Laser-assisted new attachment procedure
Laser-assisted new attachment procedure (LANAP) is a surgical therapy for the treatment of periodontitis, intended to work through regeneration rather than resection. This therapy and the laser used to perform it have been in use since 1994. It was developed by Robert H. Gregg II and Delwin McCarthy. There is little evidence to support this technique over traditional therapies.
In LANAP surgery, a variable free-running pulsed neodymium:yttrium-aluminum-garnet (Nd:YAG at 1064 nm wavelength) dental laser is used by a dentist or periodontist to treat the periodontal pocket. The laser is intended to selectively remove diseased or infected pocket epithelium from the underlying connective tissue.
There is little evidence that lasers provide any benefit over traditional therapies for the treatment of periodontitis. No study of LANAP has yet demonstrated regeneration of the horizontal bone loss that characterizes periodontitis. According to a 2010 review, research on the efficacy of LANAP and other Nd:YAG dental lasers tends to be of low quality. The authors concluded that "clinicians using lasers for the treatment of periodontitis must be cognizant of safety issues and should expect limited clinical improvement in periodontal status."
The American Academy of Periodontology stated in 1999 that it was "not aware of any randomized blinded controlled longitudinal clinical trials, cohort or longitudinal studies, or case-controlled studies indicating that 'laser excisional new attachment procedure (or Laser ENAP)' or 'laser curettage' offers any advantageous clinical result not achieved by traditional periodontal therapy. Moreover, published studies suggest that use of lasers for ENAP procedures and/or gingival curettage could render root surfaces and adjacent alveolar bone incompatible with normal cell attachment and healing."
- Dr. Robert Gregg. "50% of Americans Have Gum Disease". ABC News. Retrieved 7 January 2014.
- Cobb CM, Low SB, Coluzzi DJ (2010). "Lasers and the treatment of chronic periodontitis". Dent. Clin. North Am. 54 (1): 35–53. doi:10.1016/j.cden.2009.08.007. PMID 20103471.
- The American Academy of Periodontology (August 1999). "Statement Regarding Use of Dental Lasers for Excisional New Attachment Procedure (ENAP)" (PDF).
- Laser Assisted New Attachment Procedure in private practice (General Dentistry, September - October 2004, Vol 52, No. 5.)