Gingival Hyperpigmentation Research Articles

Glutathione Injection versus Laser in the Treatment of Gingival Hyperpigmentation (A Randomized controlled trial with Histological Assessment )

Glutathione Injection versus Laser in the Treatment of Gingival Hyperpigmentation (A Randomized controlled trial with Histological Assessment )

Effect of diode laser on oral pigmentation, pain, and wound healing in patients with gingival hyperpigmentation: a meta-analysis.

Diode laser represent a practical clinical strategy for treating gingival hyperpigmentation. However, its effectiveness remains controversial. We conducted a meta-analysis evaluating the quantitative effects of diode laser therapy on gingival hyperpigmentation. Pubmed, Embase, Web Of Science, and Cochrane Library were systematically searched for the use of diode laser in gingival hyperpigmentation. The primary outcomes assessed were the Dummett-Gupta Oral Pigmentation Index (DOPI), Visual Analog Scale (VAS) pain scores, and the Wound Healing Index (WHI) for overall evaluation. I2 index was calculated to identify heterogeneity and sensitivity analyses sources of heterogeneity. Funnel plots and Egger's test were utilized to evaluate publication bias. Thirteen randomized controlled trials (RCTs) involving a total of 233 participants were included in this study. The analysis demonstrated that diode laser had a significant effect on DOPI (standard mean difference [SMD] = -0.245, 95% CI = -0.415 to -0.040, P =.019) and VAS (SMD = -0.089, 95% CI = -1.332 to -0.285, P =.002), with no significant effect on WHI (SMD = -0.224, 95% CI = -1.100 to 0.653, P =.617). Despite the significant heterogeneity in VAS and WHI indicated by the I2 index statistic, the sensitivity analyses' results demonstrated the main findings' reliability. While no significant publication bias was detected for DOPI and WHI, the VAS results exhibited notable publication bias. The study demonstrated that diode laser prolongs gingival repigmentation time and reduces pain compared to other treatments. However, the efficacy in wound healing did not significantly promote.

A Clinical Comparison of ErCr:YSGG Laser and Scalpel Techniques in Gingival Depigmentation.

Gingival depigmentation impacts patient self-confidence and quality of life. This study compares the Er,Cr:YSGG laser to the traditional scalpel technique for reducing gingival hyperpigmentation, assessing their effectiveness and other relevant factors. We conducted a double-blind, randomized trial with a split-mouth design. Forty participants were selected from the university's dental clinic and randomly assigned to receive either the Er,Cr:YSGG laser (2780 nm) or surgical scalpel. Pain intensity and smile satisfaction were assessed post-surgery, and treatment duration was evaluated. The Dummett Oral Pigmentation Index (DOPI) was used to determine the initial severity of pigmentation and to track both reduction and potential repigmentation over time. The Gingival Melanosis Record (GMR) was used to evaluate the presence and extent of pigmentation and to monitor recurrence after 1 and 12 months. Both the Er,Cr:YSGG laser and surgical scalpel similarly reduced GMR and DOPI scores over time, without significant differences at 12 months (p > 0.05). A significant examiner variability was noted in GMR scoring (β &#61; -1.2 for Examiner 2; p < 0.001). Power analysis indicated a higher confidence for detecting treatment effects in DOPI (75%) compared to GMR (55%). Patient satisfaction with smile significantly improved (p < 0.001). Treatment type did not influence postoperative pain levels. The Er,Cr:YSGG laser required longer surgery times (p < 0.001). Under the conditions of the present study, both Er,Cr:YSGG laser and surgical scalpel were equally effective in reducing gingival hyperpigmentation. Although lasers offer better bleeding control and require less anesthesia than the scalpel technique, clinicians should also consider surgery duration, cost, and expertise when selecting a treatment method. Future research should focus on long-term outcomes and economic evaluations, utilizing standardized clinical measures.

Microneedling - A Novel Cosmetic Therapeutic Approach for Management of Gingival Hyperpigmentation and Review of Literature

Abstract A beautiful smile boosts an individual’s self-confidence. The harmony of a smile depends on the shape, colour, and position of teeth, as well as the gingival tissue. Excessive gingival pigmentation is a major aesthetic concern for many people. Gingival hyperpigmentation is usually caused by an abnormal accumulation of melanin in the gingival tissue, which gives the gingiva a dark appearance. A variety of different modalities have been proposed for removing hyperpigmentation like Scalpel technique, LASER, Radiotherapy, Electrocautery, Bur abrasion, Chemical methods etc. Though the initial results of depigmentation procedures are promising, repigmentation is a common problem associated with them which poses a financial burden to the patient. To overcome this hurdle, a promising novel technique which is in vogue in cosmetic dermatology is Microneedling. Microneedling is a minimally invasive, cost effective, simple procedure that creates microholes to facilitate the penetration of topical medications across the connective tissues. The procedure activates the natural healing process, promoting the regeneration of epithelial cells and the breakdown of clusters of melanin pigment. This article gives an insight regarding microneedling technique and also discusses in depth regarding melanin synthesis, classification, indices, etiology, gingival depigmentation procedures, and repigmentation.

Ceramic soft tissue trimming bur gingival depigmentation: clinical performance and patient experience. A split mouth randomized controlled trial

BackgroundThe ceramic soft tissue trimming bur (CeraTip™) was initially introduced for use in gingivoplasty but has recently been used for gingival depigmentation. The aim of this study is to compare the efficacy of depigmentation between the novel CeraTip™ and the gold-standard surgical scalpel technique.MethodsEight healthy, nonsmokers with moderate to severe gingival hyperpigmentation in both arches were randomly assigned for CeraTip™ depigmentation in one arch as the test group (TG) and scalpel depigmentation in the opposite arch as the control group (CG). Pigmentation indices were used to assess clinical performance. Treatment time, pain level, and esthetic satisfaction were the parameters of patient experience. The assessments were performed at baseline, one week, one month, and three months.ResultsAt all assessment visits, pigmentation intensity represented by the Dummet oral pigmentation index (DOPI), and pigmentation distribution represented by the Hedin melanin index (MI), were significantly lower than those at baseline (p < 0.001) in both groups. When comparing the two groups, Scalpel depigmentation had better initial clinical outcomes, while CeraTip™ had less visible repigmentation, pain scores, treatment time, and greater esthetic satisfaction. However, none of the differences were statistically significant.ConclusionBoth techniques successfully removed gingival hyperpigmentation with comparable clinical performance. The patients preferred CeraTip™ depigmentation.Trial registrationThe study protocol was registered on 11/09/2023 on the www.clinicaltrials.gov database (NCT06031116) after the approval of the Ethics Committee, Faculty of Dentistry, Ain Shams University (FDASU-Rec012124).

Comparative evaluation of oxygenating agent “blue m gel” and traditional periodontal dressing “Coe-Pak” on patient preference parameters (Pain and wound healing) after surgical depigmentation – A split mouth study

Individuals with high lip line and gummy smile when accompanied withdark colored gingiva have an esthetic concern while smiling. For the management of gingival hyperpigmentation surgical technique with scalpel is still considered the gold standard, although healing may occur by secondary intension and oxygen is one of the essential nutrients for cellular metabolism and production of energy through ATP. It is also involved in collagen synthesis, oxygenative killing of bacteria and angiogenesis. To clinically evaluate and compare the effectiveness of oxygenating agent (Blue M Gel) and traditional periodontal dressing COE-PAK on patient preference parameters (pain and wound healing) after surgical depigmentation. This split-mouth randomized clinical trial was conducted on 5 non-smoking individuals aged 20–40 years irrespective of gender with maxillary or mandibular physiologic gingival pigmentation class (III) and (IV) according to the Dummett–Gupta Oral Pigmentation Index (10 treated sites) who had requested an esthetic treatment for gingival hyperpigmentation of the maxillary or mandibular gingiva. The maxilla or the mandible was randomly divided into two symmetrical parts i.e. from the right second premolar to the midline and from the midline to the left second premolar—to receive either Blue M gel or Coe-Pak as a periodontal dressing after surgical depigmentation with a scalpel. Patient preference parameters such as pain was assessed after 24 hours and 7 days of intervention and re-epithelisation index with toluidine blue was assessed after 1 week and 1 month of intervention. The result of the study demonstrated that pain score and re-epithelisation score was less in Test group (Blue M Gel) as compared to control group (COE-PAK) and was found to be statistically significant. :It can be concluded that Blue M gel can also be a better alternative as a periodontal dressing compared to COE-PAK due to its properties of better healing and decreasing post-operative pain.

Case report: A Boy with an inability to walk; do not forget about scurvy

Scurvy, a condition caused by vitamin C deficiency, is characterized by a syndrome of multisystem disorder due to defective collagen production and antioxidative function. This condition is infrequent in this modern era; thus, it is often not within the list of differential diagnoses. The broad clinical picture is generally overlooked as other systemic illnesses, resulting in an extensive investigation that delays the diagnosis. Herein, we report a case of an 8-year-old boy with underlying autism spectrum disorder who presented with lower limb pain and other constitutional symptoms. Examination revealed multiple hyperpigmented scars over the upper and lower limbs and gingival hyperpigmentation. With history of picky eating habits and clinical symptoms supported by radiographic findings, scurvy was suspected and subsequently confirmed based on a low level of ascorbic acid. With vitamin C supplementation and proper nutritional support, the patient recovered well.

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

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.

Management of Gingival Hyperpigmentation – A Case Report

Gingival hyperpigmentation, characterized by darkening of the gums due to melanin deposition, can affect the aesthetic appearance of the smile, particularly in patients with excessive gingival display. Various techniques, including scalpel surgery, have been employed for cosmetic depigmentation. This case report describes a simple and cost-effective scalpel depigmentation procedure performed on a 23-year-old female patient with Dummet's score 3 pigmentation. The procedure involved meticulous removal of pigmented epithelium and a thin layer of connective tissue, followed by post-operative care and monitoring. While initial results are promising, repigmentation remains a potential challenge, necessitating long-term follow-up. Scalpel depigmentation offers reliable results, enhances smile aesthetics, and can be a preferred choice considering equipment constraints and healing times.

AESTHETIC IMPROVEMENT IN ONE VISIT PERIODONTAL PLASTIC SURGERY USING SCALPEL AND LASER SURGICAL TECHNIQUE (CASE REPORT)

Introduction: A charming smile is formed from good harmonization of teeth and gums. Short teeth clinical crown, dark gingival color, diastema between the maxillary central incisors can interfere the aesthetic of the smile. This case report aims to describe the treatment of periodontal plastic surgery in form of aesthetic crown lengthening, gingival depigmentation and frenectomy to improve function and aesthetic in one visit using scalpel and laser. Case: A 23 year old male patient complained that the maxillary front teeth spaced, short and small, and the gum of the upper jaw is dark, which caused aesthetic discomfort. Objective examination showed high frenal attachment reaching the interdental papilla to palatal, diastema of the maxillary central incisors, short clinical crown and brownish maxillary gingiva. aberrant frenum labialis superior, altered passive eruption and gingival hyperpigmentation diagnoses was made in this case. Case Treatment: Aesthetic crown lengthening treatment with scalpel, gingival depigmentation using scrapping technique and frenectomy using combination of laser and scalpel surgical technique was carried out in one visit. Discussions: The advantages performing three periodontal plastic surgeries in one visit is require just once preparation of surgical materials and instruments, once surgical trauma, once prescription and less number of control visits. Conclusions and Suggestions: Treatment of crown lengthening, gingival depigmentation and frenectomy in one visit are considered effective and efficient based on time, trauma, and costs required. The periodontal plastic surgery technique can be choosing based on clinical finding on patient, patient’s needed and clinical skills of operator.

Vitamin C mesotherapy versus diode laser for the esthetic management of physiologic gingival hyperpigmentation: a randomized clinical trial

BackgroundPhysiologic gingival hyperpigmentation is a common esthetic concern that affects individuals of various ethnicities, and can have a significant impact on individual’s self-confidence and overall quality of life. Thus, this study aimed to clinically assess the effectiveness of intra-mucosal injection of vitamin C versus 980 nm diode laser for the management of physiologic gingival hyperpigmentation.MethodsTwenty-six healthy non-smoker individuals with physiologic gingival hyperpigmentation were randomly assigned to two groups. Group I received intra-mucosal injection of vitamin C (L-Ascorbic acid 1000 mg/5 ml), and group II was managed using diode laser (980 nm, 1.5 W, continuous wave mode). Clinical evaluation of pigmentation intensity and distribution was performed preoperatively, and at 1, 2 and 3 months postoperatively using two different color assessment indices; Dummett-Gupta Oral Pigmentation Index (DOPI), and Gingival Pigmentation Index (GPI). Additionally, the study assessed pain intensity and patients’ satisfaction.ResultsPigmentation scores decreased significantly between pre-operative visit and different follow-up visits for both treatment modalities (p < 0.0001*). When compared to the vitamin C mesotherapy group, the laser group demonstrated significantly lower gingival pigmentation scores (p < 0.0001*). However, both treatment modalities were equally satisfying for the patients.ConclusionsVitamin C mesotherapy and diode laser are both effective in the management of physiologic gingival hyperpigmentation. While diode laser yields better and earlier results, vitamin C mesotherapy offers a cost-effective, safe and minimally invasive approach that is equally satisfying for the patients seeking esthetic enhancements.Trial registrationThe study was registered on ClinicalTrials.gov (NCT05608057) on (01/11/2022).

Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm

ObjectiveThis research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques.Materials and methodsTwenty-four individuals with physiologic gingival hyperpigmentation received random allocation to one of three treatment groups: scalpel, ceramic bur, or diode laser. Pain score, operation time, bleeding index, degree of epithelialization, wound healing, Dummett-Gupta Oral Pigmentation Index (DOPI), and Takashi Index score changes were all investigated at different time points.ResultsAt 12-h follow-up, significant variations in pain scores were seen between the laser and scalpel groups (p = 0.003) but not between the laser and ceramic bur groups. The diode laser group completed the procedure significantly quicker than the scalpel and ceramic bur groups (p = 0.004 and p = 0.001, respectively). The ceramic trimmer bur and diode laser groups showed significantly less bleeding tendency than the scalpel group. Wound healing and the degree of epithelialization were similar in all groups. DOPI and Takashi indices significantly decreased compared to baseline in all groups, with no significant difference recorded between all groups.ConclusionWhile diode lasers are a safe and effective treatment option for gingival hyperpigmentation, providing optimal aesthetics with reduced discomfort to patients, a ceramic trimmer bur can also be used as a simple and affordable alternative to a laser in gingival depigmentation procedures.Clinical relevanceGingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.

A Comparative Histological Study of Gingival Depigmentation by 808 and 445 nm Diode Lasers.

Introduction: Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser. Methods: In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation. Results: After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in basal membrane. Conclusion: The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode laser.

EVALUATION OF REPIGMENTATION FOLLOWING GINGIVAL DEPIGMENTATION USING LASER TECHNIQUE: A CASE SERIES

The harmony of the smile is not only determined by the shape, position and the color of the teeth but also by the level and color of the gingival tissues. Gingival hyperpigmentation is a major concern for a significant number of patients, as a relevant aesthetic or cosmetic need. Oral melanin pigmentation is considered to be multifactorial and could be related to physiological or even pathological reasons and can be the consequence of a variety of local or systemic factors. The aim of this study is to evaluate the repigmentation followed by gingival depigmentation carried out with a diode laser for 2 to 4 years of follow up. Five patients who were esthetically conscious of their dark gums were selected for this study. After reevaluation mild to moderate pigmentation was noted in all the cases.

Comparison of Diode Laser and Scalpel technique in the treatment of Gingival Melanin hyperpigmentation

Background: A smile can bring happiness into one’s life and also create positivity in the surrounding environment. Black or brown gums is a very common problem among all races of men and women that one complains to a periodontist. Depigmentation of melanin hyperpigmented gingiva can be carried out using scalpel and diode laser. Material &amp; Methods: 10 patients having uniformly dense band of bilateral physiologic gingival hyperpigmentation on the facial aspect of maxillary and mandibular gingiva were included in this study. Each patient underwent initial phase 1 therapy (oral hygiene instructions, scaling and root planning) 1 week before the depigmentation procedure. A split mouth study was followed. In test group depigmentation was done by Laser and in control group depigmentation was done by scalpel. Followup was done at 1 week,1 month , 3 months and 6 months. Results: There was no statistical significance in plaque and gingival index in both the groups. At 6 months in group A, repigmentation was seen in 7 patients and in group B, repigmentation was seen in 6 patients. Conclusion: The methods used here produced desired results and above all, the patients were satisfied with the outcome, which is the ultimate goal of any therapy. The scalpel remains the gold standard because of its convenience and cost effectiveness, but with proper adhesion to safety measures, the diode laser can also be used to remove gingival pigmentation efficiently.

Microneedling for Medical and Aesthetic Purposes: Current Indications and New Advances

Microneedling has become a valuable tool in dermatology, offering a non-surgical option to treat various skin conditions. The procedure creates microchannels in the skin, triggering the release of growth factors and promoting non-fibrotic skin remodeling. The current utilities for microneedling include treating wrinkles, scars, stretch marks, pigmentation disorders, warts, skin texture issues, rosacea, and hair regrowth. Multiple studies have shown its efficacy in improving these conditions, with significant improvements in patient assessments. However, further research is needed to optimize protocols and determine the ideal needle size, frequency, and interval between treatments for the best clinical outcomes for subjects. Through their novel research, clinicians have made significant advancements in microneedling, expanding its uses, and revolutionizing its application. Despite previous beliefs, microneedling can effectively treat active acne lesions without exacerbating the condition. It has also shown promise in treating facial spider veins, providing comparable efficacy to other methods with a better safety profile. Initiating microneedling treatment at an earlier stage for surgical scars improves outcomes compared to waiting for scar maturation. Microneedling combined with topical agents has shown positive results in treating gingival hyperpigmentation. Its expanding applications and recent advancements highlight the potential benefits of integrating microneedling into clinical practice.

Depigmentasi Gingiva Menggunakan Teknik Bedah Scalpel pada Pasien dengan Hiperpigmentasi Gingiva : Sebuah Laporan Kasus

Background: Gingival hyperpigmentation is a physiological pigmentation genetically, appearing with brown to black pigment on the gingiva and oral mucosa which is an aesthetic problem for patients. Purpose: This case report aims to discuss gingival depigmentation procedure using scalpel surgical techniques in patients with gingival hyperpigmentation. Case presentation: A 27-year-old female patient reported brown discoloration on the gums of her upper and lower front teeth which she had noticed ten years ago. Gingival depigmentation using scalpel surgical technique is performed to remove the pigment. Conclusion: Gingival hyperpigmentation is an aesthetic problem that is of concern to patients and requires surgical intervention to remove the pigment, one of them are gingival depigmentation with a scalpel surgery.&#x0D; Keywords: gingival depigmentation, gingival hyperpigmentation, scalpel surgery

Q-switched ruby laser is safe and effective in treating primary gingival hyperpigmentation.

Physiologic gingival hyperpigmentation (PGH) is a benign condition that results from increased melanin production and is prevalent among darker skin individuals. Although the use of lasers for PGH has gained popularity in recent years, the lasers being used are mostly ablative, and act through a non-selective tissue damage mechanism. The objective of this study was to evaluate the use of a non-ablative 694-nm Q-switched ruby laser (QSRL) for the depigmentation of PGH. A retrospective single-center study of patients diagnosed with PGH and treated with a QSRL Between March 2019 and November 2020. Four patients were treated with QSRL for 1-3 sessions, until complete depigmentation was achieved. The average follow-up was 11 months (range 7-18 months) with no patient exhibiting re-pigmentation. Adverse events included mild local tenderness and transient erosions in two patients. The 694-nm QSRL is a novel and promising safe and effective method for treating PGH with the advantages of being a non-ablative modality that minimizes tissue damage and optimizes the outcome.

Pink Gingiva is it the Needle or the Light!

Objectiv: Gingival depigmentation is an aesthetic periodontal procedure that is carried out to eliminate gingival hyperpigmentation. Numerous depigmentation modalities are used namely surgical scraping, gingival autograft, cryosurgery, electrosurgery, and lasers. Microneddling(MN) is a novel technique that is conservative involving the creation of micro wounds and has been tried for depigmentation. Material and Methods: A 23 yrs old female patient without any systemic conditions reported to the Outpatient Department of Periodontology, Krishnadevaraya College of dental sciences and Hospital, with the chief complaint of dark-colored gums. Depigmentation with micro needling was done in the lower anterior and laser in the upper anterior region. Result: There was a considerable reduction in the oral pigmentation scores (Dummett Oral Pigmentation Index) using both techniques in the first and the fourth week. The Visual Analogue Scale score showed lesser pain in the microneedling area. Conclusion: Depigmentation using microneedling and lasers is effective. Microneedling is a simple, economical, and viable option for the removal of gingival depigmentation.

CLINICAL FEATURES OF GINGIVAL HYPERPIGMENTATION IN VIETNAMESE OUTPATIENTS

Background: Gingival esthetics was considered one of the most significant aspects of aesthetic smiles, especially in those with gingival hyperpigmentation. Understanding the features, distribution, and causes impacting gingival pigmentation was critical for developing an effective treatment plan. Objectives: The prevalence of gingival hyperpigmentation in outpatients at Can Tho University of Medicine and Pharmacy Hospital; the association between gingival hyperpigmentation and age, gender, smoking status, and skin color. Material and Methods: Descriptive cross-sectional method; convenience sampling. Results: In a total of 100 outpatients, the rate of gingival hyperpigmentation was 53%, of which 40% had mild gingival hyperpigmentation according to DOPI (grade 1), 13% had moderate gingival hyperpigmentation (grade 2), and 13% had heavy gingival hyperpigmentation disease (grade 3). The study collected 3/6 groups of gingival melanin hyperpigmentation according to Ponnaiyan's classification. Of all the hyperpigmentation groups according to Hedin's classification, the hyperpigmentation group forming a long continuous ribbon accounted for a high proportion (45% in the maxilla, 40% in the mandible). The rates of gingival hyperpigmentation in the group of 40-year-old patients and the others were 48.8% and 75%, respectively. Conclusion: There was a statistically significant relationship between gingival melanin pigmentation and skin color. The percentage of melanin pigmentation was higher in those with dark skin. There were no differences in the ratios for age, gender, or smoking status.