LANAP — Laser-Assisted New Attachment Procedure in Bangalore
LANAP is the most evidence-supported laser treatment for moderate-to-advanced periodontitis in modern periodontics. It is a patented, FDA-cleared protocol developed over three decades of clinical research in the United States.
Many patients seek LANAP treatment because of persistent bleeding gums, gum swelling, bad breath, or loose teeth — all classic signs of progressive periodontal disease.
What makes LANAP different from conventional surgery? It eliminates periodontal pathogens and preserves healthy gum tissue — and in documented cases, it stimulates new bone formation. No scalpel. No sutures. Significantly less post-operative pain.
At Dental Solutions Clinic in Indiranagar, Bangalore, LANAP is performed by Dr. Balasubramanya K V, a specialist Periodontist and one of the very few practitioners in South India with formal postgraduate laser dentistry training from the University of Vienna, Austria. The procedure uses the specific Nd: YAG wavelength of the Fotona LightWalker — the only dual-wavelength laser system that delivers the full LANAP protocol.
What Is LANAP? — The Clinical Foundation
LANAP was developed by Drs. Robert Gregg and Delwin McCarthy in the late 1980s and refined through the 1990s. It received FDA clearance in 2004 — the first laser procedure cleared specifically for periodontal regeneration.
Since then, numerous peer-reviewed studies have validated its efficacy for:
- Reduction of periodontal pocket depths
- Reduction of bleeding on probing
- Reduction of tooth mobility in advanced cases
- Cementum-mediated new attachment — histological evidence of new connective tissue attachment to root surfaces
- New bone formation — documented on CBCT imaging in multiple long-term studies
How is it different from conventional flap surgery?
| Aspect | Conventional Flap | Laser-assisted Flap |
|---|---|---|
| Root Surface Cleaning | Mechanical instruments only | Mechanical cleaning plus Er:YAG laser decontamination of the root surface |
| Bone Defect Cleaning | Instruments and irrigation | Instruments plus laser disruption of biofilm in bone defects |
| Residual Bacteria | Some bacteria remain after instrumentation. | Bacterial load significantly reduced; laser reaches tubules and micro-crevices. |
| Haemostasis | Gauze and pressure | Laser helps cauterise and control bleeding for a clearer field |
| Healing Environment | Standard post-surgical | Lower bacterial load at closure, supporting better healing conditions |
| Photobiomodulation (LLLT) | Not used | Nd:YAG low-level settings may be used after closure to support healing and comfort |
| Post-operative Discomfort | Typical surgical recovery | Often described as milder due to the laser's bio-stimulatory and anti-inflammatory effects. |
Is Bleeding Gums a Sign of Periodontitis?
Persistent bleeding gums are not normal and are one of the earliest indicators of periodontal inflammation. While occasional bleeding may be associated with gingivitis, recurrent bleeding — especially combined with pocket formation or bone loss — suggests periodontitis. LANAP is indicated when bleeding gums are accompanied by deeper periodontal destruction.
Who Is LANAP For?
LANAP is recommended for patients with:
- Moderate-to-severe periodontitis (Stage 2, 3, or 4) — pocket depths ≥5mm with clinical attachment loss and bone loss on radiography
- Persistent pockets after non-surgical treatment — disease that did not resolve with conventional debridement alone
- Generalised or multiquadrant periodontitis — LANAP’s efficiency suits full-mouth disease requiring consistent treatment across all teeth
- Patients for whom conventional surgery is contraindicated — anticoagulant therapy, systemic conditions, or high medical risk
- Patients who have declined conventional surgery — LANAP offers a minimally invasive alternative
- International patients — LANAP’s reduced post-operative morbidity and predictable healing trajectory suit patients who need to travel home after treatment
The LANAP Procedure — Step by Step
The complete LANAP protocol is performed across two appointments — upper arch, then lower arch — each lasting around 60–90 minutes under local anaesthetic.
Pre-Treatment Assessment
Before any laser is used, we conduct:
Full periodontal charting
Six-point probing of all teeth, recording pocket depths, clinical attachment levels, bleeding on probing, and furcation involvement
PLANMECA ProMax CBCT 3D scan
Three-dimensional bone loss mapping for every tooth in the treated arch, serving as the baseline for 6 and 12-month post-treatment comparisons
Medical history review
Current medications, systemic conditions, anticoagulation status, and diabetes control (HbA1c requested where relevant)
Treatment planning and consultation
Dr. Balasubramanya reviews the CBCT findings with you, explains the staged prognosis for each tooth, and presents the treatment plan in writing
The Seven-Step LANAP Protocol
Measurement
Periodontal probe measurements are taken at each tooth to confirm pocket depths and disease severity. These serve as the baseline for post-treatment comparison.
Initial Laser Pass
The Nd-YAG laser fibre — sized to match the pocket diameter, typically 240 μm or 400 μm — is inserted into the base of each pocket. The laser energy at this stage selectively vaporises the dark-pigmented bacteria lining the pocket wall and the diseased granulation tissue, while leaving healthy tissue intact. This level of bacterial elimination is not possible with mechanical instruments alone.
Ultrasonic Scaling
Ultrasonic instruments remove calculus deposits from the root surface below the gumline — deposits that the initial laser pass has now exposed by eliminating the overlying diseased tissue.
Root Planing
Hand curettes refine root surface smoothness, removing any residual calculus and preparing a biologically compatible surface for new tissue attachment.
Second Laser Pass
A second Nd-YAG laser application — at a different energy setting — seals the pocket. It coagulates the blood at the pocket base into a stable fibrin clot, sealing the treated site from re-contamination and providing a biological scaffold for tissue regeneration.
Clot Stabilisation
The laser-induced fibrin clot is stabilised, and the gum is compressed against the root surface to encourage new attachment. No sutures are placed in the standard LANAP protocol.
Bite Adjustment (Occlusal Equilibration)
Any tooth mobility or bite interferences are corrected by adjusting the occlusion. This reduces traumatic forces on periodontally compromised teeth and improves their healing environment.
Recovery and aftercare
Most patients return to normal activities within 24–48 hours. A soft diet is recommended for 2–3 weeks. Specific written post-operative instructions are provided at the end of each appointment. A 2-week postoperative check follows, and a formal CBCT-based bone-level assessment is performed at 6 months.
LANAP vs Conventional Flap Surgery
| Feature | Details |
|---|---|
| Incisions/Sutures | None (in standard protocol) |
| Post-operative Pain | Mild — most patients use OTC analgesia for 1–2 days. |
| Recovery Time | 24–48 hours to normal activity; soft diet for 2–3 weeks |
| Gum Recession Risk | Minimal — gum architecture is preserved. |
| New Bone Formation | Documented in multiple peer-reviewed studies |
| Bacterial Elimination | Laser energy penetrates dentinal tubules — deeper decontamination than mechanical instruments alone. |
| Repeat Treatment | Can be retreated if required |
LANAP at Dental Solutions Clinic — What Sets This Apart
There is a meaningful difference between a clinic that owns a laser and applies it loosely during gum treatment and a clinic where LANAP is delivered as a precisely calibrated, protocol-adherent procedure. The difference in outcomes is significant.
At Dental Solutions Clinic:
- Dr. Balasubramanya holds a Diploma and a Master’s qualification in Laser Dentistry from the University of Vienna — the institution that trained the trainers of most LANAP practitioners worldwide
- The Fotona LightWalker is the specific laser system for which the Nd-YAG LANAP protocol was designed — not a substitute unit
- Every case is pre-planned with CBCT imaging — pocket depth, bone morphology, and root anatomy are fully mapped before the first laser insertion
- Post-treatment CBCT imaging at 6 and 12 months provides objective evidence of bone level change — not just a clinical impression
International patients Fabrice (France) and Ibrahim (Maldives, commercial pilot) both underwent LANAP and/or WPT at this clinic after being unable to access equivalent treatment in their home countries.
LANAP Results — Before & After
Our LANAP gallery includes pre- and post-treatment periapical radiograph comparisons and CBCT cross-sectional images showing bone-level changes at 3 and 6-month follow-up. These are real clinical cases from Dental Solutions Clinic — not stock images or manufacturer-supplied photographs.
Indicative Cost — LANAP in Bangalore
Prices vary based on disease severity, number of teeth involved, and whether additional procedures are required. A written, itemised treatment plan is provided at consultation.
| Service | Indicative Price (₹) |
|---|---|
| LANAP — Single Arch (upper or lower) | ₹30,000 – ₹60,000 |
| LANAP — Full Mouth (both arches) | ₹55,000 – ₹1,00,000 |
| Pre-treatment CBCT scan | ₹2,500 – ₹4,500 (may be included in treatment quote) |
| Post-treatment CBCT (6-month) | ₹2,500 – ₹4,500 |
Frequently Asked Questions
Is LANAP painful?
LANAP is performed under local anaesthetic — you will feel nothing during the procedure. Post-operatively, LANAP causes significantly less discomfort than conventional periodontal flap surgery. Most patients manage any soreness with standard over-the-counter analgesics for 1–2 days. The absence of incisions and sutures is the main reason.
I have bleeding gums. Do I need LANAP?
Bleeding gums alone do not automatically require LANAP. A clinical examination and periodontal charting are necessary to determine whether the bleeding is due to reversible gingivitis or established periodontitis. LANAP is indicated when bleeding is associated with pocket depths ≥5mm and bone loss.
How many LANAP appointments are required?
The standard protocol treats the full mouth in two appointments — the upper arch in one session and the lower arch in a second session, 1–2 weeks later. Each appointment takes approximately 60–90 minutes under local anaesthetic. A 2-week postoperative review follows, and a formal 6-month CBCT reassessment is scheduled to document bone-level changes.
Is LANAP available at other dental clinics in Bangalore?
Very few clinics in Bangalore — or in India more broadly — have both the Fotona LightWalker Nd-YAG laser required for the LANAP protocol and a clinician with formal LANAP certification. Owning a dental laser does not qualify a practitioner to perform LANAP. The protocol requires specific energy settings, fibre sizes, angulation techniques, and timing sequences that are learned through structured training. Dr. Balasubramanya’s qualifications are from the University of Vienna, which offers the most rigorous laser dentistry training programme available internationally.
Can LANAP save teeth that have been recommended for extraction?
In some cases, yes. Teeth with up to 75% bone loss have been successfully treated with LANAP in published clinical studies, provided adequate attachment remains. Prognosis depends on bone defect morphology, furcation involvement, tooth mobility grade, and systemic health.
Dr. Balasubramanya reviews each tooth individually on CBCT imaging before providing a realistic prognosis. He will not recommend LANAP for teeth that, on clinical evidence, cannot be saved. Honesty about prognosis is as important as the treatment itself.
How does LANAP compare to WPT? Which is better?
They are different protocols with overlapping indications. LANAP uses only the Nd-YAG wavelength and has the strongest evidence base for new bone formation and new attachment. WPT uses both Er-YAG and Nd-YAG in sequence — the Er-YAG component can ablate heavy calculus deposits that the Nd-YAG alone cannot address as effectively.
In many cases, both are equally valid. Dr. Balasubramanya selects the most appropriate protocol based on your CBCT findings, pocket morphology, and calculus burden.
→ Detailed LANAP vs WPT comparison
What happens if LANAP does not fully resolve my gum disease?
LANAP is the most effective non-surgical periodontal procedure available — but it is not a guaranteed cure. Where LANAP does not achieve adequate pocket reduction across all teeth, residual sites are reassessed at the 6-month CBCT review, and conventional flap surgery is considered for those specific locations.
This combination approach — LANAP first, targeted surgery for residual sites — produces the best outcomes for advanced generalised periodontitis. It is the protocol followed at Dental Solutions Clinic.
Is LANAP suitable for diabetic patients?
Yes, and diabetes does not disqualify a patient from LANAP. In fact, LANAP’s reduced surgical trauma is a significant advantage for diabetic patients, who have impaired wound healing and a higher surgical risk. Adequate glycaemic control (HbA1c <8%) is preferred before treatment; we recommend an HbA1c test at the consultation if recent values are unavailable.
Periodontal treatment in diabetic patients has been shown in multiple studies to improve glycaemic control — making treatment both clinically and systemically beneficial.