Gingival Depigmentation using Erbium-YAG LASER - Four Clinical Case

Abstract

Melanin, carotene and haemoglobin are the most common natural pigments contributing to the normal colour of the gums. Although physiologic and ethnic melanin pigmentation is not a medical problem, complains about black are common. Melanin hyperpigmentation usually does not present a medical problem, but patients usually complain of dark gums as unaesthetic. Many techniques have been used for gingival depigmentation. Recently, Laser Ablation has been recognized as one of the most effective, pleasant and reliable techniques. Effective depigmentation of the gingival requires removal of all or most of the melanocytes from the basal layer of the gingival epithelium. Using non-specific radiation means ablation of all the epithelial cell layers, as well as connective tissue rete pegs, leaving behind only remnants of the epithelial rete ridges. Erbium:YAG lasers, meeting most of these requirements and being available in the dental office, seems to be the laser of choice for this procedure. Five patients (2 F; 2 M) who were referred to the School of Dentistry at university of sulaimani for cosmetic therapy of dark/black gingiva, were treated using (Versa wave) Erbium-YAG laser . The laser beam was set up at 1000 mj/ 45 Hz per second. The beam was defocused to produce a 3 mm diameter circle, thus reducing the beam penetration while increasing the treated surface. Using the brush technique. Treatment required only topical anesthesia. Healing was perfect and required no supportive therapy. No any recurrence of pigmentation was observed during 3 months follow up. Patients' evaluation analysis showed that the results were pleasing; no pain was experienced during lasing as well as during healing.