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LANAP is a U.S. Food and Drug Administration-approved patented protocol for the treatment of periodontitis, or gum disease. This is how Wikipedia ,the online encyclopedia, describes the technique…After LANAP, 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 excellent and comparable to that achieved by conventional resective osseous or pocket reduction surgery, but without the gingival recession normally associated with osseoussurgery. Significant post-operative reduction in gingival indices, gingival inflammation, and bleeding on probing are also desirable results of LANAP.
The patient experience is also generally positive. As LANAP is tissue-sparing and contrary to the old fashioned resective paradigm, patients enjoy a smile with minimal post-operative recession and attendant disfigurement or root sensitivity. Minimization of post-therapy gingival recession also reduces the future risk of root caries/dental decay of the tooth root. Through the natural analgesic biostimulatory effects of laser irradiation, patients usually have minimal post-operative discomfort. This discomfort is easily controlled through the use of Non-Steroidal Anti-Inflammatory Drugs (over the counter NSAIDs) such as Ibuprofen.
With normal three month periodontal recall and maintenance, the LANAP-provided new attachment is remarkably stable and resistant to future periodontal breakdown. Patients are encouraged to improve and maintain standards of oral hygiene to prevent further active periodontitis.
Old school detractors do exist and tend to feel that LANAP does not succeed in its surgical result. According to the American Academy of Periodontology: “In conclusion, The Academy is not aware of any randomized blinded controlled longitudinal clinical trials, cohort or longitudinal studies, or case-controlled studies indicating that “laser excisional new attachment procedure (or Laser ENAP)” or “laser curettage” offers any advantageous clinical result not achieved by traditional periodontal therapy. Moreover, published studies suggest that use of lasers for ENAP procedures and/or gingival curettage could render root surfaces and adjacent alveolar bone incompatible with normal cell attachment and healing.” However, when considering this information, this 10 year old undated statement by the AAP was made in August 1999 and has since been rendered irrelevant by additional peer reviewed publications, namely the Yukna manuscript of human histology published in the International Journal of Periodontics and Restorative Dentistry in 2007, and the Harris article in General Dentistry in November 2004.
According to the United States Federal Drug Administration: ENAP is not LANAP (see k030290 reference below). Also LANAP is not “laser curettage” or “sulcular debridement” but is a surgical procedure when compared to non-surgical curettage or debridement.
