LANAP Protocols

In 1998 the Federal Drug Administration approved Laser Assisted New Attachment Procedure (LANAP) protocol, a technique for the removal of diseased or inflamed soft tissue from the gums. LANAP protocol replaced painful invasive oral surgery; it is performed by a dentist with special training, and can be done in his office using only local anesthesia. LANAP protocol removes infections and tumors from the gums without cutting or stitching and cleans tartar and plaque from the roots of the teeth.

History

• Before LANAP, moderate to severe periodontal disease required a painful, invasive procedure. The gum was incised, cut open with a scalpel and scraped with a curette; plaque and tartar had to be scraped from the teeth at the root. Drills were required to shaped the incised jaw bone supporting the teeth; in some cases, bone had to be cut from another part of the body to graft to the jaw. Periodontal surgery was done over multiple visits to the oral surgeon, who left sensitive roots exposed to give the gums a chance to heal; occasionally, the exposed roots developed cavities. Gums were stitched closed against the teeth, and recovery was slow. Due to the time, cost and pain involved, patients often delayed or refused such treatment.

Equipment

• The Laser Assisted New Attachment system consists of a console with an arm that ends in a hand piece. An infrared laser beam from the optical system in the arm is focused by a lens in the hand piece into pulses or a continuous wave. The focused beam produces a spot at the treatment site.

Uses

• The LANAP protocol laser surgery is used to remove inflamed soft tissue, overgrowths, tumors or mucosa from the gums and mouth. LANAP protocol can be used to debride abscesses with antibiotic therapy or to attach periodontal ligaments, the connective tissue which holds teeth to the jaw bone. The protocol may also be used in salivary gland surgery, plastic or cosmetic surgery, dermatological procedures, arthroscopic knee surgery, neurosurgery and gynecology.

Procedure

• The laser beam used in the treatment of periodontal disease is projected into a pocket cut into the outer layer of the gums. The LANAP laser destroys pathogens and bacteria and removes dead and infected gum tissue. In a pocket less than 4 millimeters deep, the laser is applied for 5-10 seconds, pockets 4-6 millimeters deep require a 20 second laser pulse and pockets 7-9 millimeters deep require 30 seconds of concentrated laser light to remove infected tissue. Pockets greater than 9 millimeters deep require 40 seconds of laser treatment.