PERF, or the Pacific Endodontic Research Foundation, is a non-profit teaching and research foundation dedicated to improving the standards of the endodontic specialty. A charitable foundation, PERF has been at the forefront of endodontics since it was founded by TDO founder and director Dr. Gary Carr in 1993. Dr. Carr’s development of the technique of ultrasonic root end preparation came out of PERF, as well as his groundbreaking work with a surgical microscope, which resulted in the establishment of the new field of “Microscopic Endodontics.”

In 2001 Microscopic Endodontics became required training for postgraduate students in order to become certified. Ironically, most endodontists were initially skeptical about introducing the microscope to the operatory. To cultivate appreciation for this radically new way of working, PERF personally trained over 2,000 endodontists and endodontic assistants over the past 15 years. The eventual acceptance of this change has dramatically improved the safety and success rate of endodontic surgeries for thousands of people around the world.

More recently, a smaller subset of TDO clinicians has initiated the TDO Outcomes Project. This trial consists of 35 endodontists treating nearly 2,000 patients who will be treated and recalled for 5 years to determine if there is a difference in outcomes between one- and two-visit endodontic treatments. Entirely funded by TDOers and their patients, The TDO Outcomes Project is the first multi-centered randomized control clinical trial in the history of endodontics.