title: Human clinical and histologic evaluation of laser-assisted new attachment procedure.
abstract: This investigation was designed to evaluate the healing response to the laser-assisted new attachment procedure (LANAP). Eight patients presenting with 12 teeth predetermined to be surgically extracted were enrolled and consented to treatment with full-mouth LANAP therapy. LANAP surgical therapy consisted of a first pass with a 360-Μm fiber diameter, laser settings with verified output of 4.0 W and energy density of 1,965 mJ/mm2, 100-Μs pulse duration, and 20 Hz applied from the gingival margin to the base of the pocket parallel to the root surface and moved laterally and apically to remove the diseased pocket epithelium. The teeth were aggressively scaled and root planed with piezo ultrasonic instrumentation. A second pass was performed with a 360-Μm fiber diameter, laser settings with verified output of 4.0 W and energy density of 1,965 mJ/mm2, 650-Μs pulse duration, and 20 Hz applied from the apical extent of the bone defect to the gingival margin. After 9 months of healing, en bloc biopsy extractions were provided. Ten teeth were analyzed histologically to assess the periodontal wound healing. Five teeth evidenced a degree of periodontal regeneration with new cementum, periodontal ligament, and alveolar bone. One tooth had new attachment with new cementum and inserting collagen fibers, and four teeth healed via a long junctional epithelium. LANAP therapy should be further investigated with long-term clinical trials to compare the stability of clinical results to conventional therapy. This report provides evidence that LANAP therapy can induce periodontal regeneration.
authors: Division of Periodontology, Dept. of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA. marc_nevins@hms.harvard.edu
authors: Marc L
authors: ML
authors: Nevins
authors: Marcelo
authors: M
authors: Camelo
authors: Peter
authors: P
authors: Schupbach
authors: Soo-Woo
authors: SW
authors: Kim
authors: David M
authors: DM
authors: Kim
authors: Myron
authors: M
authors: Nevins
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000473:pathology; D001706:Biopsy; D003739:Dental Cementum / Q000473:pathology; D012534:Dental Scaling / Q000379:methods; D004846:Epithelial Attachment / Q000473:pathology / Q000601:surgery; D005500:Follow-Up Studies; D017823:Furcation Defects / Q000601:surgery; D005889:Gingival Recession / Q000601:surgery; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D008875:Middle Aged; D055100:Optical Fibers; D017622:Periodontal Attachment Loss / Q000601:surgery*; D010513:Periodontal Ligament / Q000473:pathology; D010514:Periodontal Pocket / Q000601:surgery; D010518:Periodontitis / Q000601:surgery; D059745:Piezosurgery / Q000379:methods; D011446:Prospective Studies; D012038:Regeneration / Q000502:physiology; D016745:Root Planing / Q000379:methods; D014092:Tooth Root / Q000601:surgery; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult