Gingival Depigmentation Using Diode 980 nm and Erbium-YAG 2940 nm Lasers: A Split-Mouth Clinical Comparative Study

Aim of the Study. This study aimed to compare the effectiveness of diode laser (980 nm) and erbium-YAG laser (2940 nm) for gum depigmentation. Background. Gingival hyperpigmentation, “black gum,” refers to black discrete single or multiple pigments on the gingiva. Several factors may play a role in gingival hyperpigmentation ranging from physiologic pigmentation to manifestations of systemic diseases. Several techniques have been used for gingival depigmentation to lighten its color. Methods. Fifteen patients exhibiting nonsmoking melanin hyperpigmentation, with the mean age of 28.6 ± 7.8 years, were recruited. The facial gingiva of the anterior teeth and premolars of each jaw was divided into two halves. The right or left side of each jaw quadrant randomly received either diode laser operating at 980 nm wavelength or erbium-YAG laser at 2940 nm. Parameters such as degree of gingival depigmentation, bleeding, pain, patient satisfaction, and wound healing were assessed and compared between the two techniques. The subjects were followed up to six months for melanin pigmentation recurrence. Results. Both techniques were efficient for gingival depigmentation. Nevertheless, bleeding during surgery was statistically higher for Er:YAG laser technique as compared to diode laser. Wound healing showed statistically nonsignificant differences between the two lasers, although Er:YAG seems to give better outcomes than the diode. The patients were satisfied with both laser techniques during and after gingival depigmentation. However, the pain score was higher for Er:YAG laser than for diode laser. Conclusion. This study demonstrated that both lasers’ techniques are efficient for gingival depigmentation. However, diode laser seems to show less painful experience and relatively better bleeding control.

SURGICAL MANAGEMENT OF DEPIGMENTATION IN HYPERPIGMENTATION WITH SCRAPPING METHOD USING SURGICAL SCALPEL

Introduction:The color of healthy gingiva is often influenced by melanin pigmentation as an abnormal deposition of melanocytes located in basal and suprabasal cells. Gingival hyperpigmentation that exceeds normal causes a variety of physiological and pathological conditions. Gingival depigmentation is a periodontal surgical procedure to remove or reduce gingival hyperpigmentation by various techniques to improve aesthetics. The procedures include the use of chemicals such as 90% phenol, diamond drill abrasion, gingivectomy, soft tissue autograft, partial thickness flap, cryosurgery and laser. Case: A 19-year-old male patient came to periodontist office, after an examination he had Smoker's melanosis hyperpigmentation in the upper anterior region. Case Management: The patient was given depigmentation surgery using the scrapping method using a scalpel No. 15c.Discussion: Surgical management of gingival depigmentation with scrapping provides good esthetic results. Conclusion: It is necessary to take a proper history and adequate examination and be wise in determining the various surgical methods of depigmentation.

A case report on gingival depigmentation by scraping method by scalpel

Smile is the most wonderful gesture of the human being. A Person who is genuinally happy shows his or her pleasure in the form of smile. A beautiful smile for sure enhances individual self confidence. A beautiful smile lies in a harmonial balance between competent lips, size, color, and proper alighnment of teeth and the color of gingival tissues. The normal color of gingival is coral pink as in accordance to British population, and pale pink as in accordance to Indian population. However this gingival pigmentation varies among each and every individual in accordance with the color of the skin, various pigments present in human body like melanin, haemoglobin, carotene. However this melanin when secreted in excess, can lead to brownish, blackish, or bluish discoloration of gingiva, and this discoloration is denoted by the term hyperpigmentation, and the procedure to overcome this hyperpigmentation is called as depigmentation. Present case report is on a 21 years old female whose chief complaint was visual blackish display of gums while smiling. So the procedure depigmentation was done by surgical scalpel by scraping method, and the patient showed better results following two weeks after procedure. Esthetic dentistry is a recently emerging branch. People now a days are much more concern about the gingival esthetics and smile design, as they want their smile to be beautiful in order to boost up their confidence. . One of the gingival esthetic for which the people are concerned are the hyperpigmented gingiva. Gingival depigmentation is the process to remove this abnormal pigmented gingiva. The clinician must have a knowledge as for which condition, which type of gingival depigmentation technique can be applie so as in order to make the treatment successful.

SURGICAL CORRECTION FOR GINGIVAL DEPIGMENTATION USING ELECTROSURGERY-A CASE REPORT

The harmony of smile is determined not only by the shape, position and colour of the teeth but also by the colour of the gingival tissues. Excessive gingival pigmentation is a major aesthetic concern for many people. Though, it is not a medical problem but many people complain of dark gums as unesthetic. Aesthetic gingival depigmentation can be performed in such patients with excellent results. A case is reported here in which a simple and effective gingival depigmentation was performed with the use of electrosurgery which provides increased satisfaction in patients

Comparative Evaluation of Treatment Outcome of Gingival Depigmentation by Surgical Scalpel, Laser and Cryosurgery Techniques for the Management of Gingival Hyperpigmentation – A Randomized Clinical Trial Conducted in the Institute of Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital, Hingna

BACKGROUND Aesthetic concerns have plagued humans for ages, but now modern technology and science have presented us with various options to treat these concerns. One such aspect is gingival depigmentation which as a dentist, we often come across. A randomized controlled clinical trial was conducted to compare and evaluate the techniques of gingival depigmentation for the management of gingival hyperpigmentation. METHODS A total of 45 patients with gingival pigmentation were randomly allocated into 3 groups: Surgical scalpel (N = 15), Cryosurgery (N = 15) and 810nm Diode Laser (N = 15). Melanin pigmentation index (MPI), visual analogue scale (VAS), wound healing index (WHI) and colour intensity index were evaluated for all the groups at baseline, immediate postoperative, 1 week, 1 and 3 months postoperatively. Statistical analysis was done for the data obtained to test the significance between the variables. P value < 0.05 was considered significant. RESULTS MPI scores from baseline to the postoperative intervals were effective in the management of gingival hyperpigmentation without any statistically significant difference. Faster healing was noted with surgical scalpel than cryosurgery. VAS scores were higher for the surgical scalpel group and lower for the other groups. The colour intensity index, an increase in the red colour value and decrease in the blue colour value was indicative of effectiveness of all the three techniques in the management of gingival hyperpigmentation. CONCLUSIONS It can be concluded that all the three techniques are effective in the management of gingival hyperpigmentation. KEY WORDS Gingival Hyperpigmentation, Aesthetic, Cryosurgery, Surgical Scalpel, Laser

Photobiomodulation- Yes or No?. following laser gingival depigmentation: A case report

Gingival hyperpigmentation in many esthetic concern patient poses a psychological problem and embarrassment. Among the many procedures used for gingival depigmentation, diode laser is considered as one which is highly accepted by the patient due to the absence of bleeding during and after procedure and being a fast and effective method. Literature have also stated the beneficial effect of low dose laser therapy on wound healing due to its potential to increase mitochondrial function, adenosine triphosphate (ATP), RNA, and protein synthesis which may further increase the cellular metabolism resulting in enhancement in wound healing and acceleration of the inflammatory process. This case report presents the use of diode laser for gingival depigmentation followed by laser photobiomodulation in an attempt to fasten the healing.