Penam Periodontics - Evidence based Personalized Periodontics

LANAP Laser Periodontal Procedures

Some dentists claim that LANAP laser treatment offers an improvement in periodontal disease treatment. A scientific literature search using the keyword “LANAP” found only two clinical trials which allows us to assess the effectiveness of the LANAP treatment compared with the other accepted treatment methods. (see following web link)

This study has been conducted by David Harris PhD and his colleagues at several different American Universities (a split mouth multicentre clinical trial). This study compared within the same 54 patients the following treatment methods: 1) simple plaque removal above the gum line (control); 2) standard non-surgical treatment; 3) modified Widman flap surgery; and 4) LANAP treatment. Results: At 6 and 12 months following the procedures were collected. There was no significant difference in pocket depth changes between the LANAP procedure and either nonsurgical treatment or surgical treatment. All three of these methods were better than the control. There was no significant difference in bleeding scores between the three treatment methods at 12 months. LANAP and Surgery were found to have greater levels of discomfort post therapy compared with the controls and the nonsurgical therapy (p<.001). The LANAP procedure had less discomfort than the Surgery procedure (p<.001). Conclusion: The LANAP procedure was not found to be an improvement over the other treatment methods and in fact may have greater discomfort compared with nonsurgical therapy but less discomfort compared with surgery.

The LANAP procedure requires the dentist to perform nonsurgical therapy as part of the procedure (US Patent #5,642,977) so it not unexpected that they will have similar outcomes clinically. The only difference between the LANAP procedure and non-surgical therapy was the LANAP procedure created more post treatment discomfort than that seen with nonsurgical therapy. One may therefore question the cost of the procedure if it provides no additional clinical benefit.

A second study has been undertaken which suggests that laser therapy may be marginally more effective than standard Periodontal debridement in difficult to access root formation issues. This study does not support its use in whole mouth treatment but only those sites with these difficult root structures.

COST: To justify an increase in cost to the patient, the procedure should provide the patient with an additional clinical benefit. Therefore a major consideration as to whether a patient should have a the LANAP procedure performed is its cost. If it costs more than standard nonsurgical therapy than it does not have a cost benefit to the patient. 

The following website gives evidence of costs of the LANAP procedure

This forum suggests cost of $5,000 in 2007 and upward for the LANAP procedure.

If you are offered LANAP treatment and there is a high cost quoted for the treatment consider the following options: 1) ask for a quote for non-surgical therapy; or 2) get a second opinion.

Lasers and Periodontal Treatment.

Multiple other studies have been conducted using lasers as adjuncts to periodontal therapy. However the meta-analyses which evaluate all studies have shown that there is little difference in clinical outcome by the different treatment methods.  Laser alone was not found to be effective so it was promoted as an adjunct to non-surgical therapy. The data does not support an increased benefit in treatment provided by adjunct laser therapy at this point in time.

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