Methods: 3 patients with 2 single-rooted teeth with moderate-advanced chronic periodontitis associated with subgingival calculus deposits were enrolled. Occlusal adjustment and direct bond extracoronal splinting was performed. Under local anesthesia, a 1/4 round bur notch was placed at the apical extent of calculus as carefully as possible. One of each pair of teeth received Nd:YAG laser treatment of the inner pocket wall to remove the pocket epithelium (laser settings were 3 watts, 150 pulses/second, 10 hz). Both teeth were then aggressively scaled/root planed with an ultrasonic scaler. The pocket of the test tooth was lased again to coagulate any blood present and to form a pocket seal. Triple antibiotic ointment and a light cured dressing was placed. Control teeth received all of the above except the laser treatment. The patients were seen every 10 days for the first month, then at 2 and 3 months, at which time the treated teeth were removed en bloc for histologic processing. Decalcified step serial sections were stained with H & E.
Results: 2 of the 3 LANAP treated specimens showed new cementum, new bone, and new periodontal ligament in and coronal to the notch. The control teeth had a long junctional epithelium with no evidence of regeneration. There was no evidence of any adverse pulpal or tooth surface changes in either specimen.
Conclusions: This report supports the proof of principle that LANAP can be associated with periodontal regeneration on a diseased root surface in humans.
Supported by Millennium Dental Technologies and the Louisiana Periodontics Support Fund.