Dr. Carlos E. Nemcovsky, Department of Periodontology and Dental Implantology The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University

The PeriZone PerioPatch is demonstrated as a novel device to enhance soft tissue healing in a variety of cases.

Patients often experience oral inflammation. It may be caused by self-induced trauma or the inflammation may be in an area that must heal following a dental procedure. MIS Implants Technologies’© 

 acts as a barrier while it provides relief and absorbs excess wound exudates to promote healing.

The patch is a Class I medical device consisting of two layers: the outer backing and the gel layers. Both layers provide protection from irritation that can occur from eating and speaking.
	The following article indicates clinical applications using PerioPatch® for a variety of cases.

PerioPatch® (Izun Pharmaceuticals© Ltd., Jerusalem, Israel) is a topical hydrogel patch that adheres and immediately conforms to the shape of the soft tissues. The physical barrier created by PerioPatch® absorbs wound exudates and protects the oral mucosa from trauma and possible irritants that could aggravate the wound, thus, improving patients’ comfort. This hydrogel patch is composed of an absorptive polymolecular matrix based on natural plant extracts. Its ingredients are ingestible, and therefore, there is no risk if any part of the patch is swallowed.

Because of its herbal components, PerioPatch® not only forms a protective seal over inflamed gingiva and oral mucosa, but, at the same time, promotes natural healing and reduces the signs and symptoms of inflammation with minimal side effects.


	In clinical practice, for standard cases, the application of three PerioPatch® within the first 24 hours followed by 2-3 additional days of maintenance usage applying 1 or 2 patches per day is recommended. After application, the outer backing of the PerioPatch® will loosen and can be removed by the patient. The gel will remain in place and continue to provide protection for up to 6 hours.

Due to its easy application, this innovative medical therapeutic device presents versatile applications such as enhancing healing of all types of oral wounds, injuries and ulcerations of the gingival and oral mucosa, including stomatitis, minor chafing, traumatic ulcers, and lesions associated with dental procedures.

The purpose of the present report is to present several clinical applications in the oral cavity for this novel device including: symptomatic treatment of gingival inflammation, as well as gingival and oral mucosa ulcerations, following scaling and root planing procedures, and following periodontal and other dental procedures.

Symptomatic relief of gingival inflammation


	Reduction of gingival inflammation not related to plaque accumulation may be rapidly achieved following PerioPatch® application with the mentioned protocol (Figs. 1-3). In a double-blind, randomly controlled clinical trial in patients with moderate to severe gingivitis PerioPatch® , as a sole intervention, without any mechanical plaque debridement of the area, significantly reduced localized gingival inflammation. PerioPatch® application appeared to be a safe and effective means of topically controlling gingival inflammation.  

PerioPatch® reduced the local inflammatory mediators, along with the crevicular fluid volume and improved inflammatory signs associated with gingivitis. Another valuable application is in cases presenting gingival inflammation due to manipulation during dental and implant rehabilitation procedures such as tooth and abutment preparation with subginvial margins impression taking and provisional crowns, where a rapid resolution of the inflammation is desired.

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	PerioPatch® application is appropriate for gingival and oral mucosal ulcerations such as aphthae, small soft tissue lacerations following dental treatment and other oral inflammatory lesions. In certain cases longer patch application periods may be needed until the complete lesion resolution is achieved (Figs. 4-8).

Application following scaling and root planing procedures


	The main goal of scaling and root planing (SRP) procedures is the reduction of inflammation through elimination of bacterial contamination and calculus. However, because this inflammation is due to a disease process, elevated levels of inflammatory collagenases have been shown to be present. PerioPatch®, in addition to SRP, has been shown to reduce MMP-9 levels, compared to SRP alone.

Also, during this procedure certain laceration of the soft tissues usually occurs. PerioPatch® application immediately after these procedures leads to a rapid reduction in clinical signs of inflammation, leading to better clinical results (Figs. 9-11). Inflammation is necessary for the effective defense against pathogens and to set in motion tissue repair following injury. Yet inflammation itself is the culprit in a wide variety of common diseases, among them rheumatoid arthritis, atherosclerosis, and others.

PerioPatch® was shown to reduce inflammation when used in conjunction with conventional mechanical treatment. This improvement was significantly greater than that seen with conventional treatment alone (Figs. 12-15).

In a recent, unpublished study, PerioPatch® was applied immediately following The PerioPatch® treated area showed significantly reduced inflammation and bleeding, as measured by gingival index (GI) and bleeding on probing (BOP). The areas treated with SRP alone showed improvement as well, though this was significantly less pronounced, both with respect to GI and BOP.

Application after periodontal and other surgical oral procedures


	In addition to reducing the signs and symptoms of inflammation, PerioPatch® also assists in protecting and preventing the oral soft tissues from continued damage, especially after surgical procedures. PerioPatch® application following oral surgical procedures enhances soft tissue healing in addition to inflammation control.

PerioPatch® application leads to a rapid reduction of localized pain and irritation, which makes it useful for relieving acute and chronically inflamed soft tissues, or soothing the local trauma to the gingiva, often associated with surgical and periodontal oral treatments. PerioPatch® may also be applied to improve soft tissue healing of surgical wounds in implant (Figs. 16-25) and periodontal (Figs. 26-37) procedures.SRP treatment by the treating clinician, followed by two subsequent applications at eight-hour intervals by the patient, and re-evaluated 2-4 weeks later. On a separate visit, a similar area of gingival inflammation was identified on the contra lateral side and treated with SRP alone, here too with re-assessment after 2-4 weeks. The PerioPatch® treated area showed significantly reduced inflammation and bleeding, as measured by gingival index (GI) and bleeding on probing (BOP). The areas treated with SRP alone showed improvement as well, though this was significantly less pronounced, both with respect to GI and BOP.

PerioPatch® application leads to a rapid reduction of localized pain and irritation, which makes it useful for relieving acute and chronically inflamed soft tissues, or soothing the local trauma to the gingiva, often associated with surgical and periodontal oral treatments. PerioPatch® may also be applied to improve soft tissue healing of surgical wounds in implant (Figs. 16-25) and periodontal (Figs. 26-37) procedures.An interesting application for PerioPatch® may be in dental implant guided bone regeneration procedures (Figs. 16-25). Primary soft tissue closure and maintenance are indispensable for the success of bone augmentation procedures with use of resorbable and non-resorbable barrier membranes.

Early exposure of these membranes leads to decreased bone regeneration. 


	The PeriZone® PerioPatch® is ideal for patients suffering from the following conditions:
	• Irritated gums (such as immediately following SRP and other dental procedures), wounds, extractions, injuries, and ulcerations of the gingiva and oral mucosa
	• Stomatitis, minor chafing and traumatic ulcers
	• Abrasions caused by braces and dentures
	• Minor burns caused by food or chemicals (i.e. bleaching)

As this article has showcased, PerioPatch®, first placed by a clinician chairside, delivers optimal results in tissue healing in a variety of clinical cases. PerioPatch® acts as a protective mechanical barrier, while at the same time reducing clinical signs of inflammation and enhancing soft tissue healing at the surgical site, therefore reducing the possibility of detrimental soft tissue dehiscence over the barrier membranes.

Dr. Carlos E. Nemcovsky, Department of Periodontology and Dental Implantology The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University

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