How LANAP Technology Treats Periodontitis

As we’ve previously discussed, laser-assisted new attachment procedure (the LANAP protocol) is a surgical therapy designed for the treatment of periodontitis through regeneration rather than resection. This therapy and the laser used to perform it have been in use for more than a decade now. LANAP was developed to achieve consistently effective and predictable outcomes. The U.S. Food and Drug Administration cleared the LANAP protocol for the treatment of periodontitis, or gum disease, in 2004.

In LANAP surgery, a variable free-running pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG at 1064 nm wavelength) dental laser is used by a trained and certified Periodontist to treat the periodontal pocket. The laser energy selectively removes diseased or infected pocket epithelium from the underlying connective tissue. The necrotic epithelium is stripped from the connective tissue at the histologic level of the rete ridges.

Since the laser energy is quite selective for diseased tissue, the underlying pleuropotential connective tissue is spared, thereby permitting healing and regeneration rather than formation of a pocket seal by long junctional epithelium.

LANAP Animation

This video illustrates how the LANAP procedure works

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After the LANAP procedure, most patients experience new root surface coating (cementum) and new connective tissues (periodontal ligament) formation (collagen) on tooth roots, preventing tooth loss. Pocket depth reduction is comparable to that achieved by conventional resective osseous or pocket reduction surgery, but without the gingival recession normally associated with more conventional surgery. Significant post-operative reduction in gingival indices, gingival inflammation, and bleeding on probing are also common desirable results of the LANAP protocol.

Because the LANAP protocol spares more healthy tissue than scaling and root planning or osseous surgery, patients experience minimal post-operative pain, bleeding, swelling, gum recession or root sensitivity. These results reduce the future risk of root caries/dental decay of the tooth root. Any discomfort that may be experienced by the patient is easily controlled through the use of non-steroidal anti-inflammatory drugs (over-the-counter NSAIDs) such as ibuprofen.

Early LANAP research shows consistent mean pocket depth reduction (50%) and improved bone density (48%) in an 8-year retrospective study of the protocol’s earliest clinical results. Evidence also shows that 100% of these cases showed some amount of bone density increases. LANAP has also proven effective at reducing pocket depth without gingival recession over a 6-month period.

With regular three-month periodontal recall and maintenance, the LANAP-provided new attachment is stable and has proven resistant to future periodontal breakdown.
Patients are encouraged to improve and maintain standards of oral hygiene to prevent further active periodontitis.

The availability of LANAP as a superior treatment option for periodontal disease is crucial for many reasons.

Studies continue to uncover some startling consequences for poor gum health, which makes the creation of a palatable treatment for periodontitis an important tool in American health care. Widely reported studies have linked periodontitis with heart disease and stroke. A recent case has now linked periodontitis with a full-term baby’s death. The mother’s untreated periodontitis is thought to have introduced deadly bacteria into her womb.

Although about 80% of Americans suffer from gum disease, about 97% of those with moderate to severe periodontitis are not being treated. Acceptance of the LANAP technique in gum disease treatment, introduces an option that more patients are willing to accept.

In my office, I have used LANAP to treat over 175 patients. Most of my patients have experienced the same tremendous results from the procedure, namely, a healthy mouth with evidence of bone regeneration and resolution of periodontal disease.

Patients experience no pain, no bleeding, and little to no recovery with results like I’ve never seen in my 27 years as a Periodontist. The outcomes from this cutting edge treatment are truly extraordinary.