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Old 05-26-2018, 05:41 AM
 
21 posts, read 26,902 times
Reputation: 27

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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 ("pockets") 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 a major New York hospital. 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.
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Old 05-26-2018, 03:20 PM
 
1,538 posts, read 1,829,178 times
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Quote:
Originally Posted by Jake Fantomelli View Post

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...
Sorry to hear about your bad experience.
Just FYI, fee splitting is illegal in most states with doctors. It is considered unethical which is funny because attorneys do it routinely.
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Old 05-27-2018, 08:20 AM
 
21 posts, read 26,902 times
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Default Maybe, maybe not

Here's what Wikipedia says about fee splitting...

"However, the practice, or something resembling it, tends to be tolerated - in "Medicine, Money, and Morals: Physicians' Conflicts of Interest" by Marc A. Rodwin, forms of fee splitting and commission paying for referrals remain common in the USA and are in effect tolerated by key overseeing bodies such as the American Medical Association and Joint Commission International, or JCI.[5]"
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Old 05-27-2018, 06:21 PM
 
Location: Living rent free in your head
32,845 posts, read 14,865,925 times
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Quote:
Originally Posted by bababua View Post
I honestly dont understand why dentist are so hush hush about probiotic therapy. I for one have benefited so much from evoraplus. Honestly taking this little mint has made a world of difference in my dental health and I just dont understand why dentist are so hush hush about it. Dont take my word for it. Buy the stuff and then go get your pockets measured. I had a bunch of pockets after taking it religiously for the past year I am pocket free and have such a healthy mouth that I hope this stuff never goes away.
probiotics aren't going to remove plaque from your periodontal pockets.
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Old 08-03-2018, 05:06 PM
 
4 posts, read 7,589 times
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so what are you saying,Jake Fantomelli, the old type surgery is better? My husband is been diagnosed with very deep pockets and now it is my "job" to search through what people are experiencing and if it is worth it...Thanks to everyone for their input!
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Old 08-03-2018, 07:37 PM
 
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Has anyone here heard of periopeak? or other name is Regenerative Periodontal Endoscopy? RDH Judy Carrol invented it in 2002, I believe, and people from all over the country and overseas come to see her.
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Old 08-04-2018, 05:49 PM
 
21 posts, read 26,902 times
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I have had both the old standard procedure (about 20 years ago) and the Lanap procedure. The old method was no fun, but it worked and did not cause additional periodontal problems. The new Lanap procedure is not particularly painful, but for me, it caused months and years of ongoing periodontal problems that are flat out mentioned in the literature they provide. For me, Lanap left me in a negative space. I would not recommend it to my worst enemy, and if you research it, I think you will find there are NO studies that enthusiastically support its use, even the ones commissioned by the Lanap people show dubious results. The procedure you mention in your last post I have never heard of, and it sounds like a bunch of overblown hooey to me.
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Old 08-05-2018, 12:32 PM
 
4 posts, read 7,589 times
Reputation: 11
Quote:
Originally Posted by Jake Fantomelli View Post
I have had both the old standard procedure (about 20 years ago) and the Lanap procedure. The old method was no fun, but it worked and did not cause additional periodontal problems. The new Lanap procedure is not particularly painful, but for me, it caused months and years of ongoing periodontal problems that are flat out mentioned in the literature they provide. For me, Lanap left me in a negative space. I would not recommend it to my worst enemy, and if you research it, I think you will find there are NO studies that enthusiastically support its use, even the ones commissioned by the Lanap people show dubious results. The procedure you mention in your last post I have never heard of, and it sounds like a bunch of overblown hooey to me.
So if you would have to pick between the two, which one would you pick?

periopeak.com that is the RPE that I also found, can you have a look. Looks similar to LANAP but is non invasive.

Thanks again!
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Old 08-05-2018, 06:19 PM
 
Location: Living rent free in your head
32,845 posts, read 14,865,925 times
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Quote:
Originally Posted by koki11 View Post
So if you would have to pick between the two, which one would you pick?

periopeak.com that is the RPE that I also found, can you have a look. Looks similar to LANAP but is non invasive.

Thanks again!
I had never heard of it so I looked it up and found this:

Quote:
RESULTS:
The authors identified 8 articles as being suitable for this systematic review. The investigators of 3 studies reported results related to BOP and GI that revealed some advantages of periodontal endoscopy over traditional scaling and root planing (SRP). The investigators of 4 studies explored PD and found no difference between periodontal endoscopy and traditional SRP. The authors could not perform meta-analyses on the study results related to BOP, GI, or PD. The percentage of residual calculus after periodontal endoscope-aided debridement was significantly less than the percentage of residual calculus after traditional SRP (mean difference, -3.18; 95% confidence interval, -4.86 to -1.49; P = .002; heterogeneity I2 = 74%). The authors found that periodontal endoscopy took significantly more time than traditional SRP (mean difference, 6.01 minutes; 95% confidence interval, 4.23 to 7.8; P < .00001; heterogeneity I2 = 0%).

CONCLUSIONS AND PRACTICAL IMPLICATIONS:
Periodontal endoscopy may provide additional benefits for calculus removal compared with traditional SRP, although it could take more time to perform. With respect to BOP, GI, and PD, the authors found no sufficient evidence to support the difference between the use of periodontal endoscopy and traditional SRP. The authors concluded that additional scientific research is required to assess the effects of periodontal endoscopy on the treatment of periodontitis.
https://www.ncbi.nlm.nih.gov/pubmed/28637585
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Old 08-06-2018, 10:45 AM
 
598 posts, read 465,725 times
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Periodontist here. 2sleepy correctly posted a systematic review comparing periodontal endoscopy to traditional scaling and root planing (SRP). Periodontal endoscopy ideally should not be compared to LANAP. A better comparison to LANAP would be traditional osseous surgery, which Jake alluded to in post #37, since it has been touted as the "alternative to gum surgery" by the marketing gurus.


The plot thickens, however. As Jake mentioned, the quality and quantity of scientific evidence regarding LANAP pales in comparison to that of traditional osseous surgery (to be fair, osseous surgery has been around a lot longer). Most of the latest research that I am familiar with shows that LANAP, in the long run, produces results similar to SRP. Let that sink in for a minute - a procedure designed to replace SURGERY is not even producing long-term results that you would expect to see from traditional surgery. Instead, it is producing results similar to a garden variety "deep cleaning" aka SRP. So basically, the scientific evidence is contradicting the marketing claims.


In my hands, traditional periodontal surgery yields more consistent results and is my first choice of treatment for surgical periodontal cases. I'll usually resort to LANAP as a "Hail Mary" when we are out of options and the patient wants to try everything possible to save a tooth. I do know periodontists and general dentists that swear by LANAP, however.
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