Advanced Laser Treatment for Periodontitis and Peri-Implantitis
Inside Dentistry provides the latest in endodontics, implantology, periodontics, and more, with in-depth articles, expert videos, and top industry insights.
June 1, 2024
Volume 20, Issue 6, June 2024
Page(s): p. 44
Andrew Peterson, DMD, MS, spent his first few years of practice as a traveling periodontist. "I was practically working out of the back of my car-as many periodontists do," he says with a laugh. Although Peterson was able to work with many of his friends from dental school who were in general practice, he felt limited. "When you do not have all of the tools that you need," he says, "there is only so much that you can offer in terms of treating periodontal disease."
Fortunately for Peterson, just as he was coming to that realization, an opportunity arose for him to work alongside J. Paul Fuentes, DDS, at Arcadia Perio, a leading periodontal practice in Arcadia, California. Peterson joined the practice in 2019, became a partner in 2023, and purchased the remainder of the practice earlier this year. He notes that Fuentes's education-centered philosophy made the practice a perfect fit for him. "We educate our patients, and we educate our referrals," he says. "This was something that I always wanted, so it was nice to partner with someone who had the same philosophy and mindset."
In addition to valuing the provision of education, Fuentes also shared Peterson's commitment to using state-of-the-art technology and progressive techniques, such as the LANAP® protocol for moderate to severe periodontal disease and the LAPIP™ protocol for ailing and failing implants. Both protocols can only be performed with the PerioLase® MVP-7™ Digital TruePulse™ Laser System from Millennium Dental Technologies. The PerioLase MVP-7 can also be used to perform Millennium's BLAST protocol, which Fuentes was instrumental in developing. Millennium's BLAST protocol is designed, in part, to help prevent peri-implantitis and optimize implant osseointegration by employing a tissue-sparing decontamination and implant preparation technique. "In my experience, an average implant achieves 55% to 60% bone-to-implant contact, whereas a BLAST-modified implant achieves 96% to 98% bone-to-implant contact," Peterson says. "The expectation is that this will make the implant less susceptible to periodontal pathogens and lead to better long-term success rates."
Of course, Millennium is best known for its FDA-cleared LANAP and LAPIP protocols. The LANAP protocol is a minimally invasive "no cut, no sew" treatment alternative to conventional surgery for natural teeth that is more comfortable and results in faster recovery for patients, and the LAPIP protocol is a similar solution for the treatment of peri-implant disease. "With the LAPIP protocol, you can treat an ailing or failing implant in 10 to 15 minutes," Peterson says. "It is minimally invasive and requires no conventional flap reflection, no bone grafting, no artificial membrane, and no suturing. Patients are much more receptive to it. We all know that treating diseased implants can be somewhat unpredictable, but you can get a much more predictable result in challenging clinical scenarios with the LAPIP protocol, and you can only perform the LAPIP protocol with the PerioLase MVP-7."
Peterson also uses the PerioLase MVP-7 for what Millennium refers to as VAPS (value-added procedures), of which there are more than 100 listed on the company's website. "For any flap reflection, I perform hemostasis inside the flap before I close it," Peterson says. "I just did a crown lengthening procedure, and I went around every tooth with the hemostasis setting to help adapt that flap better. I use it on soft tissue to create stable fibrin clots to tuck acellular dermal matrices into place. I also use the hemostasis setting on sites where I harvest tissue. For third molar extractions, I use it in the sockets. I use it for almost everything that I do day in and day out. One of the biggest advantages of the PerioLase MVP-7 is its ability to provide biostimulation, which really improves vascularity and wound healing by bringing more blood flow into the area and decreasing the proinflammatory response post-healing."
The PerioLase MVP-7 features a procedure-controlled menu with seven pulse durations for maximum control over hemostasis. Because it is a pulsed Nd:YAG laser, it can selectively target soft tissue with profound hemostasis. "The PerioLase MVP-7 is selective for pathogenic bacteria," Peterson says. "It can also target darkly pigmented tissues for patient aesthetics." Peterson's practice even has one PerioLase MVP-7 specifically dedicated to hygiene. "With its hygiene curettage setting, the PerioLase MVP-7 makes laser therapy part of our standard periodontal maintenance protocol, and that saves me time by reducing the need for revision procedures later," he says.
For those who wish to perform the LANAP protocol using the PerioLase MVP-7, Millennium provides mandatory 5-day hands-on clinical training. Conducted by the Institute for Advanced Laser Dentistry (IALD), the training comprises a yearlong continuum that includes three visits to the company's facilities in Cerritos, California. The first of those visits is what Peterson describes as a 3-day boot camp. It includes treating live patients on the second day and then seeing those patients again on the third day. "Being able to see the results of your work 24 hours later makes Millennium's training stand above all other CE courses that I have taken in the United States," he says.
According to Peterson, when such high-level training is applied to technology that is backed by science, the result is a significant advancement in periodontal-focused practices that not only delivers improved clinical results but also gets more patients to accept treatment. "The LANAP protocol is the first and only FDA-cleared laser treatment with scientific evidence of true bone, cementum, and periodontal ligament regeneration," he says. "The PerioLase MVP-7 is the only laser with histologic studies behind it. Because this laser targets inflamed tissues better than anything else, we can approach the treatment of periodontal disease in a totally different and less invasive way. I have achieved incredible results on some teeth that I once would have considered hopeless. The PerioLase MVP-7 has helped me to grow as a clinician while enabling me to provide better, more comprehensive care for my patients and achieve better, more predictable long-term results."
• The PerioLase MVP-7 features seven user-selectable digital pulse durations and Android-based software with an enhanced graphical user interface.
• Unlike continuous-wave or interrupted/gated pulsed diode lasers, the PerioLase MVP-7 is a true free-running pulsed Nd:YAG laser that provides a selective soft-tissue effect with profound hemostasis. A built-in power meter ensures optimal power output for patient safety and efficacy, while the joule counter confirms the light dose to the tissue.
• The PerioLase MVP-7's flexibility regarding pulse duration and technique enable the controlled performance of the LANAP, LAPIP, and BLAST protocols, which cannot be performed using any other laser.
• The PerioLase MVP-7 can also be used to perform more than 100 additional value-added cosmetic, prosthetic, periodontic, endodontic, and surgical procedures.
