Video Details
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The Holy Grail of True Regeneration - Fibronectin
Description:
Periodontal Diseases have been associated with an increase in bacterial plaque and calculus. Recent evidence, however, suggests bacteria (biofilm) is a trigger, but the host inflammatory response is responsible for osseous structural loss. The barrier between the bacterial trigger and the host inflammatory response is the epithelial attachment. While radiographic bone loss is often used as a criteria of periodontitis it is the loss of epithelial attachment which is the real gauge of periodontal disease progression. Therefore, the goal of periodontal therapy is to regain and maintain the epithelial attachment. Our discussion will involve a histologic study review about the key role of fibronectin, “Nature’s Nectar” & why it is the Holy Grail of true regeneration. Come follow a real Professor’s histologic journey in search of the Raiders of the Lost Attachment and how to get it back.
Date Added:
6/17/2012
Author(s):
John Chrispens, DDS
Dr. John Chrispens graduated from the Loma Linda School of Dentistry, and received his Certificate in Periodontics at The Eastman Dental Center. He completed postgradua...
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Online Videos / Surgery / Other Surgical / The Holy Grail of True Regeneration - Fibronectin
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Questions & Comments
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BORNA RASHIDISANGSARY - (7/24/2012 10:59 PM)
Is it a one-time procedure? Or it's needed to be performed at different sessions? Thank you
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John Chrispens - (6/15/2012 11:38 AM)
Reginaldo - There have been two human histologic studies to date supporting the LANAP protocol. The first, by Dr. Ray Yukna, published in IJPRD December 2007. The second by Dr. Marc Nevins, which will publish in the August 2012 issue of IJPRD. More information on these (as well as numerous other clinical and peer-reviewed data) can be found here: http://lanap.com/research.php
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John Chrispens - (6/15/2012 11:09 AM)
Anchalee - There is no research that has looked at patients with specific potential contraindications. I personally treat smokers on a frequent basis. However, I try to get them to quit smoking as part of the therapy, but with limited success. I also treat patients that are on bisphospenates and have not noted significant side effects. The irradiated patient is a different story. I usually involve the physician in the discussion and have not to this point treated a patient post oral radiation.
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John Chrispens - (6/15/2012 11:08 AM)
Sophia - The actual speed of epithealial growth verses osseous tissue growth is well established. The epithelial down growth has always been the challenge to regeneration. While membranes are an aid in prevention of epithelial downgrowth, this technique is very unpredictable. The formation of the fibronectin thrombus is what prevents epithelial downgrowth and therefore, is what allows the LANAP proceedure to prevent epithelial downgrowth and lead to "true regeneration".
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Reginaldo Goncalves - (6/14/2012 10:31 PM)
Very interesting presentation, is there any published evidence of the regeneration obtained by the LANAP procedure?. Thanks Reginaldo
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Anchalee Suttiponggaiwon - (6/13/2012 11:35 PM)
Thank you for your very interesting LANAP procedure.
Is there any contraindication for this procedure such as smoking,radiated or taken Bisphosphonate patients ?
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Sophia Nichols - (6/13/2012 5:30 PM)
The presentation was very good however, the topic seems to be controversial among periodontist. I've attended several perio. lectures that say you need a membrane to stop epithelial cells from growing down into the socket and give bone and fibroblasts a chance to grow up. Epithelial cells grow about 1mm a day. Bone, which is a type 4 collagen, grows .1mm a day. The laser will de-epithelialize the pocket but the epithelium will still grow back.
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John Chrispens - (6/13/2012 5:08 PM)
Younus -
1. The LASER for use in the LANAP proceedure is specific, namely the PerioLase MVP-7.
2. I usually request that the patient not brush in the area for one (1) week post LANAP therapy.
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John Chrispens - (6/13/2012 5:07 PM)
Sam - Each LASER works within a specific wavelength. Nd:YAG absorbes within the range of heme (darker colors). Therefore, it penetrates into tissue. The diode laser uses heat, therefore "cooks" the tissue and penetrates only a short distance into the gingival sulcus before causing damage to the tissues. The CO2 and Er:YAG are absorbed by H2O, which is at the surface of oral tissues and do not penetrate into the gingival sulcus. Therefore, they have little effect on the biofilm in areas grearter than 2mm subgingivally. The goal of therapy with LANAP is not Biofilm control, but regeneration.
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