Gingival Melanin Pigmentation Research Articles

Smoking Status and Smoke-Related Gingival Melanin Pigmentation in Army Recruitments

This study aimed to define the smoking status and smoke-related gingival melanin pigmentation in army recruitments and was conducted with army recruitments in Sivas. Nine hundred eight subjects were examined. The oral and dental health of those subjects was checked and recorded. The smoking status of the subjects was self-reported and recorded on questionnaires by researchers. The chi2 test and Kruskal-Wallis test were used for statistical analysis. More than one-half of the subjects (54.3%) were primary school graduates and the mean age was 20.2 +/- 0.95 years. The response rate regarding smoking was 100%. Of the respondents, 596 (65.7%) were current smokers, 12 (1.3%) were former smokers, and 300 (33.0%) were never smokers. The gingival melanin pigmentation rate was 27.5% in current smokers and 8.6% in those who never smoked (p = 0.000). Smoking five to nine cigarettes a day appeared to be sufficient to cause gingival melanin pigmentation. The proportion of smokers who had melanin pigmentation did not change after 10 cigarettes a day. A rehabilitation project on smoking prevention and smoking cessation for army recruitments is urgently needed.

Association of lip pigmentation with smoking and gingival melanin pigmentation

We investigated the association of lip pigmentation with smoking and melanin pigmentation in the gingiva. Case-control study. Health check-up in an institute. Photos of 213 males employed in an institution were assessed in terms of pigmentation in lip and gingiva. Prevalence and scores of lip and gingival pigmentation and smoking status. Among subjects displaying lip and gingival pigmentation, 73% and 87% respectively, were current smokers, whereas 33% and 27% of individuals lacking pigmentation were current smokers respectively. Odds ratios of current smoking relative to lip and gingival pigmentation were 5.6 (95% confidence interval: 2.8-11.1) and 17.0 (8.1-36.0) respectively. Daily consumption, duration of smoking and lifetime exposure exhibited significant correlation with scores of lip and gingival pigmentation (P<0.0001). Odds ratios increased in lip and gingival pigmentation upon exposure. In current smokers, scores of lip and gingival pigmentation demonstrated meaningful correlation (P<0.0001); moreover, 95% of participants with lip pigmentation were positive for gingival pigmentation. These results indicated the presence of a striking association between smoking and pigmentation in the lip and gingiva, which was stronger with respect to gingival pigmentation. Health professionals could educate smokers, utilizing visible symptoms in the lip and gingiva.

Cryosurgical treatment of gingival melanin pigmentation with tetrafluoroethane

To introduce 1,1,1,2 tetrafluoroethane (TFE), as a new material for cryosurgery of gingival melanin pigmentation (GMP). Twenty-one patients with GMP were treated using a TFE-cooled cotton swab. Standard digital images of pigmented areas were measured preoperatively and postoperatively with image-analyzing software. The Mann-Whitney U test was used for statistical analysis. Keratinization was completed 3 to 4 weeks after application, without any trace of pigmentation. Statistical analysis revealed a significant difference between preoperative and postoperative measurements of pigmented areas (P < .05). During the follow-up period, no side effects were observed and improved esthetics were maintained up to month 30. The clinical outcomes of cryosurgery with TFE for treatment of GMP are very satisfactory. The use of TFE for cryosurgical treatment of GMP is practical and inexpensive. Moreover, unlike other cryosurgery methods no special equipment is required, and it is safe to store in the dental clinic.

Evaluation of the Efficacy of the Acellular Dermal Matrix Allograft with Partial Thickness Flap in the Elimination of Gingival Melanin Pigmentation. A Comparative Clinical Study with 12 Months of Follow‐Up

Acellular dermal matrix (ADM) has been used as a substitute for gingival allografts. The aim of this study was to evaluate the effectiveness of ADM with partial thickness flap in the elimination of gingival melanic pigmentations. Fifteen patients presenting bilateral gingival melanin pigmentation were selected for this study. Each side of the pigmentation was randomly assigned to be part of a group. The sites of the experimental group had a partial thickness flap raised, excised, followed by adaptation and suture of the ADM. On the opposite side (ie, sites from the control group), the oral epithelium was removed with a diamond bur. The healing process was evaluated at 1 and 2 weeks, and 1, 3, 6, 9, and 12 months postoperatively. Images of the patient's follow-up were digitalized, and occurrence and quantification of clinical repigmentation were evaluated. After 12 months, minimal repigmentation (mean 3.14 +/- 7.45%) was noted in 8 of 15 sites from the ADM group, while significant repigmentation (mean 55.84 +/- 27.25%) was seen in 15 of 15 abrasion sites. According to our results, it can be concluded that ADM may be successfully used in the elimination or greater reduction of gingival melanic pigmentations, and is more efficient than epithelium abrasion after 12 months (p < 0.0001). Gingival pigmentation is a common finding in several ethnic groups. Although physiologic melanin pigmentation is not a medical problem, cosmetic demands may turn it into a problem of social acceptance in different cultures. In this way, different treatment modalities have been used with the aim of removing pigmentations for esthetic reasons. In the present study, the use of ADM with partial thickness flap resulted in more effective elimination of gingival melanin pigmentation, as repigmentation occurred later and was much weaker when compared to the outcomes of epithelial abrasion.

Gingival melanin pigmentation and its treatment with the CO 2 laser

Objective There are only a few reports in the literature evaluating the effects of the carbon dioxide (CO 2) laser on gingival melanin pigmentation (GMP). This study was performed to evaluate the effects of the CO 2 laser at superpulse mode, applied for gingival depigmentation. Study design GMP at the anterior maxillary and mandibular gingiva of 10 patients was treated using the superpulsed CO 2 laser (10 watts, 0.8 mm spot size, 20 Hz, 10 milliseconds). Pigmented areas were measured on pre- and postoperative standard digital images by the aid of an image- analyzing software. Statistical analysis of the data was performed by Mann Whitney U test. Results Ablation of the hyperpigmented gingiva was accomplished with minimal carbonization and almost no bleeding. Postoperative healing was uneventful with no significant postoperative pain. Two cases of partial repigmentation were observed during 24-month follow-up. Statistical analysis of the data revealed a significant difference between pre- and postoperative measurements of pigmented area. Conclusion Application of the superpulse mode of CO 2 laser appears to be an effective and safe method for the elimination of GMP.

Potential applications of Erbium:YAG laser in periodontics.

Since lasers were introduced for the treatment of oral diseases, there has been considerable advancement in technology. As a result, numerous laser systems are currently available for oral use. Neodymium:Yttrium-Aluminum:Garnet (Nd:YAG), carbon dioxide (CO(2)) laser and the semiconductor Diode lasers have already been approved by the US Food and Drug Administration for soft tissue treatment in oral cavity. The Erbium:YAG (Er:YAG) laser was approved in 1997 for hard tissue treatment in dentistry and recent studies have reported positive results. This suggests that the Er:YAG laser system is a promising apparatus, which will be able to revolutionize and improve dental practice, in particular periodontal treatment. In this mini-review, we would like to describe the positive characteristics of the Er:YAG laser which indicate its potential as a new treatment modality in periodontics. Recent findings are summarized briefly to evaluate the potential of the Er:YAG laser for clinical application in periodontics. The Er:YAG laser possesses suitable characteristics for oral soft and hard tissue ablation. Recently, it has been applied for effective elimination of granulation tissue, gingival melanin pigmentation and gingival discoloration. Contouring and cutting of bone with minimal damage and even or faster healing can also be performed with this laser. In addition, irradiation with the Er:YAG laser has a bactericidal effect with reduction of lipopolysaccharide, high ability of plaque and calculus removal, with the effect limited to a very thin layer of the surface and is effective for implant maintenance. The Er:YAG laser seems to be an effective tool for periodontal therapy, however, further clinical and basic investigations are required to confirm its clinical application.

Gingival Depigmentation by Erbium: YAG Laser: Clinical Observations and Patient Responses

Melanin, carotene and hemoglobin are the most common natural pigments contributing to the normal color of the gums. Although physiologic and ethnic melanin pigmentation is not a medical problem, complaints about "black gums" are common. Gingival depigmentation has been carried out using non-surgical and surgical procedures. Recently, laser ablation has been recognized as a most effective, pleasant and reliable technique. The study included 10 patients who requested cosmetic therapy for melanin pigmented gums. Treatment was carried out using an erbium:YAG laser. The laser beam was set at 500 mJ/10 pulses/second. The beam was defocused to produce a 3 mm diameter circle, thus reducing the beam penetration to 2 to 4 microm/pulse while increasing the treated surface. The "brush" technique was applied until the gingival surface appeared clinically free of pigmentation. Patients were observed for 6 months. Each patient filled out a personal evaluation questionnaire for clinical analysis. Between 500 to 1,100 pulses/cm2 were recorded and a total of 800 to 2,200 pulses were required per patient, depending on the epithelium thickness and pigmentation. Treatment required only topical anesthesia. Healing was uneventful and required no supportive therapy. None of the patients experienced severe pain during or post-operatively. Mild pain or itching was common during the first week. Treatment was reported as generally pleasant. Follow-up during the 6 months showed no recurrences. Depigmentation of gingival melanin pigmentation by erbium:YAG laser radiation in a defocused mode was a safe and effective procedure. The esthetic results were pleasing and healing was uneventful. Since the erbium:YAG laser is available in the dental office, it seems to be the laser of choice for this procedure.

Periodontal soft tissue management with a high pulse rate Er:YAG laser

The purpose of this study was to evaluate the effectiveness and safety of periodontal minor soft tissue surgery with the Er/YAG laser at a high pulse rate of 30 Hz and the subsequent clinical wound healing. Sixty-one patients were subjected to gingivectomy, removal of gingival melanin pigmentation, or frenectomy using the Er/YAG laser. Clinical parameters were evaluated before, immediately after, at 1 week and 4 weeks after surgery. The Er/YAG laser was capable of cutting or ablating gingival soft tissue easily and effectively with less or no bleeding as well as less pain. The healing process was uneventful without any complications or side effects. The results of this study suggest that the Er/YAG laser at 30 Hz could be used safely and effectively for minor periodontal soft tissue management without causing major thermal damage as well as the delay of wound healing.

Er:YAG laser treatment of gingival melanin pigmentation

The Er:YAG laser has been effectively applied for periodontal soft-tissue management. The purpose of this study was to evaluate the effectiveness of high pulse rate Er:YAG laser in removal of gingival melanin pigmentation. Five patients participated in this study. An Er:YAG laser was irradiated for removal of melanin pigmentation under surgical microscope monitoring. The irradiation was performed at 27–54 mJ/pulse and 20–30 Hz under water spray in an oblique contact mode. The clinical parameters were evaluated at immediately after, 1, 2 and 4 weeks, 3 and 6 months after. The visual analog scale (VAS) was used to evaluate the pain level experienced by each patient. The ablation of the hyperpigmented epithelial tissue was easily achieved without prominent bleeding complications. The use of water spray provided a clear operation field. The surgical microscope monitoring was of great advantage for complete removal of remaining melanin pigmentation. The patients perceived slight to moderate pain such as irritation or contact pain until 4–5 days after treatment. At 2 weeks, the gingiva appeared completely normal appearance. In some cases, slight recurrence was observed after 6 months. These results indicate the removal of gingival melanin pigmentation can be performed safely and effectively by high pulse rate Er:YAG laser irradiation.

A clinical study on the removal of gingival melanin pigmentation with the CO(2) laser.

In a previous study, the possibility of removal of dog gingival melanin pigmentation with CO(2) laser therapy was reported. The present study was designed to investigate the effect of the CO(2) laser on human gingival pigmentation and evaluate the clinical outcome. A CO(2) laser (output: 6-8 W, pulse duration: 0.2 seconds) was irradiated on the melanin pigmented gingival surface of 10 patients, aged 20-49 years. Follow-up clinical and histopathological evaluations were performed. The CO(2) laser was effective in removing melanin pigmentation in all patients. In the histopathological study, no pigmented-laden cells nor any inflammatory cell infiltration was observed following laser irradiation. No re-pigmentation was seen in any case in the first year. However, four of seven cases showed re-pigmentation at 24 months. The re-pigmentation was almost equal to the preoperative state. The CO(2) laser has proved to be another effective, safe, and easily applicable therapy for the removal of gingival melanin pigmentation.

喫煙習慣が関係する歯肉メラニン色素沈着の疫学的研究

The purpose of this study was to explore the association of melanin pigmentation in attached gingiva and cigrarette smoking. Oral examinations and a questionnaire concerning smoking habits were administered to 317 male employees of two companies. Among them, 48% of subjects were current smokers, 11% were former smokers, and 41% had never smoked. Melanin pigmentation was assessed in the labial aspects of attached gingiva in the frontal region, and was found in 57% of the subjects. The presence of the pigmentation was 82% among current smokers, 51% among former smokers, and 29% among those who had never smoked. The odds ratio of the pigmentation between current smokers and those who had never smoked was 11.6 (P<0.001). This trend was similar in both companies. The melanin index, which is an indicator of the degree of pigmentation in the labial aspect of the frontal region, was positively correlated to daily number of cigarettes smoked, and the number of years of smoking, and lifetime exposure to smoking (P<0.001). The index was also correlated closely to the number of sextants having gingival melanin pigmentation (r=0.922. N=163). These result indicate that gingival melanin pigmentation is strongly associated with cigarette smoking habits.

A study on the removal of the melanin pigmentation of dog gingiva by CO 2 laser irradiation.

Removal of melanin pigmentation of the gingiva with CO 2 laser irradiation was investigated. The melanin-pigmented gingiva of 5 dogs were classified according to the degree of gingival pigmentation (slight, moderate, severe) and its extent (local, extensive). CO 2 laser was irradiated on the surface of the pigmented gingiva under the following conditions; defocused beams of spot size 4 mm, irradiation time 0.2(S), output 6-8(W)). That is, the irradiation energy density was 9.6-12.8 J/cm 2. The irradiated gingiva was examined macroscopically and histopathologically. The histopathological changes were investigated by hematoxylin-eosin staining and Masson staining for the differential diagnosis of melanin pigmentation cells. These examinations were done one week and three weeks after the laser irradiation. Immediately after irradiation, the gingiva surface showed white color and bulla-like appearance. One week after irradiation, the pigmentation of the lased gingiva disappeared in all cases macroscopically. Histologically, the pigmented-laden cells could not be found and no inflammatory cell infiltration was observed. Three weeks after irradiation, no reappearance of pigmentation was observed in either macroscopical or microscopical investigations excluding severe/extensive cases. These findings suggested that it is possible to remove gingival melanin pigmentation by CO 2 laser irradiation.

A Study on the Removal of the Gingival Melanin Pigmentation by CO2 Laser Irradiation

The possibility about the removal of gingival melanin pigmentation with CO2 laser is confirmed by our previous researches which were carried out histopathologically using dog's gingival melanin pigmentation. Since then, we have been carrying out the clinical study of the removal of human melanin pigmentation by CO2 laser.For this study, 5 patients aged 20 to 49 years with gingival melanin pigmentation were used. CO2 laser was irradiated on the surface of the pigmented gingiva under the following conditions: output; 6-8 (W), time; 0.1-0.2 (S), defocused beam of spot size; 4mm. The irradiated gingiva was evaluated macroscopically and histopathologically. The histopathological changes were invested by hematoxylin-eosin staining and Masson staining for the differential diagnosis of melanin pigmentation cells. Immediately after irradiation, the gingiva surface showed white color and bulla-like appearance. No hemorrhage and no epidermal detachment were observed. The damege to the gingival tissue was slight in comparison with the conventional surgical method. One week after irradiation, it was revealed that the disappearance of melanin pigmentation on the lased gingiva was significant in all cases. Histologically, the pigmented-laden cells could not be found and no inflammatory cell infiltrati on was also observed.From the above clinical and histopathological results, we have concluded that it was possible to remove the human gingival melanin pigmentation by CO2 laser irradiation.