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PATIENT HISTORY
A 57-year-old female presented in our office in September 2017 wanting to understand her
restorative options if she removed all her teeth. Her husband had been fitted with dentures in
our office several years prior and she was considering full-mouth implants or dentures. She
was unhappy with her smile; tooth #25 was 2-3mm taller than her other lower incisor, it was
giving her pain, and “it was loose.” She had been under the care of a periodontist, with routine
cleanings every 3 months. She was told by the hygienist at the periodontist’s office to express
the puss out from around the tooth. She was tired of it and wanted it and the other teeth out.
She was a highly phobic patient and had not been to a dentist in several years prior to seeing the periodontist. Overall, the patient was healthy without medical complications. Clinical examination showed inflamed gingival tissue, bleeding on probing, purulence, and widespread moderate-to-severe probing depths of 7-8-9; 10+ in the upper left quadrant. #25 was class 3 mobile. Visually, the mesial bone was gone nearly to the apex, with probing depths of 5,3,5 | 5,3,5.
Treatment Approach
After reviewing treatment options with the patient, I suggested we should try to save as many of her teeth as we could. As such, we recommended the LANAP treatment using the PerioLase® MVP-7™ free-running pulsed Nd:YAG, which is a full-mouth protocol, and the patient accepted the treatment plan. LANAP therapy was performed in September 2017. Lower incisors were splinted together and occlusal adjustment was performed according to the well defined LANAP protocol. #25 was reduced to be even with the patient’s other teeth.
RESULTS
The patient was compliant with recall visits and home health care. Recession was minimal as the inflamed tissue resolved. Radiographs were taken at the 6-month post-operative visit and visible bone fill was noted, #25 was no longer mobile. X-rays taken after another 6 months at the 12-month post-operative visit showed additional visible bone growth. Splinting was removed in July 2022. Probing depths as of March 2023 were 3,2,3 | 3,2,3 with zero mobility.
The patient is happy with her smile and teeth, and just as importantly is no longer phobic! Her experience with the minimally invasive LANAP treatment and the healing process has reset her feelings about dental treatment and ultimately will set her up for better long-term oral health.
She complies with routine visits and has had three crowns and a filling in the 4 years since LANAP treatment. I thought she might want anterior crowns or veneers to make her teeth look more perfect, but she is happy with her natural smile and keeping her natural teeth.
ABOUT THE AUTHOR: Andrew Erickson, DMD
A native of Springville, UT, Dr. Erickson attended BYU and served an LDS mission in Germany. He was accepted to dental school at Oregon Health Sciences, graduating in the class of 1995. After working as an associate for several years, he became LANAP trained in 2003, and opened his private practice, Jordan Landing Dental Care, in 2004.
Dr. Erickson practices at Jordan Landing Dental Care.
