¬Management of localized aggressive Periodontitis using laser assisted new attachment procedure – A case report of 24 months follow up

Introduction: Traditional surgical techniques both resective and regenerative establish periodontal health addressing the primary goal of pocket elimination. Restoration of lost periodontal tissues rather than regeneration is being accomplished with untoward side effects which led to the advent of a newer non-invasive Laser assisted new attachment procedure protocol challenging the old paradigm of periodontal healing in the absence of guided tissue regeneration barriers(GTR) or bone grafting materials. Materials and Methods: A female patient reported to the out patient department of periodontics, sibar institute of dental sciences with chief complaint of mobile teeth in posterior region and on intra oral examination probing pocket depths of 9-10mm were observed at 16,26,36,46. The details about the various treatment options available and their benefits and risks had been explained to the patient and it was decided to provide Laser assisted new attachment procedure. The initial step of Laser assisted new attachement protocol is bone sounding around each tooth with administration of local anesthesia to determine areas of osseous defects that cannot be seen radiographically. The first pass of Laser, termed troughing was passed at wavelength of 890 nm, 2 Watts, 150millisecs, around each tooth to remove diseased epithelium by forming a mini-flap followed by removal of calculus on root surface using piezoscalers. The further application of Lasers was done to enhance the ability to form a fibrin clot to close the mini-flap and to disinfect site again Conclusion: Radiographic evidence of bone regeneration with attachment gain is observed postoperatively after 24 months.