YSGG Laser Research Articles

The effect of different treatment protocols on shear bond strength in resin composite restoration repair

BackgroundIt was aimed to investigate the effect of sandblasting and laser surface treatment on shear bond strength in composite restoration repair in vitro.MethodsA micro-hybrid composite (Filtek Z250, 3 M-ESPE, USA) was used to prepare 120 samples. The samples were subjected to a thermal cycle test 5,000 times between 5 and 55 0C, and they were randomly divided into 12 groups (n = 10). No surface treatment was performed in Groups 1 to 4, which were designed as control groups. The surfaces of the samples in Groups 5 to 8 were sandblasted with a Cojet device, and the surfaces of the samples in Groups 9 to 12 were applied Er, Cr: YSGG laser. After the sample surfaces were divided into groups with and without acid etching, universal adhesive was applied, and the repair process was performed using Filtek Z250 or nano-filled resin composite (Filtek Ultimate, 3 M-ESPE, USA). The thermal cycle test was repeated 5,000 times between 5 and 55 0C on all repaired samples. The repair shear bond strength of the samples was measured using a universal testing device (Shimadzu IG-IS, Kyoto, Japan). The fracture types were evaluated by optical microscopy and scanning electron microscopy (SEM). Statistical analyses of the findings were evaluated by the Kruskal Wallis test and Mann Whitney U test at 0.05 significance degree.ResultsThe highest mean shear bond strength values were obtained from the samples sandblasted with CoJet, followed by Er, Cr: YSGG laser, and the control group. It was determined that there was a significant difference between the mean shear bond strength values obtained from the control group and the other surface treatment groups (p < 0.05). In general, significantly higher mean shear bond strength values were obtained when the universal adhesive was applied in total-etch mode compared to the application in self-etch mode (p < 0.05). Additionally, it was determined that higher shear bond strength values were obtained with Filtek Ultimate compared to Filtek Z250 (p < 0.05).ConclusionWithin the limitations of this study, it can be concluded that the use of universal adhesive in total-etch mode, in addition to surface treatments on the resin composite surface in the repair protocol and the use of nano-filled resin composite as repair material can increase the mean shear bond values in repair.

The microstructure of MIH-affected enamel after irradiation with Er, Cr: YSGG laser – a qualitative in vitro study

The microstructure of MIH-affected enamel after irradiation with Er, Cr: YSGG laser – a qualitative in vitro study

Effect of Er,Cr:YSGG Laser Irradiation on the Surface Modification and Cell Adhesion on Titanium Discs: An In Vitro Study

This study evaluates the potential of erbium, chromium-doped:yttrium, scandium, gallium, and garnet (Er,Cr:YSGG) laser irradiation to modify the titanium surface for optimal seeding of fibroblasts and osteoblasts in the treatment of peri-implantitis. Titanium discs were treated using the Er,Cr:YSGG laser, an ultrasonic device with a stainless tip, or titanium scalers. Changes in surface properties were analyzed by profilometer and scanning electron microscopy (SEM). Murine fibroblast and osteoblast adhesion and proliferation were evaluated qualitatively and quantitatively at 24 and 72 h. Profilometric surface topography and SEM showed that titanium scalers and ultrasonic debridement techniques significantly changed the structure of the machined and rough titanium surfaces. The Er,Cr:YSGG laser irradiation, on the other hand, did not alter titanium microstructures. The Er,Cr:YSGG laser irradiation with the 40 Hz group showed a significantly higher attached fibroblast cell numbers than the titanium scaler group at 72 h after treatment (p = 0.023). Additionally, the number of the attached osteoblasts in the Er,Cr:YSGG laser irradiation with the 40 Hz group was significantly higher than that of the no-treatment groups 24 h after treatment (p = 0.045). The Er,Cr:YSGG laser effectively promoted adherence of fibroblasts and osteoblasts to the titanium surface without significantly altering the titanium surface, suggesting its superiority for treating peri-implantitis.

Effect of laser irradiation during in-office tooth bleaching on surface properties of resin-based restorative materials.

This study evaluated the changes in surface properties of three resin-based restorative materials after two laser-assisted, in-office tooth bleaching protocols using erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) or diode (980nm) lasers. A nanohybrid composite (Enamel Plus HRi), a Bis-GMA-free composite (Enamel Plus HRi Bio Function), and a resin-matrix CAD-CAM ceramic (Shofu Block HC) were tested. Forty specimens for each material were prepared and divided into four groups (n=10/group). The control specimens did not undergo any bleaching treatment, whereas group 2 received bleaching with 40% hydrogen peroxide (H2O2), while groups 3 and 4 underwent the same bleaching procedure with the use of diode (980nm) or Er,Cr:YSGG lasers, respectively. Surface microhardness and roughness measurements were conducted using a Vickers tester and an optical profilometer. Microhardness was lower in bleached specimens, with the nanohybrid composite exhibiting the largest difference from the no bleaching group. For the Bis-GMA-free composite the microhardness difference between no bleaching and laser-assisted bleaching were smaller than seen for the conventional bleaching technique. Surface roughness was higher in bleached specimens, with nanohybrid composite showing the largest differences from the control specimens. The examined laser-assisted tooth bleaching protocols were found not to impact surface microhardness and roughness of the tested resin-based specimens and they are deemed suitable for clinical use.

Laser and remineralising agents in dental erosion: a systematic review and meta-analysis.

This systematic review aimed to evaluate, by means of statistical comparison between selected studies, the effectiveness of laser irradiation on dental erosion applied alone or in combination with anti-erosive agents (fluoride, Acidulated phosphate fluoride APF and CPP-amorphous calcium fluoride phosphate CPP-ACFP), through optical profilometry and microhardness measurement. The searching strategy was conducted according to the International PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, to answer research ques-tions regarding the effectiveness of lasers used in the context of dental erosion (such as Nd:YAG, CO2, Er:YAG, Er,Cr:YSGG, Diode, and Argon Ion lasers). A comprehensive and unrestricted sys-tematic searching was performed using the electronic databases of PubMed and Cochrane Library, for all articles published up to the end of January 2023. The review record was registered by the International prospective register of systematic reviews (PROSPERO) under the identification number CRD408639. Change in microhardness for the lasers group, irrespective of the type of laser used in the sample, was significantly greater compared with the one in the control group. Regards microhardness, the combination of Laser and APF gel showed promising results compared to APF gel agent.

Shear bond strength of a composite resin restoration in primary teeth following cavity preparation using laser- an in-vitro study.

To evaluate and compare the shear bond strength of composite resin restorations in primary teeth, following cavity preparation with both traditional dental burs and laser irradiation. One hundred primary molars extracted from the children visiting our department were collected and randomly divided into five groups (A-E) with 20 teeth in each group. In groups A, B, C, D, and E the teeth samples were etched with phosphoric acid, Er; YAG laser followed by acid etching, Er, Cr: YSGG laser followed by acid etching, Er; YAG laser etching only and Er, Cr: YSGG laser etching only, respectively. Following, all the samples were restored with composite resin and subjected to 500 cycles of thermocycling. The shear bond strength of the resin composite was analyzed. The type of fractures was also noted. Data obtained were subjected to statistical analysis. The mean value of shear bond strength of Group A, B, C, D, and E was 17.562 ± 0.810, 15.928 ± 0.415, 14.964 ± 0.566, 11.833 ± 0.533 and 11.187 ± 0.517, respectively. Adhesive failure was most commonly seen in all the groups. The phosphoric acid etching remains a highly effective technique for pre-treating dentin in composite resin restorations. The shear strength of composite resin to the dentin of laser-prepared cavity in primary teeth can be improved by the addition of acid etching.

Efficacy of sodium perborate assisted by Er:Cr;YSGG laser induced photoacoustic streaming technique for enhancing the color of internally stained teeth

Efficacy of sodium perborate assisted by Er:Cr;YSGG laser induced photoacoustic streaming technique for enhancing the color of internally stained teeth

Efficiency of dry versus wet Er,Cr:YSGG laser debonding of lithium disilicate veneers using different power outputs

Since water is the chromophore for the erbium, chromium-yttrium scandium gallium garnet (Er,Cr:YSGG) laser, the laser energy reaching the restoration decreases as part of it is absorbed by water. Theoretically, reducing the water or implementing dry debonding could reduce the energy consumed by water, increasing laser efficiency. Studies on whether it is suitable for removing veneers without using coolant are lacking. The purpose of this in vitro study was to evaluate the debonding time, intrapulpal temperature, and translucency of veneers during wet versus dry debonding with an Er,Cr:YSGG laser using different power outputs. Sixty-three maxillary central incisors were flattened labially to receive ceramic specimens. After cementation, ceramic specimens were irradiated with an Er,Cr:YSGG laser for debonding with different power outputs and water percentages (N=70): subgroup A1, 4W and 1% water; A20, 4W and 20% water; A40, 4W and 40% water; B1, 5W and 1% water; B20, 5W and 20% water; B40, 5W and 40% water; C1, 6W and 1% water; C20, 6W and 20% water; C40, 6W and 40% water, and a control group of unbonded ceramic specimens. During debonding, the temperature rise and debonding time were evaluated, followed by the evaluation of the translucency and surface topography of the debonded specimens. Two-way analysis of variance (ANOVA) and the Dunnett test were used to analyze the data (α=.05). The mean intrapulpal temperature rise varied significantly among groups B and C (P<.001), with the highest mean temperature rise found in subgroup B1 (4.00 ±0.00 ºC) and the lowest mean temperature rise in subgroup C20 (1.20 ±0.45 ºC). For the debonding time, the mean values of time required for debonding varied significantly among different groups (P<.001), with the longest time recorded in subgroup A1 (333.4 ±74.8s) and the shortest time recorded in subgroup C20 (17.0 ±6.0s). Only subgroups C1 (18.89 ±0.2) and C40 (18.60 ±0.2) showed a significantly lower translucency than the control group (19.44 ±0.06) (P<.001). Dry Er,Cr:YSGG laser debonding resulted in increased intrapulpal temperature when using high power outputs, but without exceeding the critical threshold of dental pulp temperature. Dry debonding also limited the transmission of laser energy, affecting the debonding efficiency. A power output of 5W and 20% water can be considered efficient and safe laser parameters for debonding lithium disilicate veneers if their reuse is intended.

Early Application of Er,Cr:YSGG Laser in Endodontics: Effects on Patency Achievement and Debris Reduction

Early Application of Er,Cr:YSGG Laser in Endodontics: Effects on Patency Achievement and Debris Reduction

Efficient diode-end-pumped continuous-wave and pulsed 2.79 μm mid-IR Er:YSGG laser for potential use in blood sampling

Efficient diode-end-pumped continuous-wave and pulsed 2.79 μm mid-IR Er:YSGG laser for potential use in blood sampling

Shear bond strength of composite resin to dentin after Er, Cr: YSGG laser irradiation or phosphoric acid etching

Shear bond strength of composite resin to dentin after Er, Cr: YSGG laser irradiation or phosphoric acid etching

Comparison of the efficacy of Er,Cr:YSGG laser on oral biofilm removal from implant surfaces with various application times for the treatment of peri-implantitis defects: ex vivo study

PurposeThe major struggle in peri-implantitis therapy is the availability of successful decontamination of the infected implant surface. The main hypothesis of this study was the Er,Cr: YSGG laser decontamination efficacy investigation on the infected implant surfaces with various peri-implantitis defects. The primary objective of this study was to decide the efficacy of Er,Cr:YSGG laser as a decontamination tool at various peri-implantitis simulating defects. The secondary objective was to compare the efficacy of the Er,Cr: YSGG laser on oral biofilm removal between two protocols the first protocol (4 cycles at 2.5 min) and the second protocol (5 cycles at 5 min) at various peri-implantitis simulating defects.Materials and methodsA total of 3 subjects whose plaque biofilms formed in-vivo on twenty-four tested implants were divided into four tested groups. Two native implants were tested as controls.The in vitro defect model was computer‐aided designed and printed into a 3D-printed model with various anulations in peri-implant infrabony defects, which were 15,30,60,and 90 degrees.ResultsBoth Er, Cr: YSGG decontamination protocols at 50 mJ (1.5 W/30 Hz), 50% air, and 40% water were effective at reducing the total implant surface area/ biofilm ratio (%), but the second protocol had a markedly greater reduction in the duration of application (5 cycles at 5 min) than did the first protocol (4 cycles at 2.5 min).ConclusionThe Er, Cr: YSGG laser is an effective decontamination device in various peri-implantitis defects. The second protocol(5 cycles at 5 min) with greater application time and circles is more effective than the first one. The defect angulation influence the decontamination capability in peri-implantitis therapy.Clinical relevance (Scientific rationale for study)Clinicians anticipate that the exploration of suitable therapeutic modalities for peri-implantitis therapy is limited by the obvious heterogeneity of the available evidence in the literature and need for a pre-clinical theoretical basis setup. The major challenges associated with peri-implantitis therapy include the successful decontamination of the infected implant surface, the absence of any damage to the treated implant surface with adequate surface roughness, and the biocompatibility of the implant surface, which allows osteoblastic cells to grow on the treated surface and is the key for successful re-osseointegration. Therefore, these are the expected empirical triads that need to be respected for successful peri-implantitis therapy. Failure of one of the triads represents a peri-implantitis therapeutic failure. The Er, Cr: YSGG laser is regarded as one of the expected devices for achieving the required triad.Trial registration"Efficacy of Er,Cr YSGG Laser in Treatment of Peri-implantitis". ClinicalTrials.gov ID NCT05137821. First Posted date: 30 -11–2021.

The Clinical and Biochemical Effects of Er,Cr:YSGG Laser as an adjunct to Scaling and Root Planing in Management of Chronic Periodontitis

The Clinical and Biochemical Effects of Er,Cr:YSGG Laser as an adjunct to Scaling and Root Planing in Management of Chronic Periodontitis

Impact of Er,Cr:YSGG Laser Debonding on the Mechanical Properties of Aged and Non-aged Lithium Disilicate Ceramics

Aim: The aim of this study is to evaluate the effects of Er,Cr:YSGG laser debonding on the mechanical properties of aged and non-aged lithium disilicate ceramics. Material and Methods: A total of 36 lithium disilicate samples with dimensions of 14x4x1 mm were prepared. Half of the samples underwent 5000 thermal cycles to simulate artificial aging. The aged and non-aged samples were divided into two subgroups: one subgroup was designated as the control group and did not receive laser treatment, while the other subgroup was treated with Er,Cr:YSGG laser for debonding (n=9). The flexural strength and modulus of the lithium disilicate samples were assessed using three-point bending tests before and after artificial aging. The surface roughness of a sample that did not undergo the three-point bending test was measured with AFM, its microhardness was assessed using Vickers hardness tests, and surface morphology was examined with FESEM. Two-way ANOVA and Bonferroni correction to determine the significance of the results were used for statistical analysis. Results: The results indicated that aging significantly reduced the flexural strength (p=0.031), however, laser debonding did not have a significant effect on the flexural strength or modulus of either aged or non-aged samples. Conclusion: Laser debonding effectively removes lithium disilicate restorations without compromising their mechanical properties, supporting their reuse in clinical practice. It is important to note that aging reduces the flexural strength of lithium disilicate ceramics.

The Effects of Dental Hygiene Instruments on Streptococcus sanguinis Adhesion to Titanium Implant Abutments.

Maintenance of dental implant with different hygiene methods or instruments may cause a surface alteration. It directly affects bacterial colonization and adhesion on titanium implant surfaces that result in peri-implant diseases. This study aimed to compare the Streptococcus sanguinis (S. sanguinis) adhesion on titanium implant abutments after instrumentation with a rubber cup with pumice and erbium, chromium-doped: yttrium, scandium, gallium, and garnet (Er, Cr: YSGG) laser using scanning electron microscope (SEM) observation and colony-forming unit (CFU) measurement. Twenty-one MegaGentitanium implant abutments were randomly distributed into three groups. Seven abutments were respectively selected for the control/untreated (C) group, while the other two groups were treated with rubber cups with pumice (P) and Er, Cr: YSGG laser (L). All samples were cultured with S. sanguinis for bacterial colonization and adhesion. One sample for each group was selected for SEM observation, while the other samples were prepared for CFU calculation. For SEM results, at 2,000× magnification, machining marks were intact in the C group, roughened in the L group, and smoothened in the P group. At 5,000× and 10,000× magnifications, moderate colonies of S. sanguiniswere revealed in C and L groups, while sparse bacterial colonies were detected in the P group. However, for CFU results, statistical analysis showed no significant value (p>0.05) comparing all three groups. P instrumentation revealed a lesser amount of S. sanguinis adhesion in SEM photographs, but no statistical significance of CFU results was noted for all three groups.

The effect of laser therapy for the treatment of dentin hypersensitivity on surface roughness and bacterial adhesion

The aim of the study was to measure the degree of dentine surface roughness caused by five distinct lasers used to treat dentine hypersensitivity, as well as to evaluate the subsequent bacterial colonization on these irradiated surfaces. Sixty human maxillary premolar teeth without caries or restoration which were extracted for periodontal reasons were used in this study. Five different types of lasers were applied to the root dentin surface. Tested samples were divided into six groups of 10 samples each; control, diode (810 nm), diode (980 nm), Nd: YAG, Er: YAG, and Er, Cr: YSGG laser groups. The arithmetic mean of the surface roughness values (Ra) and the average roughness over a measurement area (Sa) were measured pre- and post-application using any of the laser types. Swab samples were then collected from the dentin surface. Following a 24-hour incubation period at 37 °C, the colony forming units were counted using a stereoscope. The results demonstrated a statistically significant difference in the surface roughness values pre- and post-application (Ra and Sa, respectively) in the Er, Cr: YSGG laser group (p = 0.037,p = 0.007). No significant difference was observed in the other groups (p > 0.05). There was no statistically significant difference in the number of bacterial colonies observed between the test and control groups. Diode and Nd: YAG lasers showed either a decrease or no change in surface roughness; however, the hard tissue lasers (Er: YAG, Er, Cr: YSGG) showed an increase. The Er: YAG and Nd: YAG laser groups exhibited decreased bacterial adhesion compared to the other groups.

Effects of Er,Cr:YSGG Laser Surface Treatments and Composites with Different Viscosities on the Repair Bond Strength of CAD/CAM Resin Nanoceramic.

This study aims to evaluate the repair micro-shear bond strength of the CAD/CAM resin nanoceramic block treated using four different surface treatments and composite resins of different viscosities. For the current study, 96 samples with dimensions of 14 × 12 × 2 mm were obtained from a CAD/CAM resin nanoceramic block (Cerasmart) with a low-speed precision cutting saw under water cooling. The relevant samples were randomly divided into four groups according to the surface treatment processes: grinding with diamond bur, aluminum oxide airborne-particle abrasion, long-pulse laser, and short-pulse laser. Following silane application, universal adhesive was applied to all surface-treated samples and cured with an LED for 10 s. The samples prepared for the repair procedure were divided into two subgroups (microhybrid composite and injectable composite) according to the viscosity of the repair material to be used (n = 12). After the repair procedure, care was taken to keep the samples in distilled water in an incubator at 37 °C for 24 h. The repair micro-shear bond strength values (μSBSs) of CAD/CAM resin nanoceramic-composite resin complexes were tested. In addition, randomly selected samples from each group were examined with a scanning electron microscope to evaluate the surface topography after both surface treatments and the micro-shear bond strength test. Data were analyzed by two-way ANOVA and Bonferroni test. It was determined that the surface treatment preferred in the repair protocol significantly affected the μSBS value (p < 0.001). While the highest μSBS value was obtained with the short-pulse laser airradiation group, the lowest μSBS values were found in samples with long pulse laser irradiation. However, samples grinded with a bur and airborne-particle abrasion showed similar μSBS values (p > 0.05). The preferred composite viscosity in the repair procedure has a significant effect on the μSBS value (p < 0.001). However, the interaction between the surface treatment and the viscosity of the repair composite does not affect the μSBS values in a statistically significant way (p = 0.193). It may be recommended to clinicians to repair CAD/CAM resin nanoceramic restoration surfaces with injectable composites or after treatment with short-pulse lasers.

Effect of Laser Treatment of Root Dentine on Retention of Dental Fiber Post in Endodontically Treated Teeth: An In Vitro Study.

Introduction: The most common causes of fiber post-failure are inadequate restorations and dislodgement. This study aimed to evaluate fiber post-bond strength to dentin following Er,Cr:YSGG laser irradiation. Methods: A total of 65 human mandibular premolars with single roots were included. The 14 mm root length was instrumented with the rotary system using the crown-down technique. Gutta-percha was used for obturation, followed by conventional post space preparation. The samples were divided into two major groups: control (A) and Er,Cr:YSGG (2780 nm) laser group (B). The laser group was subdivided into (B1) 1.25 W, (B2) 1.5 W, and (B3) 1.75 W. All laser groups were set at 20 Hz, 10% and 30% water/air ratio. Fiber posts were cemented with selfadhesive cement. Each sample was divided horizontally into two slices, coronal and apical. The universal testing equipment was used to conduct a push-out test. All groups were examined by SEM and temperature changes. The statistical analysis was performed by using one-way ANOVA and Tukey HSD tests. Results: SEM images of all laser groups revealed the elimination of the smear layer and opened dentinal tubules, which was particularly noticeable in the apical region with no thermal risk to the periodontal tissue. In the push-out test, all laser groups had highly significant (P<0.001) increases in the bond strength of fiber post to dentin. The failure mode of the control group was a predominantly adhesive failure, whereas the laser groups were a predominantly mixed type. Conclusion: The three laser protocols can be used safely in the surface treatment of the fiber post space of endodontically treated teeth. Laser help to increase the bond strength of fiber post to dentin, especially in the apical area.

Effectiveness of therapy of complicated forms of dental caries using an Er,Cr:YSGG laser with a wavelength of 2780 nm

BACKGROUND: The use of laser technologies in the treatment of complicated forms of dental caries is promising in dentistry. However, the available literature does not fully cover the use of the Er,Cr:YSGG laser (wavelength: 2780 nm) in the treatment of purulent pulpitis and pulp necrosis. AIM: To determine the effectiveness of therapy for complicated forms of dental caries using an erbium–chromium laser with a wavelength of 2780 nm for biomechanical treatment of root canals. MATERIALS AND METHODS: Overall, 106 patients were examined and divided into three groups: group 1 (control), 15 patients whose treatment was performed using a generally accepted method; group 2, 50 patients who were treated with erbium–chromium laser radiation at the second visit, immediately before root canal obturation; and group 3, 41 patients who were treated in one visit and divided into two subgroups. In group 3-A (n=18), the root canal was irradiated with a laser with factory settings, and in group 3-B (n=23), the frequency and power of the laser were increased from 20 to 40 Hz and from 1.25 to 1.5 Watts, respectively. RESULTS: In group 1, 59 microorganisms from all 17 strains were seeded before the treatment of the root canal system of teeth with chlorine-containing disinfectants. Moreover, the proportion of seeded microorganisms in each strain was 6.6%–40% (average value: 23.1%). After treatment, the seeding rate of Streptococcus mitis decreased from 40% to 13%, Streptococcus intermedius from 20% to 6.6%, Enterococcus spp. from 33.3% to 13.3%, and Candida spp. from 33.3% to 20%. In group 2, after complex biomechanical treatment of root canals and the use of a hydrokinetic laser, none of the 17 strains sown before treatment were observed. The Candida spp. (5.5%) were not neutralized due to the use of a hydrokinetic laser with a wavelength of 2780 nm in the factory settings in group 3-A (power, 1.25 W; pulse frequency, 20 Hz; air, 10%; water, off). The combined use of the traditional protocol and hydrokinetic Er,Cr:YSGG laser in group 3B enabled complete elimination of microorganisms from those sown before treatment (p 0.001). CONCLUSION: Treatment of purulent pulpitis and pulp necrosis in one visit using a hydrokinetic Er,Cr:YSGG laser with a wavelength of 2780 nm with increased parameters (i.e., power, 1.5 W; frequency, 40 Hz; air, 35%; water, 25%) is recommended.

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.