Traditional gum surgery involves making incisions and pulling back the gum tissue to gain access for debridement of the infected gum tissue and tooth. Surgical objectives include either recontouring the bony defects and gum tissue around the teeth or placing regenerative materials to regrow the lost supporting tissues.
LANAP (Laser Assisted New Attachment Procedure) uses a specialized laser to destroy the bacteria which cause disease and alter the tissue to allow for healing through a minimally invasive procedure. The use of the laser results in less gingival recession than traditional scalpel surgery while avoiding the use of sutures. The recovery period is very similar to having scaling and root planing which may require the use of over the counter anti-inflammatories for comfort management.
LANAP is the only FDA approved laser treatment for the regeneration of periodontal tissues. Scaling, root planing and occlusal management are important components of the treatment that are aided by benefits of the laser. The Millenium Periolase MVP-7 Nd-Yg laser provides the following tissue interactions that are unique to this wavelength and process:
1. Selective removal of diseased gum tissue lining the periodontal pocket leaving healthy tissue intact gingiva.
2. Inflamed tissue has a darker color, as do many pathogenic bacteria specific for periodontal disease. The wavelength of this laser has significant absorption into dark pigmented tissue and bacteria resulting in specific interaction with laser and minimal affect on adjacent healthy tissue.
3. The laser penetrates the gingival tissue and root to provide a deep anti-bacterial effect.
4. Results in denaturation of the bond of the calculus to the root surface facilitating its removal.
5. Provides hemostasis, or blood clotting, to minimize bleeding during the procedure to aid in debridement and increase patient comfort during and after the procedure.
The LANAP procedure is illustrated in the following schematic:
A. Depth of pocket is measured under anesthesia
B. Laser selectively removes infected tissue
C. Ultrasonic instruments clean root surfaces
D. Laser disinfects pocket and seals the wound
E. Pressure is applied to gum tissue to aid in healing
F. Bite is adjusted through selective grinding
G. Healing results in new attachment
LANAP treatment is usually provided during 2 separate appointments followed by a few followup visits to monitor the healing and further adjust one's bite as needed. Normal brushing and flossing usually resumes 1-2 weeks after treatment and patients rinse with a prescription rinse during this early post surgery period. A periodontal maintenance program every 3-4 months is commenced approximately 2 months after treatment and a reevaluation of the treated areas is performed 6 months after treatment.
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