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Combating Peri-Implantitis with Laser Technology

By Dr. Stephen R. John, DDS, APC

Discovering Laser Technology

After starting my own periodontal practice in 1986, I spent much of my time as a periodontist perfecting minimally invasive techniques. A little over 12 years ago, during my quest to find the latest and greatest minimally invasive technology, I discovered laser therapy. Lasers seemed like a perfect fit for my practice, so I began a deeper dive into researching laser therapy, laser options, and different laser companies. After extensive research, I found BIOLASE’s Waterlase Er,Cr:YSGG laser, and decided to try out this unique technology in the hopes of benefitting my practice and my patients.

When adopting laser technology into my practice, the learning curve was simple. Implementing lasers required only a slight modification of the surgical techniques I was already familiar with. In fact, the learning curve was so minimal, as I continued to do my research on laser technology, I chose to add more of BIOLASE’s lasers, including the Waterlase iPlus, Waterlase Express, and Epic Hygiene, to my practice. I was able to use this technology in almost all of my surgical therapies because of the versatility of these different devices. Laser therapies have even allowed me to address one of the biggest issues plaguing the periodontist community–peri-implantitis.

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Fighting Back Against Peri-Implantitis

One of the most recent challenges among periodontists has been the prevention and treatment of peri-implantitis. In order to prevent this, it is essential that periodontists and other dental professionals address the early inflammatory response. Unfortunately, for established patients, proper treatment in the various stages of breakdown has not been well defined. As it turns out, I have found that laser therapy is one of the best treatments that address the inflammatory issue in the prevention and treatment stages of peri-implantitis. I have also observed firsthand that laser therapy can reverse the destructive granulation tissue to healing reparative tissue.

Early attempts at bone grafting the peri-implantitis implant emphasized the need for optimal cleaning, decontamination, and preparation of the implant surface. More traditional methods, such as scalers, ultrasonics, rotary brushes, and topical medicaments, often result in residual hard and soft tissue deposits on the implant surface. Similarly, thread removal of the implant surface often resulted in the titanium becoming embedded in the surrounding tissues and a foreign body reaction in patients.

Research has shown that the Erbium lasers, such as the Waterlase, are particularly efficient at removing both hard and soft tissue deposits for decontamination while being safe on the implant surface when used properly. In my practice, I have found that proper implant surface decontamination using the Waterlase laser has greatly improved my surgical results on my peri-implantitis cases.

Benefits of Laser Therapy

Over time, I found that with the Waterlase, I was able to replace many of my surgical instruments for good. Now, many of my surgeries are performed with the laser as my only surgical instrument. In many cases, lasers have actually proven to be superior to the handpieces and surgical knives that I used before discovering laser technology.

Another benefit of using the Waterlase is improved patient acceptance. When I discuss surgery with a patient, they often become reluctant or fearful about what that surgery may entail. However, when I discuss surgery using a laser, patients tend to be more attentive and excited about the prospect of solving their dental woes through this minimally invasive technology.

When I began using the Waterlase on refractory maintenance patients, I was able to provide an alternative treatment therapy in an attempt to stabilize their conditions. I was extremely impressed with not only the surgical result, but with the feedback, I received from my patients.  A majority of my patients had commented on how much easier laser therapy was compared to more traditional surgical procedures where a scalpel, knife, and/or rotary bur was used. I also saw post-op results that I had never been able to achieve when using traditional therapy, including faster healing times. The first year I began using the Waterlase, our production increased by 35%, demonstrating the impact laser technology can have when you bring it into your office.

The Most Valuable Investment

Although I have made many notable investments in my practice over the past 35 years, purchasing the BIOLASE Waterlase laser has been the most significant. With improved patient outcomes, decreased bleeding and optimal visual access during surgery, faster healing times, and an effective solution for patients with peri-implantitis, the value in adding BIOLASE’s laser technology to my practice has been immeasurable.

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Dr. Stephen R. John, DDS, APC

About Dr. Stephen R. John, DDS, APC

Dr. Stephen John is a practicing Periodontist with over 35 years’ experience in his office located in San Mateo.  He completed a Post-doctorate Periodontal Program at The University of California at San Francisco in 1986. Dr. John is a member of the American Academy of Periodontology, California Society of Periodontists, American Academy of Implant Dentistry, Academy of Laser Dentistry and several other associations.  Dr. John is a fellow of the Pierre Fauchard Academy, World Clinical Laser Institute and The Academy of Dentistry International. Dr. John implemented Laser Therapy in his office about ten years ago and appreciates the advantages of the use of Laser Therapy in the treatment and outcome of his patients.