Case 3
“Age Is Just A Number”
By Larry Gelb, DDS
An 83 year old healthy female who has been a patient in my practice for many years presented with a localized periodontal lesion on the mesial aspect of tooth #30 which had developed during the previous year. Pocketing in the area was no more than 2-3mm except for a 9mm and 12mm pocket on the mesio-buccal and mesio-lingual aspects of tooth #30 respectively.
The tooth gave a normal response to both cold and pulp-testing. Having ruled out an endodontic component to the problem, periodontal treatment was discussed. The patient was presented with her treatment options which included conventional periodontal therapy involving the reflection of muco-periosteal flaps, root conditioning with tetracycline paste, intra-medullary penetration, bone grafting with a mixture of human freeze dried bone and a platelet derived growth factor, placement of a barrier membrane, primary closure, and occlusal adjustment or LPT-Laser Periodontal Therapy.
The patient’s reaction was typical of most of my patients. She was very grateful that there was an alternative to conventional periodontal therapy and did not hesitate at all to choose LPT.
LPT was totally uneventful. The treatment area extended from #29-#31. 1000 joules at 3.6 watts and 100 micro-seconds were used during the ablation phase and 160 joules at 3.6 watts and 550 micro-seconds during the hemostasis phase. Finally 200 joules at 3.6 watts and 100 micro-seconds were applied during bio-stimulation. The occlusion was adjusted in accordance with the LANAP/LPT protocol. Anti-inflammatory medication and antibiotics were prescribed and the post treatment care and diet considerations were reviewed.
At the one year post treatment point, an x ray and photo were taken and the area was re-charted. Both the 9mm and 12mm pockets were reduced in depth to 3mm as determined with moderate yet purposeful probing.
As LANAP/LPT/LAPIP do not involve cutting and sewing and are free of pain, swelling, patient anxiety, and architectural alteration/disfigurement of the gingival tissues, many patients are now seeking treatment that had previously decidedly chosen not to access periodontal care in the past. Finally, I do make a point of saying to my patients at the consultation visit, “Make no mistake, LANAP is a surgical procedure, however you will not perceive it to be one.”
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Pre-treatment x ray and photo taken on day of presentation for LANAP
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1st post op x ray and photo at 4.5 months
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Final x ray and photo and charting after one year