Clinical and patient reported outcomes using autologous fibrin sealant as adjunct to diode light amplification by stimulated emission of radiation‐assisted gingival depigmentation: A randomized controlled trial

Abstract

AbstractBackgroundGingival depigmentation is quite an invasive procedure and often results in healing by secondary intention, postoperative morbidity, and repigmentation. Autologous fibrin sealant (AFS), a platelet concentrate commonly used due to its adhesive nature and presence of growth factors, has shown good clinical results and improved healing with anti‐inflammatory properties. Hence, the current study aims to evaluate clinical outcomes and patient reported outcomes (PROs) with the adjunctive use of AFS along with Diode light amplification by stimulated emission of radiation (LASER) in gingival depigmentation.MethodologyThis was a randomized double blinded split mouth clinical trial including 10 participants (six females and four males) in age range of 20 to 50 years with gingival hyperpigmentation (Dummet's index 2–3). Test (AFS) and control (no AFS [N‐AFS]) groups received Diode LASER depigmentation with and without adjunctive application of AFS, respectively, along with periodontal dressing. Clinical outcomes assessed were postoperative healing (Landry healing index) and repigmentation. PROs were patient comfort and aesthetics. Healing was assessed at 7 and 15 days and 1 month postoperatively. Repigmentation was assessed at 1, 3, and 6 months postoperatively. Patient comfort was assessed immediately after surgery and 1 week postoperatively using visual analog scale (VAS). Aesthetics was assessed at 1, 3, and 6 months postoperatively using VAS.ResultsBetter early postoperative healing was found at 1 (4.7 ± 0.516, p = 0.043) and 2 weeks (5.0 ± 0.0, p = 0.048) postoperatively in AFS group. No significant difference between the groups was observed in postoperative discomfort, that is, AFS‐1.4 ± 0.516 and N‐AFS‐1.7 ± 0.483 (p = 0.591), aesthetic satisfaction (AFS‐0.1 ± 0.316, N‐AFS‐0.3 ± 0.483, p = 0.168), and repigmentation (p = 0.00).ConclusionThe use of autologous fibrin sealant as adjunct to Diode LASER‐assisted depigmentation in the treatment of gingival pigmentation showed improved clinical outcomes in terms of postoperative healing.