The Effects of LANAP on Periodontal Microbiota

Laser Assisted New Attachment Procedure (LANAP) is a minimally invasive periodontal surgical protocol using the Nd:YAG laser. Multiple reports have shown both favorable clinical and radiographic improvement in the advanced periodontal sites. Histological studies have shown new periodontal regeneration with the formation of new attachment comprising of new cementum and alveolar bone with inserting periodontal ligament fibers. However, the effect on the composition of the subgingival bacteria following LANAP surgical treatment had not been evaluated. A recent study* by McCawley’s group studied the LANAP treatment compared to ultrasonic root debridement alone for immediate post-treatment effects on deep human periodontal pocket pathogens.

The study included 26 systemically healthy adults with severe periodontitis, with one group undergoing LANAP protocol and the other group receiving ultrasonic root debridement only. Subgingival bacterial samplings were collected before and immediately after both treatments and selected periodontal pathogens (red and orange complex bacteria, which are associate with advanced periodontal disease) were identified using anaerobic culturing techniques. The results showed the red and orange complex bacteria were not detected in 85% of the deep pockets in the LANAP group, but only 16% in the ultrasonic root debridement group. Although more research is needed, this study showed that the LANAP surgical protocol immediately suppressed the most virulent periodontal pathogens in the deep periodontal pockets. Conventional ultrasonic root debridement showed minimal effect on these pathogens

*    McCawley, T.K, et, al. JIAP 2018; 20(4)