Management Of Gingival Hyperpigmentation Research Articles

A contemporary approach to management of gingival hyperpigmentation: a case series

A contemporary approach to management of gingival hyperpigmentation: a case series

A comparative study of diode laser and CO2 laser in the treatment of gingival hyperpigmentation

Background: Pigmented gingival tissue, many a times forces the patients to seek treatment for esthetic periodontal therapy. Gingival hyperpigmenta- tion is caused by excessive deposition of melanin in the basal and suprabasal layers of epithelium. Materials and methods: This double blinded prospective study was undertaken to evaluate the effectiveness of diode laser and CO2 laser in gingival depigmentation in ten patients using split mouth technique by evaluating the parameters like colour of the gingiva, bleeding, difficulties of the operator, pain, esthetic perception by the patient and post-operative wound healing. Out of 10 patients in the study group 6 were males and 4 were females. Gingival depigmentation was done from canine to canine in the upper anterior region. A total of 20 an- terior segments were treated: 10 randomly to Carbon dioxide & Diode Laser group using Flip coin method. The data collected were tabulated and statistical analysis was performed. Results & conclusion: The results of this study showed that the degree of pigmentation at the end of 4th week was less in diode group with 20% of the patient showing no pigmentation compared to CO2 group (10%). From our study, the first of its kind to compare the two lasers, we come to the conclusion that on comparing both the group, diode laser study group had appeared to be ef- fective in the management of gingival hyperpigmentation in terms of pain, bleeding intra operatively, difficulty of the operator, wound healing and esthetics.

A comparative evaluation of management of hyperpigmented gingiva using surgical stripping technique and diode laser: A clinical study

BackgroundTo compare the treatment outcome of laser and its effectiveness in the management of gingival hyperpigmentation over scalpel surgical method. MethodsThe patients were selected and were divided into two groups by the split-mouth design. Group A: Right half upper and lower central incisors to premolars were treated using the laser technique. GROUP B: Left half upper and lower central incisors to premolars were treated by Scalpel technique. This study was a comparative, split-mouth analytical study, and the results were observed for a period of 9 months. ResultsDiode laser technique gave better results in this perio-esthetics procedure as compared to scalpel technique. However, recurrence of pigmentation has been reported even after this duration. Diode laser was superior over the scalpel technique in the aspect of operator convenience, reduced postoperative bleeding, and reducing the incidence of repigmentation in terms of intensity and extent of pigmentation. Patient comfort was more in scalpel technique. ConclusionLaser can be used for better periodontal esthetic procedure over the standard scalpel technique, although repigmentation was reported in both groups. But delayed healing occurred on the laser side due to the thermal effect of the laser on the adjacent tissues. Provision of such advanced instruments to dental surgery can give better satisfaction to patient clientele in terms of good esthetic results.

Evaluation of Treatment Outcome in Gingival Hyperpigmentation with Scalpel Vis-a-Vis Laser

Context: Melanin pigmentation of the gingiva is a physiological process that occurs in all ethnicities. Many treatment modalities are available to treat gingival hyperpigmentation. These are based on the principle of complete removal of the epithelial layer along with a part of subepithelial connective tissue which is then permitted to heal by secondary intention. Aim: This study aims to compare the treatment outcome of laser and its effectiveness in the management of gingival hyperpigmentation over scalpel. Design: A split-mouth study. Methods: Twenty young patients, between the ages of 18–35 with no systemic comorbidities with concerns regarding of dark-colored gums were selected for the study. A split-mouth study involving treatment of melanin pigmentation using scalpel abrasion on one side (left side upper and lower jaws) and Diode laser (980 nm) on other side (right side upper and lower jaws) was carried out. Observations regarding time taken, amount of bleeding during procedure, postoperative pain, healing of wound, and recurrence were made. Statistical Analysis: Data were analyzed using SPSS version 21.0 for Microsoft Windows. Results: Pain and healing were comparable in both the groups, though intraoperative time consumed and bleeding was significantly lower for laser group. Recurrence also was significantly lower on the laser group. Conclusion: Diode lasers can give better results in the management of gingival pigmentation compared to conventional scalpel abrasion technique.

English

BACKGROUND Aesthetic concerns have plagued humans for ages, but now modern technology and science have presented us with various options to treat these concerns. One such aspect is gingival depigmentation which as a dentist, we often come across. A randomized controlled clinical trial was conducted to compare and evaluate the techniques of gingival depigmentation for the management of gingival hyperpigmentation. METHODS A total of 45 patients with gingival pigmentation were randomly allocated into 3 groups: Surgical scalpel (N = 15), Cryosurgery (N = 15) and 810nm Diode Laser (N = 15). Melanin pigmentation index (MPI), visual analogue scale (VAS), wound healing index (WHI) and colour intensity index were evaluated for all the groups at baseline, immediate postoperative, 1 week, 1 and 3 months postoperatively. Statistical analysis was done for the data obtained to test the significance between the variables. P value < 0.05 was considered significant. RESULTS MPI scores from baseline to the postoperative intervals were effective in the management of gingival hyperpigmentation without any statistically significant difference. Faster healing was noted with surgical scalpel than cryosurgery. VAS scores were higher for the surgical scalpel group and lower for the other groups. The colour intensity index, an increase in the red colour value and decrease in the blue colour value was indicative of effectiveness of all the three techniques in the management of gingival hyperpigmentation. CONCLUSIONS It can be concluded that all the three techniques are effective in the management of gingival hyperpigmentation. KEY WORDS Gingival Hyperpigmentation, Aesthetic, Cryosurgery, Surgical Scalpel, Laser

A novel approach for the management of gingival hyperpigmentation: Diode laser

The color of normal gingiva depends on the vascular supply of the gingiva, epithelial thickness, degree of keratinization of the epithelium, and the presence of pigmented cells. Excessive gingival display and gingival hyperpigmentation are major concerns for a large number of patients visiting the dentist. The foremost indication for depigmentation therapy is the demand by a patient for improved esthetics. This case report represents a correction of gingival hyperpigmentation by diode laser with satisfactory and pleasant results.

Management of Gingival Hyperpigmentation by Scalpel Technique

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.

Management of gingival hyperpigmentation by the surgical abrasion: A case report

Health and appearance of gingiva are important parts of a smile. The spread of pigmentation depends on melanoblastic activity. The gingival color plays a role in esthetics. Diff erent treatment modalities have been reported for depigmentation of gingiva such as bur abrasion, partial thickness fl ap, cryotherapy, electrosurgery and laser. In this case, depigmentation was done with bur abrasion, which is simple, eff ective and yields good results, along with good patient satisfaction.

Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study.

Background:Gingival depigmentation is a periodontal plastic surgical procedure whereby the gingival hyperpigmentation is removed by various techniques such as electrosurgery, cryosurgery, abrasion with diamond bur and lasers. The aim of this study was to determine the pain levels during the gingival depigmentation procedure using electrosurgery and lasers.Materials and Methods:Twenty patients, both male and female, between the ages of 20 and 40 years were randomly allocated into two groups of 10 patients each: Those undergoing depigmentation with electrosurgery (Group I) and those by diode lasers (Group II). Patients of both groups were asked to define the level of pain and discomfort by using the Visual Analog Scale (VAS) intraoperatively, 24 h post-operatively and 1 week post-operatively.Results:Both the groups showed a decrease in the pain levels, which was statistically highly significant 1 week post-operatively when compared 24 h post-operatively. There was a statistically highly significant difference in the pain levels between the electrosurgery and the lasers groups after 24 h (P < 0.001), with the lasers group demonstrating lesser pain and discomfort. Although there was no significant difference between the two groups intraoperatively and 1 week post-operatively on comparison, lesser mean scores were observed for the lasers group.Conclusion:The growing concern for esthetic requires the removal of hyperpigmentated gingival areas to create a confident and pleasant smile, which could be easily attained by using either electrosurgery or lasers. This study concluded that lasers produce lesser pain and discomfort compared with electrosurgery during gingival depigmentation.

Management of gingival hyperpigmentation by the surgical abrasion: A case report

Management of gingival hyperpigmentation by the surgical abrasion: A case report

"Management of Gingival Hyperpigmentation" - 2 case reports

Gingival hyperpigmentation is mostly caused by the physiologic deposition of melanin by melanocytes. Melanin pigmentation of the gingiva is completely benign and does not present a medical problem. In Gummy Smile Patients, melanin gingival hyperpigmentation causes an esthetic problem and physiologic disturbances. Many methods are now available for depigmentation of the gingival. This paper reports two cases of gingival hyperpigmentation managed by surgical method.

Management of gingival hyperpigmentation by semiconductor diode laser

Gingival hyperpigmentation is caused by excessive deposition of melanin in the basal and suprabasal cell layers of the epithelium. Although melanin pigmentation of the gingiva is completely benign, 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, gingivectomy with free gingival autografting, cryosurgery, electrosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond burs, Nd:YAG laser, semiconductor diode laser, and CO2 laser. The present case report describes simple and effective depigmentation technique using semiconductor diode laser surgery – for gingival depigmentation, which have produced good results with patient satisfaction.