Cherilyn G. Sheets, DDS and James C. Earthman, PhD with Perimetrics Innerview

As dentistry continues to evolve, many of our digital tools, such as cone beam CT and intraoral scanners, have transformed how we plan and deliver care. Yet when it comes to assessing the functional stability of teeth and implants, our current methods remain largely qualitative. Radiographs, tactile evaluation, and patient-reported symptoms provide valuable information, but they are all visually based. Often, they fail to detect early changes until damage is already advanced.

One emerging technology designed to address this gap is Quantitative Percussion Diagnostics (QPD). QPD provides measured, repeatable data on site integrity — both immediately and over time — by monitoring the structural health of each site across appointments. By evaluating how a structure responds to mechanical load, QPD helps uncover developing issues even when radiographs and clinical symptoms appear normal, supporting earlier, more informed clinical decisions.

How QPD Works

QPD measures and analyses the entire mechanical response of a site (natural tooth or implant– restored or unrestored) to a light, standardized percussive tap. The InnerView® system is currently the only clinical device that uses QPD. It captures the resulting energy response in a graph (Energy Return Graph—ERG) and returns two key metrics:

• Mobility (Loss Coefficient): A numerical value indicating how much the site moves under load. In implants, higher values may suggest poor osseointegration, low bone quality, or inadequate volume. In teeth, elevated mobility may reflect reduced periodontal support. An upward trend over time can signal developing instability.
• Internal Mobility (Damage or NFE): The shape of the energy response graph reflects how energy moves through the site. For implants, waveform irregularities may indicate a loose screw, abutment issues, marginal breakdown, or internal fracture. In teeth, they can point to cracked restorations, loose crowns, or localized bone loss.

InnerView  does not require removal of restorations. Each scan takes just a few seconds and can be repeated over time to create a Structural Health Trendline for each site.

Where It Fits in Clinical Practice

QPD does not replace traditional tools — it enhances and complements them. When integrated into the clinical exam, it enables clinicians to:

• Identify areas of structural vulnerability with a full-mouth scan in under two minutes
• Evaluate site stability prior to restorative procedures
• Establish post-treatment structural baselines
• Pinpoint potential sources of discomfort during emergency visits
• Monitor long-term changes and uncover developing issues during hygiene appointments

Trendline data can help clinicians detect subtle issues early, often before symptoms or radiographic signs appear. This supports more proactive, conservative care and enhances communication with patients.

A Validated, Chairside Tool

QPD is supported by 29 peer-reviewed studies, FDA clearance, and over 78 global patents. The InnerView system is simple to use in daily practice. No smart pegs are needed, no disassembly is required, and each scan takes only seconds.

As our diagnostic standards continue to evolve, tools like QPD offer more than just efficiency — they offer clarity. By adding measurable data to routine evaluations, we gain a clearer view of functional health, empowering us to intervene earlier, plan with greater precision, and better protect the longevity of our patients’ restorations and natural dentition.

For clinicians focused on proactive, evidence-based care, QPD represents a meaningful advancement in diagnostic capability.