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Lanap (laser gum surgery)
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blueyedndn52 posted:
Since this is a fairly new procedure and I am in the near future getting this done I am hoping someone out there that has had it done could talk about it here. From all of the research I have done this is by far the best way to go. Traditional gum surgery is very painful and leaves you with hardly any gums left. And there is no guarranties it will fix the gum desease. With this lanap very little pain is associated with it. The biggest problem is it cost over $5,000.00. On top of that the dentist says he has to stablize my teeth and typically that is done by bonding my teeth together but since I have a couple of missing teeth I now have to have braces put on. I havn't been to the orothdontis yet so I have no idea how much that is going to cost. And we all know that dental insurance doesn't cover much. I am begining to wonder if dentures arent the better way to go. At least cheaper. Any thoughts?
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MarkMHB responded:
Dear blueyedndn52,

With due respect to your research, please be advised that most of the available online literature dealing with LANAP is from those clinicians or researchers that have a significant psychological or financial investment in the technology. The effect of this is to unfairly bias the subjective and objective data to favor LANAP. Make no mistake that the purchase of a laser is a significant capital expenditure, and dentists willing to make such an expenditure will tend to discount the available evidence that refutes its advantages.

Conventional periodontal surgery cannot be categorized as "very painful" (although pain is ultimately a subjective matter, no matter what is causing it), and though it is resective in nature, does not leave the patient with "hardly any gums left".

The vast majority of periodontists do not use LANAP, and are far more familiar with the indications and protocol of more time-honored techniques, as well as the typical postoperative responses that can be expected. In short, your preference for LANAP is not justified by the facts, and you should not inconvenience yourself either financially or in your selection of a suitable periodontist based on whether he offers this modality of treatment.

As for dentures being the better way to go--- unless your teeth clearly need to be extracted, the answer is "no".

Mark Bornfeld

Brooklyn, NY
 
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LANAP1 replied to MarkMHB's response:
The world of Periodontal therapy has evolved since the above post. The LANAP protocol has been a "game changer" in treating gum disease. In many cases, we have seen new bone formation and regeneration on x rays. In addition, the clinical results have exceptional, the healing is rapid, and the results are long standing. The tooth survival studies that have been done compare "traditional" surgeries to LANAP are at least comparable if not superior. It is probably best that a Periodontist who has the background and expertise in treating gum disease make a clinical judgment if LANAP would be a good fit. Sometimes traditional surgery has to be done, but if a laser can achieve the goals, then it is very obvious which modality of treatment would be less traumatic to the patient.

Eric Linden

New York/ New Jersey
 
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jared1451 replied to MarkMHB's response:
The vast majority of Periodontists are not very interested in treating gum disease these days... From everything I see they are far more interested in extracting teeth and placing implants... There are over 350 periodontists that offer lanap. For me as a patient it is nice to see the specialty starting to get back to treating the disease... I would hate to be the periodontist that does not inform their patients about the option of lanap... No matter how "old school" your point of view is, the patient should be given the choice. over 50% of the population has moderate to severe gum disease and less than 3% accept treatment every year... hmmmm wonder why... 1.) It IS PAINFUL 2.) IT IS UNPREDICTABLE 3.) PERIODONTISTS WILL JUST TELL YOU THE TEETH ARE HOPELESS AND TAKE THEM OUT.

If you are a periodontists you MUST know other periodontists that offer lanap...
 
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flatasapnck replied to jared1451's response:
I am searching for information about the LANAP procedure. I had osseous flap surgery on my upper left and right gums 7 days ago with the back #2 molars left and right extracted due to extensive periodontitis. I had abcesses from both over the last 3 years. The procedure lasted 2 1/2 hours, Motrin that afternoon and evening, but nothing after that and no pain the next day. I had some discomfort from the dental packing, but nothing more. My periodontist did not discuss LANAP and my regular DDS was not forthcoming other than to say it's not common. All I've read intrigues me and my main desire is to save my teeth in as healthy a condition as possible. I don't need a sales pitch, but would like input. I know LANAP is available here in town. If I proceed with the osseous on my lower as suggested the total cost is about $4,380. Any information would be appreciated. I'm in central Illinois.
 
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flatasapnck replied to LANAP1's response:
May I request that you or another professional view my reply in this discussion. I am not sure how to receive input regarding my question of LANAP vs. osseous flap surgery. My upper teeth were done 7 days ago and I am to have the lowers done soon, but may have to wait until January for additional dental coverage availability.
Thank you.
 
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Zev Kaufman, DDS replied to flatasapnck's response:
Let me try and settle this question in the most diplomatic way possible.
Dentistry, as any other human endeavor, is subject to very rapid technological developments. I can tell you that I diagnose, treatment plan, practice and execute procedures much differently than what was taught to me in Dental School over 15 years ago. In addition, many common opinions at that time have since been proven to be misguided and empirically based (someone's opinion) rather on science and statistics. We are getting better and better. Experience means very little these days without proper updates and continual educational/professional growth.
However, I can tell you that there are things that are constant: The human anatomy is the same, the healing response to injury and surgery is the same, and our response to bacterial insult is the same. Biology Does Not Change. What changes (and gets better) is our ability to diagnose, treat, and evaluate the long term outcomes of our treatment. Hence, certain "traditional" therapies have been proven effective, and some were proven to be less effective and have been dropped from treatment protocols. The problem with new technology is that long-term data is not available. This is why most educated professionals tend NOT to "jump" on a new procedure, but wait for some data to accumulate.
LANAP is only but one of many, technology based, treatment modalities. The data is very favorable and is pouring in. Few periodontists have incorporated LANAP into their practice. It is very expensive technology (the laser costs tens of thousand of dollars). The higher end practices can afford it, but their patients are ready to foot the bill. Unfortunately there are dentists out there who advertise TECHNOLOGY as the solution to all problems. The LANAP technology is best performed by a trained Periodontist as it is just another procedure, and required the dentist to have the same advanced education as it is to perform the more traditional surgical modalities. Ultimately IT IS NOT THE TECHNOLOGY, but WHAT YOU DO WITH IT, the counts. Forget about the technology itself and concentrate on finding the BEST trained Periodontist and the one with whom you are most comfortable. Then go with his/her advise. You MUST ask about the LANAP technology, but if you trust the Periodontist and he/she is uncomfortable with the technology and are comfortable delivering more "traditional" established methods, go with his/her recommendations. I personally prefer a more traditional method with a trained professional, than the newest technology with a less trained, doctor.
www.perio.org will have a link to locating a trained Periodontist near you. You might want to go for a second opinion.
Best wishes and good luck,
Dr. Zev Kaufman


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