This study examines the effectiveness of the laser-assisted new attachment procedure (LANAP) as measured by tooth loss, comparing data to published studies using conventional surgical treatment modalities for the primary treatment of Types III and IV periodontitis. Retrospective data from 107 patients presenting with Types III and IV periodontitis were gathered and evaluated. All patients received LANAP periodontal therapy as their primary surgical treatment according to the FDA-cleared LANAP protocol. The patients averaged 6.2 years post-treatment. The data were compared to several published studies for outcome classification and tooth loss over time. The effectiveness of LANAP as a primary treatment method for Types III and IV periodontitis compares very favorably with conventional surgical treatment modalities concerning tooth loss and stability over time, need for surgical retreatment, and outcome classification. Dentistry continues to develop less invasive means of providing patient care without sacrificing results. Less invasive treatment of periodontitis, with reduced postoperative morbidity yet equal results in tooth retention over time is an important goal. LANAP treatment for moderate and advanced periodontitis provides a less invasive treatment alternative for the dentist and patient to consider as a part of informed consent.