LAPIP, or Laser Assisted Peri-Implantitis Procedure can successfully treat infected dental implants!

Invasive flap surgery and dental implant removal can often be avoided with minimally invasive treatment!

Dental implants have been a minor miracle for people who have lost a tooth or teeth. They began being placed in larger numbers in the mid to late 1980’s. Among the advantages that were touted for dental implants was that because they were made of titanium, they would never decay. Early studies also seemed to show that the bacteria found between the gums and dental implants was different than bacteria found around natural teeth, with those commonly associated with periodontal disease either being found in diminished numbers or even lacking altogether. This led to the belief that implants would be immune to tooth decay and at least more resistant to periodontal disease, the two most common reasons for tooth loss in adults. While being immune to decay, unfortunately, implants have not been immune to destructive inflammatory disease, termed peri-implant mucositis and peri-implantitis. How big is this problem today? One study reported that Peri-implant mucositis occurred in approximately 80% of the subjects and in 50% of the implants. Peri-implantitis was found in 28% to 56% of subjects and in 12% to 43% of implant sites!

Treatment Procedure

A. Perio probe indicates excessive pocket depth.
B. Laser vaporizes bacteria, diseased tissue, pathologic proteins and titanium corrosion contaminants in soft tissue.
C. Ultrasonic scaler tips are used to remove surface accretions.
D. Bone is modified at the time of surgery.
E. Laser is used to form a stable fibrin clot containing stem cells from bone
F. Adhesion to clean surface, with a stable fibrin clot at the gingival (gum) crest to create a “closed system.”
G. Occlusal (bite) trauma is adjusted.
H. New attachment is regenerated.

Peri-implant mucositis is inflammation around the implant, without bone loss around the implant. Usually with conservative treatments, improved oral hygiene and possibly with a course of antibiotics, health can be restored.

Peri-implantitis is a much more serious matter. Most dental implants have a roughened surface to increase surface area for a strong bone attachment to the implant. If the peri-implant infection reaches this roughened surface, the infection can be extremely difficult to control or eliminate. In the past, treatments, both nonsurgical and surgical, mainly slowed down the infection and bone loss. Very often, the only practical choice was to remove the implant and start the whole implant placement and restoration process all over again!

More recently, complex, invasive surgical procedures, involving chemical implant disinfection and the combination of multiple bone regenerative techniques have shown some promise in at least halting the destruction and regaining some bone around the implant. Unfortunately, the types of materials used, and the variety of materials needed to perform these techniques makes the cost of this treatment, in some cases, greater than the cost of placing the implant in the first place.

The good news is that the LAPIP procedure, only performed with the PerioLase MVP-7 laser, is capable of restoring health to and regenerating lost bone around ailing/failing implants in the same, minimally invasive way LANAP can restore health to teeth with periodontal disease! Combined with the good preventative program LAPIP therapy requires, the chances of re-infection in the future are greatly reduced.

Case #1

Dental implant with extensive infection and bone loss present

Dental implant 24 months after LAPIP treatment with new bone growth.

Case #2

Dental implant with extensive infection and arrows pointing out extent of bone damage.

Dental implant with new bone growth 16 months after LAPIP laser treatment.

Case #3

Infected dental implant, with arrows showing extent of bone loss

Dental implant showing new bone growth 11 months after LAPIP laser treatment

Case #4

Infected dental implant, with arrows showing extent of bone damage

Dental implant, with arrows showing new bone regeneration, 12 months after LAPIP laser treatment.