A novel minimally‐invasive approach for metal tattoo removal with Er:YAG laser

Abstract

Objective: Few effective and established treatment methods can remove gingival metal or amalgam tattoos. With this case series, we aimed to demonstrate the use of a novel minimally invasive technique to remove metal tattoos using an erbium-doped yttrium aluminum garnet (Er:YAG) laser. Materials and Methods:We retrospectively collected clinical data from 18 patients who had undergone Er:YAG laser treatment to remove metal tattoos. Minimal gingival ablation using an Er:YAG laser directed towards the pigmented area was performed, which exposed metal debris within the connective tissue that was carefully removed. A dental microscope was employed to identify the metal debris, for accurate irradiation, and to minimize wounding by reducing invasion. Postoperative gingival color and morphology, and visual analog scale as a patient-reported outcome assessing postoperative pain were evaluated.Results: All patients' metal tattoos were removed completely and safely during short procedures. Considerable esthetic improvements and favorable wound healing were achieved with almost no postoperative pain or complications. Conclusion:The findings from this case series suggest that this novel minimally invasive therapy for metal tattoo removal that involved the Er:YAG laser is effective and safe, is associated with successful outcomes, and contributes greatly to patients' esthetic satisfaction.Clinical Significance: Metal tattoo removal using an Er:YAG laser safely and successfully improved gingival esthetics. This novel technique is much simpler and less invasive than conventional periodontal plastic surgery, and it may be more reliable regarding esthetic gingival improvements as it is associated with favorable wound healing, and it could offer significant benefits to patients by alleviating physical and mental stresses via reduced chair time and postoperative pain.

Novel flapless esthetic procedure for the elimination of extended gingival metal tattoos adjacent to prosthetic teeth: Er:YAG laser micro-keyhole surgery

“…No recurrence or complications were observed after 2 years of follow-up. Thus, this novel surgical modality can be considered clinically safe and effective, as in our previous case reports of metal tattoo removal with an Er:YAG laser [13,26].…”

“…Micro-keyhole preparation is a unique technique that has not been previously used to remove expansive discolored tissue with metal fragments from the deep connective tissue layer through small access holes. In our previous laser treatment [26], discolored tissue was ablated by preparing grooves along the band-shaped, occasionally long, pigmentated area. Most of the epithelium was ablated in the treated area.…”

“…It is a minimally invasive treatment [14][15][16] that enables selective removal of pigmented connective tissue and metal journal of prosthodontic research 65 ( 2021) •-• fragments [13]. Recently, we proposed that the application of the minimally invasive Er:YAG laser technique for metal tattoo removal resulted in improved esthetics [26]. Consequently, in this study, we developed a novel, minimally invasive technique for metal tattoo removal called Er:YAG laser micro-keyhole laser surgery (EL-MIKS).…”

Tatouage d’amalgame sur les gencives

“…Même si les tatouages d’amalgame ne requièrent aucun traitement, une ablation chirurgicale peut être effectuée à des fins esthétiques. L’ablation à l’aide d’un laser à grenat d’yttrium et d’aluminium dopé à l’erbium est moins effractive et plus simple que l’exérèse avec greffe de gencive libre; elle abrège le temps opératoire et réduit la douleur postopératoire 3 .…”

Gingival amalgam tattoo

“…Removal using an erbium-doped yttrium aluminum garnet laser is less invasive and easier than removal with free gingival grafts, and can reduce operative time and postoperative pain. 3 …”