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What are the best applications for lasers in periodontal therapy? What would be the most appropriate type of laser?

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I have been practicing Periodontics since 1985. I am currently using a FDA cleared protocol called LANAP for many of my periodontal cases. At the current time, my partner and I have over 500 cases documented with radiographs and clinical photos.

Anybody out there interested to discuss this further...or have any questions, please comment.

Thanks..

Eric Linden
see reply below regarding laser therapy
Hello Dr Linden I am very interested in further discussion.

What results have you found?
There are many things to know about lasers. First, not all lasers do the same things. Some are approved only for soft tissue applications, and some for both hard tissue (teeth, bone) and soft tissue applications. The differences are determined by the wavelength of the energy, and, in some cases, the specific treatment protocol. You should read the FDA clearances for each laser. For example, the "LANAP" (laser assisted new attachment procedure) is a specific for the Millennium Dental Technologies laser. The Biolase Waterlase MD also recently received FDA clearance for "Deep Pocket Therapy with New Attachment". Both claim to assist in new attachment of periodontal structures to natural teeth.

Check out the most recent American Dental Association position statement on the use of lasers in dentistry. The American Academy of Periodontology has consumer information about dental lasers, as well. This information is a bit outdated, in my opinion. Based upon my personal experience at the recent AAP meeting in Boston, I would assume that the consumer information will be updated in the near future as new research papers are published.

A quick overview chart of a few of the lasers can be found below and at AMD lasers. They have introduced a relatively inexpensive "Picasso" laser. They are also a good source for some clinical articles, as other the other major laser manufacturers.

Hope this helps. Keep the discussion going!

Chart:

Yes I agree with you the ADA and AAPposition on LANAP is completely outdated.

Cary Feuerman, DMD said:
There are many things to know about lasers. First, not all lasers do the same things. Some are approved only for soft tissue applications, and some for both hard tissue (teeth, bone) and soft tissue applications. The differences are determined by the wavelength of the energy, and, in some cases, the specific treatment protocol. You should read the FDA clearances for each laser. For example, the "LANAP" (laser assisted new attachment procedure) is a specific for the Millennium Dental Technologies laser. The Biolase Waterlase MD also recently received FDA clearance for "Deep Pocket Therapy with New Attachment". Both claim to assist in new attachment of periodontal structures to natural teeth.

Check out the most recent American Dental Association position statement on the use of lasers in dentistry. The American Academy of Periodontology has consumer information about dental lasers, as well. This information is a bit outdated, in my opinion. Based upon my personal experience at the recent AAP meeting in Boston, I would assume that the consumer information will be updated in the near future as new research papers are published.

A quick overview chart of a few of the lasers can be found below and at AMD lasers. They have introduced a relatively inexpensive "Picasso" laser. They are also a good source for some clinical articles, as other the other major laser manufacturers.

Hope this helps. Keep the discussion going!

Chart:

It has been found in various research that the use of lasers as an adjunct to scaling and root planing (SRP) may improve the effectiveness of this procedure and can even leads to less bleeding, swelling and discomfort to the patient during surgery. However, the use of laser may or may not harm the patient. At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.

THE GOOD: dental lasers are a tremendous asset in soft tissue surgeries, including gingivectomy/gingivoplasty, frenectomy, soft tissue biopsies, gingival sculpting associated with periodontal plastic surgical procedures because of their proven hemostatic effect. Additionally, they have been used successfully in treatment of drug-induced gingival overgrowth either alone or in conjunction with conventional surgery.

THE QUESTIONABLE: there is preliminary evidence that lasers may be useful for treatment of dentinal hypersensitivity, but this requires further investigation.

THE BAD: lasers have been claimed to be more efficient than conventional scaling and root planning.

You will face minimum discomfort with laser therapy as compared to the traditional method of treating periodontal infections, which involved cutting and removing tissue.

Well, you are correct! Laser dentistry is fascinating. Lasers may just revolutionize the way we practice dentistry and change the way we approach periodontal disease as a whole. This new invention is a very innovative technology and is very intriguing. It will surely affect the life of a normal people who want to quit from periodontal disease. Lasers on the market today now treat periodontal disease. Many periodontists and even general dentists are utilizing this laser technology and watching their practices thrive from its results. Thanks for sharing this.

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