Acta Scientific Dental Sciences (ISSN: 2581-4893)

Research Article Volume 6 Issue 9

Gingival Melanin Pigmentation by Surgical Scalpel and Diode Laser - A Comparative Clinical Study

Sridevi Shetty KS* and Eric Mario Shailander A

Department of Periodontology and Implantology, Rajiv Gandhi University of Health Sciences, India

*Corresponding Author: Sridevi Shetty KS, Department of Periodontology and Implantology, Rajiv Gandhi University of Health Sciences, India.

Received: July 25, 2022; Published: August 18, 2022

Abstract

Aims and Objectives: The purpose of the present study was to evaluate and compare the effectiveness, extent of repigmentation of the gingiva, time taken for the procedure, subject’s response and preferences after surgical scalpel and diode laser as a treatment of gingival hyperpigmentation.

Materials and Methods: A randomized controlled clinical study with 17 periodontally healthy subjects, having esthetic complaints of excessive gingival melanin pigmentation on maxillary and mandibular labial gingiva was included. The maxillary and mandibular anterior regions were treated alternatively by surgical scalpel technique or Diode laser irradiation. Clinical measurements like plaque index, gingival bleeding index, DOPI and gingival shade guide assessment were evaluated at baseline (at the day of surgery), 3 months and 6 months after surgery. All subjects answered a VAS questionnaire (pain, bleeding, swelling of mucosa and mean number of analgesics taken post-operatively) at each day following surgery till one week, to evaluate post-operative symptoms as well as subject’s preference.

Statistical analysis was performed by using Descriptive statistics, Wilcoxon signed-rank test and Fisher exact test.

Results: The plaque index and gingival bleeding index at 3 and 6 months showed gradual rise but was not of statistical significance. The DOPI score at the end of 6months showed no difference in the repigmentation and thus no statistically significant variation was found in both the study groups. The gingival shade guide score also recorded repigmentation at the end of 6 month with lesser intensity of pigmentation in the control group and this was statistically significant when compared to the test group.

It was also noted that there was no difference in the VAS score which was recorded in relation to post-operative pain, swelling, bleeding and number of analgesics taken in both the treatment groups. However, subjects preferred Diode laser as a treatment option when compared to surgical scalpel, as the intra-operative time taken for the treatment procedure was less which was statistically significant.

Conclusion: Therefore, both the techniques evaluated are an effective treatment option for the management of gingival hyperpigmentation. Thus, the option of treatment technique is entirely practitioner’s prerogative.

 

Keywords: Gingival Depigmentation; Diode Laser; Surgical Scalpel; Pigmentation; Esthetics; SmilE

References

  1. Hessam Nowzari. “Esthetic periodontal therapy”. Periodontology 2000 27 (2002): 7.
  2. Kanakamedala AK., et al. “Management of Gingival Hyperpigmentation by the Surgical Scalpel Technique- Report of Three Cases”. Journal of Clinical and Diagnostic Research 4 (2010): 2341-2346.
  3. Dummett CO., et al. “Attitudes towards normal pigmentation of the oral mucosa”. Quintessence International 10 (1981): 115-1122.
  4. Kaur H., et al. “Duration of reappearance of gingival melanin pigmentation after surgical removal- A clinical study”. Journal of Indian Society of Periodontology 14.2 (2010): 101-105.
  5. Lagdive S., et al. “Management of gingival hyperpigmentation using surgical blade and diode laser therapy: A comparative study”. The Journal of Oral Laser Applications 9 (2009): 41-47.
  6. Stabholz A., et al. “The use of lasers in dentistry: Principles of operation and clinical applications”. Compendium of Continuing Education in Dentistry 24 (2003): 935-948.
  7. Hagenaars S., et al. “Soft tissue wound healing following periodontal surgery and EMDOGAIN application”. Journal of Clinical Periodontology 31 (2004): 850-856.
  8. Dummett CO., et al. “The relationship of facial skin complexion to oral mucosa pigmentation and tooth color”. Journal of Prosthetic Dentistry 43 (1980): 392-396.
  9. Vallittu PK., et al. “Dental aesthetics- A survey of attitudes in different groups of patients”. Journal of Dentistry 24.5 (1996): 335-338.
  10. Shah S., et al. “Management of gingival hyperpigmentation using surgical blade and diode laser therapy: A case report”. Advances in Human Biology 2.3 (2012): 30-34.
  11. Azzeh MM. “Treatment of gingival hyperpigmentation by Erbium-Doped: Yttrium, Aluminium, and Garnet laser for esthetic purposes”. Journal of Periodontology1 (2007): 177-184.
  12. Pick RM and Colvard MD. “Current Status of Lasers in Soft Tissue Dental Surgery”. Journal of Periodontology 7 (1993): 589-602.
  13. Thangavelu A., et al. “Pink esthetics in periodontics - Gingival depigmentation: A case series”. Journal of Pharmacy and Bioallied Sciences 2 (2012): 186-190.
  14. Gupta G. “Management of gingival hyperpigmentation by semiconductor diode laser”. Journal of Cutaneous and Aesthetic Surgery 4.3 (2011): 208-210.
  15. Hale GM and Query MR. “Optical constants of water in the 200nm to 200µm wavelength region”. Applied Optics 12 (1973): 555-563.
  16. Baxter GD. “Therapeutic Lasers: Theory and practice”. New York: Churchill Livingstone (1994): 80.
  17. Perlmutter S and Tal H. “Repigmentation of the gingiva following surgical injury”. Journal of Periodontology 1 (1986): 48-50.
  18. Shah SS. “Surgical esthetic correction for gingival pigmentation”. Journal of Interdisciplinary Dentistry 2.3 (2012): 195-200.
  19. Ozbayrak S., et al. “The treatment of melanin pigmented gingival and oral mucosa with CO2 laser”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 1 (2000): 14-15.
  20. Ginwalla TM., et al. “Surgical removal of gingival pigmentation: A preliminary study”. Journal of Indian Dental Association 38 (1966): 147-150.
  21. Tal H., et al. “Cryosurgical depigmetation of the gingival. A case report”. Journal of Clinical Periodontology 14 (1987): 614-617.
  22. Coleton S. “Lasers in surgical Periodontics and Oral Medicine”. Dental Clinics of North America 48 (2004): 937-962.
  23. Esen E., et al. “Gingival melanin pigmentation and its treatment with the CO2 laser”. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 98.5 (2004): 522-527.
  24. Tal H., et al. “Gingival depigmentation by Erbium: YAG laser: Clinical observation and patient responses”. Journal of Periodontology 74 (2003): 1660-1667.
  25. Bergamaschi O., et al. “Melanin repigmentation after gingivectomy: A 5 year clinical and transmission electron microscopic study in humans”. International Journal of Periodontics and Restorative Dentistry 13 (1993): 85-92.
  26. Prasad D., et al. “Treatment of gingival pigmentation: A case series”. Indian Journal of Dental Research 16 (2005): 171-176.
  27. Atsawasuwan P., et al. “Treatment of gingival hyperpigmentation for esthetic purposes by Nd: YAG laser: Report of 4 cases”.Journal of Periodontology 71 (2000): 315-321.
  28. Janam P., et al. “Gingival depigmentation by laser: A case series”. Journal of Indian Society of Periodontology 4 (2010): 5-7.

Citation

Citation: Sridevi Shetty KS and Eric Mario Shailander A. “Gingival Melanin Pigmentation by Surgical Scalpel and Diode Laser - A Comparative Clinical Study". Acta Scientific Dental Sciences 6.9 (2022): 33-39.

Copyright

Copyright: © 2022 Sridevi Shetty KS and Eric Mario Shailander A. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.278

Indexed In





News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is December 15, 2022.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of “Best Article of the Issue”.
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.
  • Contact US