Management of Gingival Hyperpigmentation by Scalpel Technique

Abstract

Oral melanin pigmentation is well documented in the literature and is considered to have multifaceted etiologies including genetic factors, tobacco use, systemic disorders and prolonged administration of certain drugs especially antimalarial agents and tricyclic antidepressant. Melanin, non-hemoglobin derived brown pigment, is the most common of the endogenous pigments and is produced by melanocytes present in the basal layer of epithelium. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, cosmetic concerns are common, particularly in patients having a very high smile line (gummy smile). Various depigmentation techniques have been employed, such as scalpel surgery, gingivectomy with free gingival autografting, cryosurgery, electrosurgery, chemical agent such as 90% phenol and 95% alcohol, abrasion with diamond burs, ND:YAG laser, semiconductor diode laser, and CO2 laser. One of the first and still popular techniques to be employed is the surgical removal of undesirable pigmentation using scalpels. The present case report shows a simple and effective surgical depigmentation technique that does not require sophisticated instruments or apparatus, yet yields esthetically acceptable results.