Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm

OBJECTIVE

This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.

MATERIALS AND METHODS

Twenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points.

RESULTS

At 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups.

CONCLUSION

While diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures.

CLINICAL RELEVANCE

Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.

Gingival depigmentation with diode and Er,Cr:YSGG laser: evaluating re-pigmentation rate and patient perceptions

OBJECTIVE

To evaluate the efficiency of depigmentation, patient perceptions, and the recurrence rates of physiological gingival pigments during a 2-year follow-up after ablative depigmentation using two laser wavelengths: diode 940 nm and Er,Cr:YSGG 2780 nm.

MATERIALS AND METHODS

Sixty patients exhibiting physiological melanin hyperpigmentation in the buccal maxillary gingiva were randomly divided into two equal groups treated with an Er,Cr:YSGG laser at 2780 nm, and a 940 nm diode laser, respectively. The depigmentation procedure essentially involves the ablation of epithelial tissue exhibiting melanin pigmentation. The intensity and extensity indices of gingival pigments were evaluated at baseline, 1 month, 1 year, and 2 years.

RESULTS

At all time points following depigmentation treatment, oral pigmentation index (OPI) and melanin pigmentation index (MPI) scores were less significantly (p <0.05) compared to the baseline in both groups. Treatment was significantly faster with Er,Cr:YSGG laser and required no anesthesia, with faster healing and less postoperative discomfort after 1-week of treatment, compared to the diode laser treatment (p <0.001). The re-pigmentation intensity and extensity were higher significantly in the Er,Cr:YSGG group than in the diode group at 1 year and 2 years (p <0.05).

CONCLUSION

Both lasers efficiently removed gingival pigments with comparable clinical outcomes and overall positive patient experience. Diode laser treatment exhibited better long-term stability of gingival color, with a lower incidence of re-pigmentation.

CLINICAL RELEVANCE

The color of the gingiva plays an important role in the esthetics of oral soft tissues and the overall ideal smile. Laser-assisted gingival depigmentation is an effective, comfortable, and reliable technique with good esthetical outcomes. The rate of re-pigmentation was affected by the laser wavelength and the technique used.

Clinical and histological comparison of platelet-rich fibrin versus non-eugenol periodontal dressing in the treatment of gingival hyperpigmentation

Background

The platelet-rich fibrin (PRF) has proven an immense role in angiogenesis and epithelization in a wound healing process. The present study aims to ascertain PRF's beneficial role in wound healing after depigmentation surgery.

Materials and Methods

A total of 12 systemically healthy controls included were divided into two groups after scalpel depigmentation procedure. PRF was prepared according to Choukroun's standard protocol. Using split-mouth design after depigmentation, one group received PRF membrane, and in second group non-eugenol periodontal dressing was placed. The participants were evaluated for visual analog scale (VAS), healing index (HI) on 3^rd and 5^th day. Epithelization test using toluidine blue and histological examination employing punch biopsy was done on the 5^th day.

Results

On statistical scale, VAS, HI, epithelization test, and histological findings were statistically significant in the two study groups. PRF group proved better epithelization test and inflammatory cell infiltration was less in PRF group which confirmed superior wound healing in the group.

Conclusion

PRF membrane postdepigmentation provided satisfactory patient comfort and enhanced the wound healing cascade.