A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser

Abstract

Please cite this article as follows: Suragimath G, Lohana MH, Varma S. A split mouth randomized clinical comparative study to evaluate the efficacy of gingival depigmentation procedure using conventional scalpel technique or diode laser. J Lasers Med Sci. 2016;7(4):227-232. doi:10.15171/jlms.2016.40. IntroductionA smile is an expression denoting pleasure, sociability, happiness or amusement and can reflect self-confidence of an individual. A smile seems to have a favorable influence upon others and makes one likeable and more approachable. The beauty of a smile is not only influenced by how the teeth and lips look, but also by the way gingival tissue appears. A dark or black colored gum is one of the concerns of patients reporting to dental clinics. Dark pigmentation of the gum usually occurs due to excessive melanin deposition in gingival epithelium. Melanin pigmentation of the gingiva is a physiologic process that occurs in all ethnicities.1 The prevalence of melanin pigmentation varies between 0% to 89% in different populations with regard to ethnic factors and tobacco usage. Gingival hyperpigmentation is termed as physiological or racial pigmentation, as it occurs as a genetic trait in some populations.3 Gingival hyperpigmentation in patients with gummy smile or excessive gingival display could pose an esthetic problem. Gingival depigmentation is a periodontal plastic procedure carried out by various techniques like conventional scalpel technique, gingivec- Abstract Introduction: Dark or black coloured gingiva is an esthetic concern especially in subjects with high lip line or gummy smile. Gingival depigmentation procedure is a type of perioplastic surgery where the gingival epithelium is excised with various techniques to lighten the colour of the gingiva. The aim of this study was to compare the clinical efficacy of gingival depigmentation procedure with conventional scalpel technique and diode laser application. Methods: This split mouth randomized study was conducted on 12 subjects (18-40 years of age), exhibiting melanin hyperpigmentation of gingiva. The anterior labial sextant of maxilla and mandible were divided into two halves involving three anterior teeth i.e. central incisor, lateral incisor and canine on each side. The divided areas were randomly allotted for depigmentation procedure either with scalpel technique or diode laser operating at 980 nm wavelength. Various parameters such as bleeding, pain, difficulty of procedure and wound healing were assessed and compared between the two techniques. The level of melanin pigment was assessed with Dummette Gupta index and photographic analysis with the help of adobe software. The subjects were followed up to one year to see for recurrence of melanin pigmentation. Results: Bleeding during surgery, pain score and difficulty of procedure assessed by the operator were statistically higher for scalpel technique as compared to laser technique. Wound healing did not show any statistical significant difference between both techniques. Gingival depigmentation ...

Gingival melanin depigmentation by 810 nm diode laser

“…Application of the laser in pulsed mode prevents overheating of surrounding tissues that may cause necrosis and jeopardize healing. Taking into consideration the previously published studies,[ 3 4 14 15 ] diode laser was used in continuous mode in this study knowing the fact that it may penetrate deeper and affect connective tissue as well. That's why, the evaluations were also made at weeks 4 and 12.…”

Gingival Melanin Depigmentation With Diode Laser - Case Report

“…The smile is a manifestation of self-confidence that involves aesthetic and psychological factors, and it includes teeth, lips, and gingival tissue. The color of the gingival tissue is usually pink, but it may be darker in some cases, also known as gingival hyperpigmentation (Suragimath et al, 2016).…”

“…Gingival hyperpigmentation causes aesthetic complaints, especially from patients with a gummy smile or excessive gingival exposure when smiling. The depigmentation treatment aims to remove melanin, and the techniques proposed include the scalpel technique (gold standard), gingivectomy, grafting, electrosurgery, cryosurgery, and laser (Suragimath et al;Bakutra et al, 2017).…”

Comparison of Different Types of Cutting Devices in Surgery (Review)

“…Suragimath G et al conducted a randomized clinical comparative study to assess the effectiveness of the procedure for depigmentation of the gums by using the conventional scalpel and diode laser (980 nm) and showed that depigmentation of the gums was equally effective in both the scalpel and laser methods. However, the areas treated with a laser caused less pain in patients [10]. Alhabashneh R. et al conducted a 6-month trial and showed equal efficacy in the treatment of hyperpigmentation of the gums with a laser and a scalpel, postoperative pain perception and the time required for treatment were also the same, with laser therapy requiring more advanced technology and higher financial costs [11].…”