Peri-implantitis / LAPIP

Peri-implantitis is characterized by the loss of bone around dental implants. Peri-implantitis, just like periodontitis, develops as a result of poor oral hygiene and/or excessive biting forces around a dental implant. Early diagnosis is the key to treating dental implants and returning the dental implant to a healthy state.

The LAPIP protocol uses a specific wavelength of the PerioLase MVP-7 laser to treat peri-implantitis. The laser is able to remove infected tissue and vaporize bacteria deep within the pocket around a dental implant while leaving healthy tissue intact and able to regenerate. This process stops the disease around the dental implant and in some cases regenerates new bone. Because of the gentile nature of the procedure, patients typically experience less discomfort compared to traditional extensive surgery repair of a dental implant suffering from peri-implantitis. Doctor Fiandaca has completed extensive training and is certified by the Institute for Advanced Laser Dentistry in the LAPIP protocol that treats ailing and failing dental implants. 

The drawing below illustrates the steps taken during the LAPIP protocol:

Treatment Procedure

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

Post care Instructions following Laser

1. Do not be alarmed with any color changes or appearance of gum tissue following laser therapy. Gum tissue that turns white, gray, yellow, red, blue, purple, and/or “stringy” reflects a normal response to laser therapy. Soreness and/or tooth sensitivity is also a normal response to laser therapy.

2. Swelling may also occur. To keep this at a minimum, gently place an ice pack on the outside of your face for 15 minutes then rest for 15 minutes. Repeat this cycle as much as possible for the first 24 hours.

3. Some oozing of blood may occur and will appear to be greatly exaggerated when it dissolves in saliva. Determine the area of oozing and place pressure on it. If you cannot locate the origin of the bleeding, rinse your mouth gently with iced water and apply a wet tea bag to the general area.

4. Please take Over-the-Counter pain medications to prevent inflammation, swelling, and pain. For the next 4-5 days, we suggest taking 400mg-800mg of Ibuprofen every six hours to reduce swelling and pain and quicken healing. DO NOT take more than 2400mg in a 24-hour period. If you experience excessive pain or discomfort, take the narcotic that has been prescribed to you. If you do not have one, please call our office and the doctor will call in a prescription to your pharmacy. Please take as directed along with the Over-the-Counter pain medication. If you’ve been prescribed an antibiotic, please take as directed. We ask that you finish the entire dosage. If any medications are causing you extreme nausea, itching, or a rash; discontinue its use and call our office immediately.

5. Rest with your head elevated when you arrive at home after the procedure. We ask that you please limit your physical activity and keep moving to a minimum for the first 24-hours.

6. Keep your mouth as clean as possible in order to help the healing process. Only brush and floss the untreated area of your mouth. Do not brush or floss the laser treated area for at least the first 10 days.

7. You may gently rinse your mouth the day of treatment. Rinse your mouth gently 3 times a day with an antiseptic mouthwash. In between the antiseptic mouthwash rinses, rinse your mouth gently 3 times a day with warm salt water (1/2 teaspoon of salt dissolved in an 8oz. glass of warm water). For the next several days rinse as previously mentioned but with a little more vigor.

8. You will be on a liquid diet for 3 days (avoid spicy or excessively hot foods during this time), then a diet of “mushy”/soft foods for 7 days, and then a diet of smart food choices for the remainder of the month. It is very important to maintain a good food and fluid intake. Try to eat soft but nutritious food such as eggs, yogurt, cottage cheese, malts, ice cream, etc., until you can comfortably return to a normal diet. Please refer to the Post Laser Treatment Diet Instructions on the reverse side.

9. When eating, do not chew on the laser treated side of your mouth. You also do not want to apply excessive tongue or cheek pressure to this side.

10. Do not be alarmed that as early as 2 weeks after laser treatment and extending as long as 1 year or more, your teeth may become sore and tender as the bone and ligaments around the teeth regenerate and become more firm. This is a sign of healing, but also indicates the presence of a bite imbalance that may need to be adjusted. Please notify my office if you are experiencing a tender area.

11. “Spaces” between your teeth can result from reduction of inflammation, swelling, and the removal of diseased tissue after the Laser treatment. These spaces usually fill in over time, and again, bite adjustment is critical to making sure your teeth and gum between your teeth is not traumatized and can regrow.

Post Laser Treatment Diet Instructions

  • The first three days following Laser Therapy, follow only a liquid- like diet to allow healing. Anything that could be put into a blender to drink is ideal. The purpose of this is to protect the blood clot that is acting as a “Band-Aid” between the gums and the teeth. Do not drink through a straw, as this creates a vacuum in your mouth that can disturb the blood clot or “Band-Aid”. Take daily multi-vitamins.
     
  • Next seven days after treatment, foods with a “mushy” consistency such as those listed below are recommended.
     
  • Starting at ten days after treatment, soft foods may be allowable. The time to start on soft foods is dependent upon the loss of the white material that appeared around your teeth following laser treatment. You were introduced to this material by your doctor or doctor’s assistant during your follow-up visit immediately following your initial treatment session. It was explained to you that you must leave this material alone until it naturally heals and disappears. Once the white material has disappeared, then soft foods can be introduced. Soft foods have the consistency of pasta, fish, chicken or steamed vegetables. You may then gradually add back your regular diet choices.
     
  • Please remember that even after ten days, healing is not complete. The first month following treatment you should continue to make smart food choices. Softer foods are better.
     

“Mushy” Diet Suggestions

  • DAILY MULTI-VITAMINS!
  • Anything put through a food blender
  • Mashed Potatoes, Baked Potatoes – OK with butter/sour cream
  • Mashed Banana or any mashed/blended fruit – no seeds
  • Mashed Yams, Baked Sweet Potato or Butternut squash
  • Creamy peanut butter without solid pieces
  • Jell-O, Pudding, Ice Cream, Yogurt
  • Milk shake/smoothies – no seeds or straws
  • Mashed steamed vegetables
  • Cottage cheese Cream or Soft cheese
  • Broth or Creamed Soup
  • Mashed Avocado, Applesauce
  • Cream of wheat, Oatmeal, Malt O Meal
  • Eggs any style, with or w/o melted cheese
  • Omelets can have cheese and avocado
  • Ensure, Slim Fast - nutritional drinks

DON’T - Chew gum, candy, cookies, chips, nuts, popcorn, anything hard or crunchy, anything that has seeds or hard pieces, meat that shreds and can lodge under the gum and between teeth, raw vegetables, and salad.

If you have any questions or concerns, please call our office at 847-658-3355