Periodontal surgery vs LANAP

[eric2005]

I'm confused. I've been to several dentists / periodontists and I get different opinions. I have serious recession in four upper back teeth. One perio wants to do LANAP for a huge price. Another says that LANAP will not regrow receded gums so recommends traditional surgery. I don't know WHAT to think! Help!

 

[geos]

Do you have a regular dentist who you could ask what he recommends? Is there one person you feel more comfortable with and think you will get the best output? In my case, when I needed some perio work, I went with the recommendation from my orthodontist and my mother had the same operation a few months before me with the same periodontist.

I hope someone can come in and give you their input on the subjects.

 

[comfortdentist]

My general preference:
LANAP for periodontal disease
Connective tissue graft utilizing your tissue for recessions due to lack of attached tissue(different cause than periodontal disease)

 

[eric2005]

Gum recession

I am still confused and have seen another highly respected periodontist (outside the USA this time)


A LANAP specialist wants to do LANAP. Another periodontist wants to do traditional surgery. Insists LANAP will not regrow gums.


WHAT is the truth?


Thanks.

 

[jayfan59]

I'm coming to this thread late, but on the off chance someone gets here via a search, I want to post my experiences with Lanap surgery. First, let me state that my dentist (who is no longer my dentist) recommended that I see a periodontist in my area who specialized in Lanap surgery. The hygienist who cleaned my teeth saw periodontal issues which she felt needed to be looked at by this particular periodontal group. At the time I had absolutely no subjective periodontal issues, no pain, no swelling, no bleeding, no nothing — but on the strength of this woman's opinion, supported by the dentist, I went for a checkup. The periodontist felt that absolutely an intervention was required, and Lanap was the state of the art. I signed up for about $6,000 worth of treatment (two one-hour visits, that's pretty good money on an hourly basis). And here's what I experienced:


The surgery itself, not so rough — certainly better pain- and discomfort-wise than the old cut and stitch method. You need to go on a soft food diet for a period of time after the surgery, which is not as bad as it sounds. My first checkup about a month later seemed fine, everything looked great they told me. Ditto for the second checkup. These checkups consisted of the doctor looking in my mouth and saying everything looked fine, nothing more. It wasn't until about four months after the surgery that everything started to go south. I began having problems with my bite — these are known as occlusions in the trade. Then chewing on the right side of my mouth became painful. Then my gums got swollen, literally infected. I was treated with antibiotics. My troubles persisted for nearly six months, by which time I had determined that the original periodontist that treated me was worthless in terms of dealing with these issues. I saw a succession of specialists, including a new periodontist, an endodontist, and the head of dentistry at Sloan Kettering. For one thing, the Lanap surgery had not made one iota of difference in the "pockets" that were the original reason for the surgery (this was measured one year after treatment). For another, the surgery itself had created a drastic misalignment in my teeth that the periodontist/Lanap surgeon did not know how to treat. And the biggest issue of all, for the first time in my life, following the Lanap procedure, I developed severe and persistent infections in my gums. Coincidence? I don't think so.


To make a long story short, my new endodontist performed a couple of root canals that allowed him to file teeth significantly enough to adjust my bite properly. (Read the Lanap literature folks, bite misalignment is a very common side effect of the Lanap procedure.) This fixed 90% of my problem. Then, my new periodontist cultured the bacteria in my gums and performed a deep cleaning in conjunction with a round of TWO antibiotics based on the data from the culture. So, about $8,000 later, I am now more or less back to normal. In fact, thanks to the deep cleaning with antibiotics, the "pockets" are greatly minimized. Total out of pocket for Lanap plus everything needed to correct the damage it did: roughly $14,000. So my experience-based advice is this: do your research very carefully before embarking on a Lanap procedure. I believe you will find that there are no really credible long-term studies that demonstrate any lasting benefit for this approach. Read the literature about the procedure — you will find a long list of issues that may need to be dealt with as part of your treatment. I mean face it, this is basically loosening your teeth for a period of months. How good can that be? Last, research the person who will he performing the surgery. Did they buy their Lanap equipment last month? Are you the third person they will be practicing their skills on? Do they have a track record? Can they demonstrate their success rate in treating patients with this approach?


It is my personal belief (and I have no evidence to support it) that the Lanap procedure is being "pushed" on patients by dentists who get a referral fee, and periodontists who love the fact that they can get the same money out of a two-hour procedure that they used to get for the much more labor-intensive cut and stitch procedure — probably even more. So I am adding this post to balance the many positive reviews for Lanap that have been seeded throughout the internet and social media. As always, your mileage may vary.

 

[Rcw1457]

Hi @jakefantom, thanks for writing about your experience. Can I ask how your gums are today? Did you get black triangles from the treatment? Also I saw that you mentioned Sloan Kettering - are you in nyc by any chance and if so do you have a periodontist recommendation? Thanks!

 

[comfortdentist]

"It is my personal belief (and I have no evidence to support it) that the Lanap procedure is being "pushed" on patients by dentists who get a referral fee "
This is illegal in USA and in my 35 years I have never heard of a case in dentistry or have been approached by a specialist suggesting such relationship.