Oral Pigmentation Index Research Articles

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

Diode laser represents a practical clinical strategy for treating gingival hyperpigmentation. However, its effectiveness remains controversial. The aim of this meta-analysis was to evaluate 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 pain scores, and the Wound Healing Index (WHI) for overall evaluation. The I2 index was calculated to identify heterogeneity, and sensitivity analyses were performed to identify sources of heterogeneity. Funnel plots and the Egger test were utilized to evaluate publication bias. Thirteen randomized controlled trials involving a total of 233 participants were included in the study. The analysis demonstrated that diode laser had a significant effect on DOPI (standard mean difference [SMD] = -0.245, 95% CI -0.451 to -0.040, P = .019) and pain (SMD = -0.809, 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 pain results exhibited notable publication bias. The study demonstrated that diode laser prolongs gingival repigmentation time and reduces pain compared to other treatments. However, efficacy in wound healing was not significantly affected.

Gingival Depigmentation by 810 nm Diode Laser and Cryosurgery Using 1,1,1,2-Tetrafluoroethane: A Clinical Study

Abstract Introduction: Pigmented gingival tissue is a common complaint of patients as unaesthetic. There is a dearth of literature comparing the efficacy of depigmentation by cryosurgery using a biocompatible material 1,1,1,2-tetrafluoroethylene gas and diode laser, which are relatively newer techniques. The study aims to evaluate and compare the efficacy of two different modalities of gingival depigmentation – 810 nm diode laser and cryosurgery using 1,1,1,2-tetrafluoroethane in managing gingival melanin pigmentation. Materials and Methods: A randomised controlled split-mouth trial was conducted on 15 participants. Depigmentation was done using an 810 nm diode laser and a cryosurgery technique using 1,1,1,2-tetrafluoroethane. Re-evaluation was performed at the 1st, 3rd and 6th months postoperatively. Dummett’s Oral Pigmentation Index (DOPI), Hedin’s Melanin Index (HMI), the Visual Analogue Scale for pain and Photometric analysis (RGB scale) were recorded and analysed. Results: DOPI and HMI in the subjects treated by laser and cryosurgery showed statistically significant differences (P < 0.001) from baseline to 1 month, 3 months and 6 months. Intergroup comparison of RGB scores between the laser and cryosurgery depicted no significant difference at baseline (P = 0.06). Conclusions: Cryosurgery using 1,1,1,2-tetrafluoroethylene and laser ablation using an 810 nm diode laser technique was found to be equally effective for treating gingival pigmentation.

A New Index for Assessment of Severity and Extent of Gingival Pigmentation; A Diagnostic Cross-Sectional Study According to Inter and Intra-Observer Variability.

Classification of gingival pigmentation (GP) is often performed using gingival pigmentation index (GPI), melanin pigmentation index (MPI), oral pigmentation index (DOPI), melanin index (MI), or physiologic/pathologic GPI. However, the internal and external reproducibility of these indexes have not been evaluated. This study aimed to introduce a new simple and applicable GPI and assess its internal and external reproducibility. This diagnostic cross-sectional study was conducted on 40 patients with maxillary and mandibular GP. Patients were in the age range of 12-60 years, and degree of GP was determined by four periodontists using DOPI, MI, MPI, GPI and the new index namely the severity and extension of gingival melanotic pigmentation index (SEMPI) under similar environmental and lighting conditions. The inclusion criteria were in the age range of 12-60 years and presence of melanin pigmentation (physiologic or pathologic) in the gingival margin, papilla, or attached gingiva. The exclusion criteria were systemic diseases, vascular lesions, hemochromatosis, amalgam tattoo, hyperbilirubinemia, or use of medications causing nonmelanotic pigmentation (hemoglobin, iron, and amalgam). The Fleiss kappa between all examiners for all indexes at 0, 7, and 14 days was higher than 0.8, indicating high agreement among the examiners. The Spearman's correlation coefficient for all indexes was positive and high at 0, 7, and 14 days (P < 0.001). Considering the high agreement among the examiners for all indexes and at all-time points as well as the positive, strong correlations among them, it seems that the new index is useful for classification of GP.

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.

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.

Comparative Assessment of Gingival Depigmentation Using Scalpel Versus Microneedling With Ascorbic Acid: A Randomized Controlled Trial.

Background Gingival pigmentation (GP), characterized by the presence of melanin in the gingival tissues, is a common aesthetic concern in dental practice. While it poses no inherent health risks, the visible discoloration may cause psychological distress for individuals seeking optimal dental aesthetics. Understanding the efficacy of various methods is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival depigmentation (GD). Aim The objective of the study was to compare the effectiveness of scalpel and microneedling (MN) with ascorbic acid in the treatment of GD. Materials and methods Sixteen patients who had a complaint of GP were included in the study, of whom eight were allocated for depigmentation with a scalpel, and the other eight patients were treated with the MN technique with ascorbic acid. Postoperative wound healing scores were evaluated on the first and seventh days, respectively. The intensity of depigmentation was assessed at baseline, in the first month, and at the end of the third month, respectively. Results The mean Dummett-Gupta Oral Pigmentation Index (DOPI) score at baseline was 2.65±0.16 and 2.61±0.17 in the surgical and microneedling groups with ascorbic acid, respectively. The mean DOPI score at the end of the third month was 1.67±0.39 and 0.87±0.17 in the scalpel and MN with ascorbic acid groups, respectively. There was a statistically significant difference between the scalpel and MN with ascorbic acid groups at the end of the first and third months, respectively, where MN with ascorbic acid showed aesthetically pleasing outcomes. Patients treated with the scalpel technique showed incomplete healing and ulceration on the first and seventh days after the procedure when compared to the MN technique with ascorbic acid. The healing index scores were statistically significant in the MN with ascorbic acid group. Conclusion The MN technique with ascorbic acid is a successful technique for treating GD. It showed aesthetically gratifying outcomes when compared to the conventional surgical technique.

Relationship of skin complexion with gingival tissue color and hyperpigmentation. A multi-ethnic comparative study

Background and ObjectiveThe most frequently seen intra-oral soft tissue is the gingiva. Most often, it is seen as coral-pink tissue that surrounds the neck of the teeth. Gingiva that encircles the tooth necks and covers the alveolar processes of the jaws is an intra-oral tissue that exhibits biomimetic features. The wide range of colors of the gingiva depends on the configuration of gingival vascularity, the degree of epithelial cornification, level of melanogenesis, and the depth of epithelialization. However, the color of the gingiva varies depending on the degree of melanin pigmentation. The current study aimed to identify the different distribution patterns of gingival color and determine the correlation between skin color, gender, and geographical area of origin.Materials and methodsA total of 839 subjects were involved in the study where the gingival color and skin tone were measured using the Dummett-Gupta Oral pigmentation Index (DOPI) combined with VITA VMK MASTER and skin shade method developed by Revlon (USA) and L’Oreal (France) for makeup foundation shades. One investigator was calibrated for the examination of the colors after being tested for normal color vision and color aptitude using the line test.ResultsA significant association was found between skin color and gingival pigmentation (χ2 value (6) = 114.48; P = 0.001). It was also found that females (67.1%) significantly had darker gingiva than males (58.3%). The study statistics display that location of the individual was also statistically associated with melanin pigmentation of the gingiva (χ2 value (57) = 559.33; P = 0.001).ConclusionThe study concluded that gender, skin color, and individual location are significantly associated with gingival melanin pigmentation.

Comparison between clinical and computerized methods for assessing gingival pigmentation.

Digital computerized assessment can provide objective values for the measurement of gingival pigmentation. This study aims to compare the Commission Internationale de l'Eclairage Lab color space (CIELAB) values and the computerized intensity values (CIVs) from digital imaging with clinical evaluations using the Dummett-Gupta Oral Pigmentation Index (DOPI) for assessing gingival pigmentation in a multi-ethnic population. Digital photographs of 188 participants were taken using standardized parameters. The buccal gingival pigmentation was evaluated using three methods (a) a clinical evaluation by two independent assessors using the DOPI, (b) the CIELAB values using the Adobe Photoshop® software (Version 23.1.1) and (c) the CIV calculated using the ImageJ software (Version 1.53k). A hierarchical clustering analysis was used to identify colour groups that clustered together. Agreement between the clinical and digital categorization of the pigmentation was carried out using weighted kappa analysis. Agreements between CIELAB and CIV were compared using intra-class correlation coefficient. There was a statistically significant difference in the DOPI, the L*, a*, and b* coordinates, and the CIV between the different ethnic groups of the participants. Cluster analysis for the CIELAB and CIV both identified four clusters. The gingival pigmentation categorization using the L*, a*, and b* values moderately agreed with the clinical evaluation using the DOPI index while the categorization with the CIV was in slight agreement with the clinical evaluations. This study identified four clusters of gingival pigmentation in 188 multi-ethnic participants. The clusters, determined by CIELAB values, align with the clinical assessment of gingival pigmentation. Digital measurements derived from clinical photographs can serve as an effective means of pigmentation measurement in dental clinics.

A Comparative Evaluation of Gingival Depigmentation by Scalpel versus Diode Laser versus Electrosurgery: A Clinical In vivo Study

Context: Melanin pigmentation of the gingiva exists in all ethnicities and genders. Demand for repigmentation is mainly for esthetic reasons. Gingival depigmentation is a mucogingival surgical procedure where depigmentation is done by various techniques. However, the selection of a method depends on the clinical experiences and individual preferences. Aim: The aim of the study is to compare the pain score using the Visual Analog Scale (VAS) and the recurrence rate of gingival pigmentation, using the three different techniques, i.e., scalpel, laser, and electrosurgery. Settings and Design: This randomized control trial was conducted on 30 systemically healthy patients divided into two groups. Materials and Methods: A split-mouth design was adopted and pigmentation was removed using scalpel and laser in Group I and scalpel and electrocautery in Group II. Dummett Oral Pigmentation Index scale and VAS were used to appraise the potency of hyperpigmentation and pain of the patient, respectively. Statistical Analysis Used: Independent t-test was used for the comparisons. P &lt; 0.05 was considered statistically significant. Results: The pain intensity was up high in patients treated with scalpel compared to laser and electrocautery, which was statistically highly significant. Conclusion: The findings suggest that laser depigmentation still serves to be the best modality considering the bloodless field and reduced postoperative pain.

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.

Comparative evaluation of the efficacy of BlueM active oxygen gel and Coe-pak dressing on post-operative healing of gingival depigmentation: a study protocol

Introduction Dark colored gingiva is an esthetic concern that cannot be ignored, especially when accompanied by a high lip line or gummy smile. Gingival depigmentation is a periodontal plastic surgical procedure wherein the hyperpigmentation is removed or reduced by various techniques. Protecting the wound from mechanical trauma and stability of the surgical site during the healing process are among the most important advantages of periodontal dressing application after surgery. Aim This study is aimed to comparatively evaluate the effectiveness of reactive oxygen gel species (BlueM gel) and the traditional Coe-Pack dressing on gingival healing and pain after surgical depigmentation. Protocol This split-mouth randomized clinical trial will be conducted on 20 patients aged 18–45 years with maxillary physiologic gingival pigmentation classes (II) (III) and (IV) according to the Dummett–Gupta Oral Pigmentation Index (40 treated sites). The maxilla will be randomly divided into two symmetrical parts—from the right second premolar to the midline and from the midline to the left second premolar—to receive either BlueM gel or Coe- Pack as a dressing after surgical depigmentation with a scalpel. Various indices will be assessed, such as plaque index, papillary bleeding index, pain index, healing index and reepithelization index with toluidine blue, and the follow-up period will be one month. Expected results- A total of 20 patients will be included in this study. Statistically significant differences are expected to show in the pain index and healing index after one, two, three, four, and five days. The BlueM gel group is expected to show a higher significant difference after one, two, three and four weeks in the reepithelization index.

Validity and Reliability of Polarized vs Non-Polarized Digital Images for Measuring Gingival Melanin Pigmentation.

This study aimed to compare the validity and reliability of polarized and non-polarized intraoral photography for the measurement of gingival melanin pigmentation. A case series study was conducted on ten patients scheduled for gingival depigmentation. A total of 976 polarized and non-polarized image samples were collected, capturing two rows above the gingival margin, for analysis. These images were taken both before and one year after the depigmentation procedure. Three independent evaluators assessed the photographs (an orthodontist, a general dentist, and a layperson). The Dummett Oral Pigmentation Index (DOPI) and Gingival Melanosis Record (GMR) indices were used to measure the level of gingival pigmentation. The study found no significant differences between polarized and non-polarized images taken before and after depigmentation. Both methods of imaging received similar scores from the evaluators. The orthodontist identified more pigmented slides than the layperson and the general dentist. Both polarized and non-polarized photographic methods may be used for assessing gingival pigmentation. However, further research is warranted to confirm this finding and examine additional factors.

Gingival Pigmentation Features in Correlation with Tooth and Skin Shades: A Cross-Sectional Study in a Saudi Population.

The present study aimed to observe the anatomical distribution of gingival melanin pigmentation and evaluate its intensity and extent in different age groups and in correlation with skin and tooth shades. The participants of this study were 391 patients attending the Dental University Hospital. The presence of gingival pigmentation was assessed using De Krom's Oral Pigmentation Chart and its intensity was assessed using the Dummett-Gupta Oral Pigmentation Index. Skin colour and tooth shade were measured using the Fitzpatrick scale and the VITA classical shade guide, respectively. Statistical analyses included descriptive statistics and Pearson's Χ2 test for the association between the study variables. The prevalence of gingival pigmentation among the sample size was 74.4%, and pigmentations were present on both arches in 57.6% (n = 224) of the participants. The extent (category 1) was highest when pigmentation was evident in both arches, with category 4 being the least extent. Age and sex did not show a correlation with gingival pigmentation. Gingival pigmentation intensity was mild when pigments were present in one arch (p < 0.00), whereas it was heavy when both arches presented with gingival pigmentation. Medium brown colour and tooth shade A1 were the most common among participants with gingival pigmentation (p < 0.00). The association between gingival pigmentation intensity and extent in relation to skin colour was statistically significant (p < 0.00), as was tooth shade (p < 0.05). Gingival pigmentation is highly prevalent in the Saudi population, with different severity and extent levels. The effect of gingival pigmentation on smile and overall facial aesthetics should be considered when providing dental and cosmetic treatments.

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.

Comparison of Er,Cr:YSGG laser and diode laser in the treatment of gingival melanin pigmentation: a randomized clinical trial.

This investigation has aimed to compare the efficiency of clinical depigmentation and repigmentation rate of erbium chromium-doped: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) and diode lasers during a 1-year follow-up and to evaluate patient satisfaction. Twenty-two participants were divided into Er,Cr:YSGG laser and diode laser groups using computer-aided randomization. Dummett Oral Pigmentation Index (DOPI) and photographic assessment with ImageJ Software version 10.2 were performed at the preoperative period and postoperative 1st month, 6th month, and 12th month. Moreover, the study assessed intra- and postoperative intensities of pain and postoperative patient aesthetic satisfaction using the Visual Analog Scale in both groups. The median values of DOPI did not differ statistically between the groups according to time (p > 0.05). In the Er,Cr:YSGG group, the extension of repigmentation was less as compared to the diode group at 1-year follow-up (p = 0.045). In the Er,Cr:YSGG group, the patients felt less intraoperative pain and discomfort compared to the diode group (p = 0.007). No significant differences were found between the two groups in terms of patient aesthetic satisfaction at the 1st and 12th months. The findings indicate that diode and Er,Cr:YSGG lasers can be used safely in depigmentation treatment, while the Er,Cr:YSGG laser has been shown to have superiorities in pain management and patient comfort parameters. Clinical Trial No.: NCT05304624.

Gingival Depigmentation Using Microneedling Technique With Topical Vitamin C: A Prospective Case Series.

Introduction Gingival pigmentation is mainly physiological due to the production of melanin. This study aimed to evaluate the effectiveness of a microneedling technique using topical ascorbic acid in treating gingival hyperpigmentation. Methods A case-series study was established, and 16 out of 42 participants enrolled in this study according to the inclusion and exclusion criteria. A microneedling technique was performed using a Dermapen instrument, followed by the topical application of ascorbic acid on the pigmented gingiva. Variations in the Dummett oral pigmentation index (DOPI) and Hedin melanin index (HMI) scores were considered for each patient. A one-month follow-up was conducted on all patients. Results All the reported cases demonstrated noticeable improvement at the end of the sessions. Moreover, seven patients showed complete depigmentation of the gingiva. Analysis using paired T-tests showed a statistically significant lower post-treatment DOPI score with a mean difference of 1.8 ± 0.7, 95% CI: 0.17-1.49. Similarly, the HMI score was lower post-treatment with a mean difference of 3.1 ± 0.7, 95% CI: 2.74-3.50. Conclusions Microneedling combined with topical ascorbic acid is a novel, non-invasive dental technique that can effectively treat gingival hyperpigmentation.

Transepithelial Gingival Depigmentation Using a New Protocol with Q-Switched Nd:YAG: An In Vivo Observational Study.

Gingival melanin hyperpigmentation is a para-physiological condition that may have a negative impact on smile esthetics. In the present study, the use of the Q-Switched Nd:YAG laser, according to a defined protocol, was proposed to treat Gingival Melanin Hyperpigmentation with a transepithelial approach. A total of 10 Patients with different grades of gingival hyperpigmentation were treated with Q-Switched Nd:YAG in one to four laser sessions without local anesthesia. The grade of depigmentation was evaluated by comparing Oral Pigmentation Index (OPI) and Melanin Pigmentation Index (MPI) at baseline and three weeks after the laser session. Additionally, oral discomfort rated by the Numeric Rating Scale (NRS) was recorded one, three, and five days after the procedure. Complete depigmentation was achieved in all cases. Patients reported no-little discomfort (NRS 0 to 3) during the laser session that lasted a maximum of five days. No major complications were reported, and no recurrences were observed at least after one year of follow-up. In addition, patients were available to be re-treated if necessary. These findings suggested that the Q-Switched Nd:YAG could be an effective and well-tolerated approach in the treatment of gingival melanin hyperpigmentation.

Evaluation of Carbon Dioxide Laser-Assisted Treatment for Gingival Melanin Hyperpigmentation.

Smile aesthetics has a vital role to play in an individual's life and one of the factors affecting the beauty of the smile is gingival color. A gingival color change or gingival hyperpigmentation causes an unesthetic smile line, especially in patients with a gummy smile, which is also known as a black gummy smile. Numerous gingival depigmentation methods have been performed successfully for ablating gingival melanin pigmented epithelium. Thus, the aim of this study is to evaluate the treatment efficacy of gingival hyperpigmentation by using a carbon dioxide (CO2) laser. A cross-sectional descriptive study was carried out with 38 patients at a hospital in Vietnam. Ponnaiyan classification and the Hedin melanin index were used to assess the distribution and extent of gingival pigmentation in the study. Pain assessment was performed using the Visual Analog Scale (VAS) to evaluate the intensity of pain during the laser treatment. In addition, clinical evaluation (i.e., wound healing) of each treatment procedure was conducted using the three level Dummett-Gupta Oral Pigmentation Index (DOPI) assessment. This study showed that less pain was experienced by patients treated by CO2 laser; the rates of no pain, mild pain and moderate pain after treatment were, respectively, 21%, 76% and 2.6%; there was 100% complete epithelization after 1 week. The DOPI rates for turning from a DOPI score of 1, 2 or 3 to a DOPI score of 0 after a 12-week treatment were 87.5%, 76.9% and 24%, respectively. Using a CO2 laser for gingival melanin pigmentation treatment is a safe and effective procedure.