Slowly I Turn…. Step By Step

Hi All..

Just a quick case before the weekend. For those that have been following this series over the past few years.. we are becoming accustomed to seeing these results from LANAP. Whether you are a LANAP’er or just “an LANAP (Athletic ) Supporter” …..points for guessing the movie reference, it is becoming almost commonplace for cases that appear hopeless to now have a chance to heal, if not thrive. Truth is, we see better results than this, as do many of you, on a regular basis. What is interesting about this case is that the patient has minimal if no oral hygiene habits to speak of.

She presented with horrific periodontitis, and despite the best attempts by her dentist and myself to deal with issues head on- this patient for various reasons elected to not deal with anything. That is , except, #19 ( as well as 2 other areas ) that were acute at the time. As with all sites.. mobility was class III, suppurative, and tissue was especially erythematous. There was a fistula on the buccal aspect of this tooth and little chance was given re: the prognosis. I will admit to not be convinced that we could save this either. Pt refused endodontic treatment but at a minimum, perhaps we could generate some healing and deal with her issues at a later date. There was no pain at the time of the LANAP procedure.

LANAP was performed and the patient promptly disappeared. She surfaced a few months later and at that time this area seemed much better clinically. No probing was done but a periapical was taken which showed minimal change. Or so I thought at the time. She disappeared again and presented today for something else and lo and behold, there was minimal probing, no bleeding and zero mobility. Radiographs were taken and the picture is concomitant with the clinical presentation. In retrospect- there was the beginning of new growth at the first post-op. And relatively speaking, this is as good a result as one could hope for.

What is interesting about this case is that it reinforces the notion that with LANAP we are approaching patient care from the point of view that we expect longer periods of healing- but that the longer timeframe allows for more complete repair. Perhaps when approaching other regenerative procedures, such as conventional Guided Tissue Regeneration, or even implant dentistry – we would ( as well as the patient ) benefit from the notion that time ( and more of it ) heals. We live in a world where everything is instant. You will receive this seconds after I send it. And when it comes to dentistry- we want to restore everything before it has even had a chance to set. Perhaps the lessons learned from this new paradigm in care should be carried over to other more established aspects of dentistry. It would be incumbent upon as the clinicians to guide the patient and their expectations through this but m sense is that in the end, everyone would be happier with the results. Perhaps, we had the right ideas before we got so smart 🙂

To All A Happy Thanksgiving.. and of course, please pray for the NY Jets to show up sometime in the next month or 2…

Be Good,


Before LANAP with Dr. Neal Lehrman in New York

10/11 Pre-op

Soon After LANAP with Dr. Neal Lehrman in New York


Post LANAP with New York Periodontist Neal Lehrman

today 11/12