Laser Treatment at HSORC

Article by: Harley Street Oral Reconstruction Centre

The Harley Street Oral Reconstruction Centre is delighted to now be able to provide the latest laser technology available to treat periodontal disease and infections that can occur around implants. This laser technology is also able to provide surgical removal of tissue that requires biopsy and some types of surgical treatment without having to resort to a scalpel or sutures.

The Millennium PerioLase® is an American laser that was specifically developed to treat periodontal disease using LANAP (Laser Assisted Reattachment Procedure). This is a patented process which is FDA approved and allows for the treatment of disease with a minimally invasive procedure which in many cases eliminates the need for conventional scalpel and suture surgery.

The Millenium PerioLase® is an Nd:LYAG laser and is equipped with all the unique features necessary to perform Laser Periodontal Therapy™. The PerioLase® is able to effectively reach down into deep periodontal pockets to help eliminate infected tissue and destroy pathogenic bacteria. LANAP laser therapy reduces pockets by establishing a new connective tissue attachment to the tooth at the coronal level. It creates an ideal situation in which new bone and periodontal ligaments can form on root surfaces that were diseased before treatment began. It is a minimally invasive periodontal procedure and in many cases will eliminate the need for conventional periodontal surgery where tissue is cut with a scalpel, requiring suturing, flaps are raised and bone surgery is carried out. The pulsing laser is able to distinguish between healthy and diseased gum tissue by colour. The infected tissue which has a darker pigment than healthy tissue, as well as the bacteria, are ‘zapped’ away by the laser leaving healthy gum tissue behind. LANAP is able to help connective tissue and bone form between the gum and teeth. The laser’s heat also seals the gum with a thermal blood clot and creates a physical barrier, helping to block any bacteria or tissue that could recreate a gum pocket. Where scaling and normal root planning procedures have not provided sufficient results, in many cases blade surgery would be indicated for a patient with this problem. These patients can now be treated with PerioLase which allows patients to obtain a comparable result to conventional therapy.

The benefits of LANAP therapy include:

  • Less pain
  • Less gum recession
  • Decreased bleeding
  • Reduced swelling
  • Reduced root sensitivity

In many cases this therapy allows patient recovery in far less time than conventional methods. The laser creates an excellent anti-bacterial effect which helps to disinfect the periodontal pockets.

It is also beneficial for patients who have existing medical problems which require them to be on anti-coagulants such as asprin, clopidogrel (plavix) and other anti-coagulants. The technique produces far less bleeding than traditional surgical procedures and because of this patients do not have to discontinue using these medications prior to surgery. The LANAP PerioLase eliminates infected tissue and leaves the healthy tissue relatively untouched. Ultrasonic scalers or hand scalers are used to remove calculus deposits that were loosened by the lasers first pass when the pocket is treated. A second pass is then used to kill the bacteria in the periodontal pockets and on the bony tissue. Formation of a sticky fibrin clot is also stimulated by the second pass. This seals off the pocket allowing bone and other soft tissue an ideal environment for regeneration.

The LANAP process can be broken down into six simple steps: 

  1. A periodontal probe identifies excessive periodontal pocket depths
  2. The initial pass of the laser removes bacteria and diseased tissue
  3. An ultrasonic scaler and/or special hand instruments remove root surface tartar loosened by the initial laser pass.  With the second pass the laser blood clot stimulation occurs in the pocket to keep the epithelium from growing back into those areas.
  4. Re-attachment of the soft tissue and bone to the cleaner root surface is initiated.
  5. The patient’s bite is adjusted to eliminate the bite trauma
  6. New connective tissue attachment and bone growth occurs

Laser Treatment Around Implants

Where plaque and debris is allowed to accumulate around implants a condition termed implantitis can occur. In the case of implantitis bone loss is seen around an implant, starting from the head of the implant or the crest of the ridge, to the apex of the implant which is imbedded in the bone. Bone loss normally occurs at a slow rate, however, applying the same periolase principal to the tissue around the implant it is possible to destroy the bacteria causing the problem and generate new bony tissue and a healthy environment.

LANAP procedures can be carried out under local anaesthesia and it is important to follow the post-operative regime which encourages new tissue to form in the depth of the pockets.