and November 13, 2014. At a re-evaluation visit on December 19, bleeding on probing was present at one site and the deepest pocket measured 5 mm; the deeper pockets remained around the implants.

From December to February, the patient continued to use the Perio Trays regularly. At the February 20, 2015 periodontal maintenance visit, all pockets were within normal range except for four 4mm pockets. There was no bleeding and a secondary diagnostic test confirmed a reduction in oral bacteria. Five of eight bacterial species present in the pre-treatment test were completely eliminated, including T. forsythia.

Dr. Goldstein has been prescribing Perio Trays since 2006.

“I’ve completely changed my approach with these trays,” he said. “I can help patients treat the cause of the disease between visits instead of just treating symptoms. In my practice, those patients who accept Perio Trays show significant improvements and are able to maintain good results. I’ve found that this tray delivery is the best way to manage oral biofilms between visits. In some cases, I’ve prescribed it to reduce bacteria and discomfort before debridement.”

For details on the Orkos Award or to view other case study winners, visit Additional information on prescription tray delivery is available at



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