LANAP: Laser Periodontal Therapy

The newest technology available for periodontal are is the Nd:YAG Millennium PerioLase. This is the latest generation of the Nd:YAG laser, and it’s designed specifically to treat periodontal disease using LANAP (Laser Assisted New Attachment Procedure). Like LASIK surgery for the eyes, this therapy using the new laser is a breakthrough in the treatment of periodontal disease. It’s therapy that eliminates the need, in some cases, for conventional blade and suture surgery. Instead of cutting away tissue, we’re now able to regenerate soft tissue and bone by encouraging the body to heal itself naturally.

The LANAP procedure is patented and FDA-approved. The objective of LANAP laser therapy is pocket reduction achieved by establishing a new connective tissue attachment to the tooth at a more coronal level. The LANAP procedure provides an environment in which new bone, cementum, and periodontal ligament can form on previously diseased root surfaces. LANAP laser therapy allows us to treat periodontal disease with a minimally invasive procedure that eliminates the need, in some cases, for conventional blade surgery (flap and osseous surgery).

Some of the clinical advantages of the new laser include:

• Precision
• Deeper penetration- kills bacteria beyond the tip up to 1.5 mm into dentin tubules
• Selective photo-thermal ablation of red inflamed tissue
• Affects calculus so it’s easier to remove
• Neutralizes endotoxins in root and tissue
• Biostimulation of stem cells in the periodontal ligament to promote regeneration
• Hemostasis
• Less recession
• Much less sensitivity
• Quicker healing overall

Limitations include:

• Specialized training and safety precautions required, and equipment is relatively expensive
• An initial delay in soft tissue healing
• Cannot be used to remove bone or on amalgam
• Somewhat slower than conventional modalities
• Not appropriate for crown lengthening with osseous contouring, gingival grafting, or procedures to expose fractures, etc.
• Not every tooth can be saved and double-digit pockets may need double treatment
• Not every pocket responds well- i.e.: smokers.
• As with flap surgery, Class II and Class III furcations will usually still be a problem.

In addition to the clinical benefits and limitations, laser therapy benefits for patients include significantly less pain, recession, bleeding, and root sensitivity, as well as minimal swelling and downtime after treatment. Less downtime is cost effective because patients don’t have to miss work (usually 2-3 days with conventional treatment).

Laser treatment is also great for patients who have medical problems requiring drugs such as aspirin, Plavix, or Coumadin because they do not have to discontinue use of the drugs with laser therapy. Patients with advanced periodontal disease who take bisphosphonates such as Fosamax can avoid extractions that can lead to osteonecrosis of the jaw because teeth with a poor prognosis can now often be saved by treatment with the new laser.

The Millennium PerioLase’s fiber optic tip removes diseased tissue and kills bacteria in the pockets. Healthy tissue is minimally affected by the laser. Ultrasonic scalers and/or hand tools remove the loosened calculus deposits. The laser makes another pass on a different setting to kill bacteria in the bottom of the pockets and on the bone. The laser also stimulates formation of stick fibrin clots to seal the pockets and allow regeneration of bone and soft tissue.

Laser treatment can be achieved, in most cases, in only one visit because the new laser therapy eliminates the separate deep scaling visits. This makes it ideal for patients who area fearful of conventional periodontal deep scaling and surgery. Of course, regular maintenance visits and good plaque control will be necessary following laser treatment.

Simply put, the Laser Treatment Procedure can be described in the seven steps illustrated below:

1. A perio probe indicates excessive pocket depth.
2. The laser removes bacteria and diseased tissue.
3. An ultrasonic Piezo scalr and special hand instruments are used to remove root surface tartar.
4. Blood clots in the pockets and keeps the epithelium from growing back into the pockets (barrier membrane not required).
5. The soft tissue and bone begin to reattach to the clean root surface.
6. Any bit trauma is adjusted.
7. New connective tissue attachment and bone growth occur.

The Appointment Process with Laser Treatment

• First Visit- Patient examination including digital x-rays to measure the bone, plus bacterial samples and culturing if indicated.
• Second Visit- Treatment recommendations are presented.
• Third Visit- Laser treatment is usually completed in one visit, and the patient can return to work the same day if not sedated.
• Short follow-up visits and regular maintenance are scheduled after the laser treatment.

One Patient’s Experience

“I’ve had gum surgery numerous times since I was in my 30s. Following the surgeries, there was bleeding, a lot of discomfort and pain. Recently laser gum surgery was performed on me and this was a totally new experience- nothing like the gum surgeries I had in the past. The laser equipment is state-of-the-art and the doctor took care of all four quadrants at one time- it was a world of difference! I had no discomfort at all following the procedure. The doctor gave me his cell phone number in case I needed to reach him and the office staff also called to check on me. It was the best follow-up I’ve ever experienced. In addition to the procedure going to smoothly, the office experience was a pleasure. From the moment I walked in, it was great. It’s refreshing to see that the doctor and everyone on staff has a smile on their face, and is super nice. I would definitely recommend them for anyone who needs periodontal treatment and already have.”

-Phyllis R., Hollywood, FL

Laser Treatment Can Be Life Changing

For patients who are concerned about conventional blade surgery for treatment of periodontal disease, the new laser treatment can be a life-changing event. They’re often able to save their teeth, preserve their natural smile, and avoid the potentially life-threatening systemic effects of untreated periodontal disease. Laser treatment gives these patients another possible option.

We are one of only a very few periodontal practices in the Detroit Metropolitan Area to offer this new laser treatment. If you would like more information about LANAP laser therapy, call our office at 248-357-3100 to schedule a consultation appointment.