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Mikhail FF, El Menoufy H, El Kilani NS. Assessment of clinical outcomes and patient response to gingival depigmentation using a scalpel, ceramic bur, and diode laser 980 nm. Clin Oral Investig 2023; 27:6939-6950. [PMID: 37878070 PMCID: PMC10630251 DOI: 10.1007/s00784-023-05310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 10/03/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This research compares the clinical outcomes of gingival depigmentation procedures with conventional scalpel, ceramic trimmer bur, and diode laser techniques. MATERIALS AND METHODS Twenty-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. RESULTS At 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. CONCLUSION While 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 RELEVANCE Gingival hyperpigmentation is a major aesthetic issue for many individuals. Laser and ceramic trimmer bur treatments produce equivalent aesthetic outcomes for gingival hyperpigmentation.
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Affiliation(s)
- Faten Fawzy Mikhail
- Surgery & Oral Medicine Department, Oral & Dental Research Institute, National Research Centre, 33 El Buhouth St., Ad Doqi, Dokki, Giza, 12622, Egypt.
| | - Hala El Menoufy
- Laser Research Centre, Faculty of Dentistry, Misr University for Science and Technology (MUST), 6Th of October City, Giza, Egypt
| | - Naglaa Shawki El Kilani
- Laser Research Centre, Faculty of Dentistry, Misr University for Science and Technology (MUST), 6Th of October City, Giza, Egypt
- Oral Medicine, Periodontology, Diagnosis, and Radiology Department, Faculty of Dentistry, Al-Azhar University, Cairo, Egypt
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Noyman Y, Kornowski Y, Slodownik D, Lapidoth M, Levi A. Q-switched ruby laser is safe and effective in treating primary gingival hyperpigmentation. J Cosmet Dermatol 2023; 22:2481-2484. [PMID: 37143439 DOI: 10.1111/jocd.15765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/21/2023] [Accepted: 03/28/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Physiologic gingival hyperpigmentation (PGH) is a benign condition that results from increased melanin production and is prevalent among darker skin individuals. Although the use of lasers for PGH has gained popularity in recent years, the lasers being used are mostly ablative, and act through a non-selective tissue damage mechanism. AIMS The objective of this study was to evaluate the use of a non-ablative 694-nm Q-switched ruby laser (QSRL) for the depigmentation of PGH. METHODS A retrospective single-center study of patients diagnosed with PGH and treated with a QSRL Between March 2019 and November 2020. RESULTS Four patients were treated with QSRL for 1-3 sessions, until complete depigmentation was achieved. The average follow-up was 11 months (range 7-18 months) with no patient exhibiting re-pigmentation. Adverse events included mild local tenderness and transient erosions in two patients. CONCLUSION The 694-nm QSRL is a novel and promising safe and effective method for treating PGH with the advantages of being a non-ablative modality that minimizes tissue damage and optimizes the outcome.
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Affiliation(s)
- Yehonatan Noyman
- Laser Unit, Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Dan Slodownik
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Dermatology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Moshe Lapidoth
- Laser Unit, Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Assi Levi
- Laser Unit, Division of Dermatology, Rabin Medical Center, Petah Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Mahayni M, Kujan O, Hamadah O. Aesthetic Gingival Melanin Pigmentation Treatment in Smokers and Non-Smokers: A Comparison Study Using Nd:YAG Laser and Ceramic Bur. J Pers Med 2023; 13:1034. [PMID: 37511647 PMCID: PMC10381627 DOI: 10.3390/jpm13071034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/28/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Aesthetic concerns are increasing rapidly; thus, several approaches have been suggested for treating gingival melanin pigmentation. Lasers have been reported as an effective new tool, and the Nd:YAG laser beam has an affinity for melanin and haemoglobin. However, ceramic gingival bur is simple and has less bleeding effect during operation than conventional techniques. This study aimed to compare the outcomes of gingival depigmentation using the Nd:YAG laser and ceramic bur in two different groups (smokers and non-smokers). A total of 40 patients presenting with gingival melanin pigmentation were enrolled in this split-mouth study. The sample was divided into two groups: smokers and non-smokers. Treatment was performed using the Nd:YAG laser (3 W, 60 mJ/pulse, and 50 Hz) and ceramic bur with a one-week interval between the two methods. Clinical indices were recorded, including intraoperative bleeding, wound healing, post-operative pain, and the recurrence of pigmentation, and follow-up periods were determined in the 3rd, 6th, and 9th months postoperatively. Both treatments promoted a similar pain experience and recurrence rate of pigmentation (p > 0.489, p = 1.000, respectively). Bleeding during surgery and complete healing recovery after one week were statistically significantly higher when using ceramic bur (p = 0.00, p = 0.041, respectively). Concerning the effect of smoking on the treatment, a higher recurrence rate was observed in SG than N-SG in laser sites (50%, and 95%, respectively) and bur sites (60%, and 85%, respectively), but statistically no significant difference was observed (p > 0.080). In conclusion, both procedures are adequate for aesthetic gingival depigmentation treatment. The Nd:YAG laser showed greater effectiveness in controlling bleeding, while ceramic bur showed a faster clinical recovery. Furthermore, smokers were more likely to have low depigmentation treatment stability.
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Affiliation(s)
- Massa Mahayni
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, 17 Monash Avenue, Nedlands, WA 6009, Australia
| | - Omar Hamadah
- Department of Oral Medicine, Faculty of Dental Medicine, Damascus University, Damascus P.O. Box 30621, Syria
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Mostafa D, A.Alaizari N, M.AlOtaibi S, Ahmed Aldosari N, Rabie Al-Anazi J, S.Alsughayer R, M.AlFayir H, S.AlHarthi M, H.AlAnazi M. Gingival Depigmentation Using Microneedling Technique With Topical Vitamin C: A Prospective Case Series. Cureus 2023; 15:e35345. [PMID: 36974245 PMCID: PMC10039435 DOI: 10.7759/cureus.35345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
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.
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Kawar NI, Alrayyes SM, Khuzam M, Haddad JR, Tilwani SK. Gingival Sculpting-A Simple Gingival Depigmentation Technique using Bur Abrasion and Scalpel Combined: A Case Report. Clin Adv Periodontics 2021; 11:145-149. [PMID: 33538102 DOI: 10.1002/cap.10148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/15/2021] [Indexed: 11/10/2022]
Abstract
INTRODUCTION Dentofacial esthetics demands have increased tremendously in the past decade. Psychological impact of unsatisfactory esthetic appearance can manifest in decreased sense of self-esteem and can negatively affect social and professional interactions. Esthetic awareness of dental patients has extended to include requests of gingival color modification. Gingival pigmentation can be physiological due to ethnic pigmentation or can be a result of various pathological processes. Different surgical modalities, tools and materials have been used in management of gingival pigmentation. This case report is introducing a simple, cost effective, minimally invasive technique of gingival sculpting for the purpose of significantly reducing gingival pigmentation. CASE PRESENTATION A healthy 32-year-old male patient presented with a chief complaint of gingival pigmentation that is causing him distress and low self-esteem. Gingival sculpting technique was used. This simple technique uses a combination of two methods, bur abrasion and scalpel blade with copious irrigation. The procedure resulted in minimal intra and postoperative complications and excellent esthetic results achieved instantly and maintained at 3 months postoperatively. High patient esthetic satisfaction was achieved. CONCLUSION Gingival sculpting is minimally invasive procedure that can be performed at any dental office. It renders excellent esthetic results using minimal chair time and down time for the patient. It is well tolerated by the patient with minimal bleeding, postoperative pain, and rapid healing time. Long-term follow-up is needed to ensure stability and lack of recurrence.
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Affiliation(s)
- Nadia I Kawar
- College of Dentistry, Periodontics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Sahar M Alrayyes
- Department of Pediatric Dentistry, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maher Khuzam
- College of Liberal Arts, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jacob R Haddad
- College of Liberal Arts, Benedictine University, Lisle, Illinois, USA
| | - Sunny K Tilwani
- College of Dentistry, Periodontics, University of Illinois at Chicago, Chicago, Illinois, USA
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Agurto Mariluz V, Castro-Rodríguez Y. Despigmentación gingival mediante mucoabrasion en el sector anterior. Reporte de caso. DUAZARY 2021. [DOI: 10.21676/2389783x.3838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
La melanosis gingival una alteración frecuente que causa disconformidad en la sonrisa de los pacientes. Existen múltiples tratamientos que ofrecen resultados favorables y con poca o nula recidiva. El propósito de los presentes casos clínicos fue evaluar los resultados que ofrece la técnica de mucoabrasión en la remoción de manchas melánicas en el sector anterior. Los casos incluyeron a dos pacientes se sexo femenino, sin enfermedades sistémicas, las cuales al examen clínico presentaban manchas melánicas. El primer caso presentó pigmentaciones en el maxilar superior, mientras que el segundo caso presentó pigmentaciones en ambos maxilares. Se combinó la remoción de las manchas con el uso de bisturí y medios rotarios. Se logró eliminar las manchas melánicas en su totalidad en ambos casos con una técnica completa, sin la necesidad de equipos de alto costo y no se observó recidiva al cabo de 6 meses. La técnica de mucoabrasión fue efectiva para tratar la melanosis gingival resaltando que es de fácil manejo, de corto tiempo operatorio, cicatrización rápida, con un posoperatorio aceptable para el paciente y de costos económicos.
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Gul M, Hameed MH, Nazeer MR, Ghafoor R, Khan FR. Most effective method for the management of physiologic gingival hyperpigmentation: A systematic review and meta-analysis. J Indian Soc Periodontol 2019; 23:203-215. [PMID: 31143000 PMCID: PMC6519100 DOI: 10.4103/jisp.jisp_555_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Background and Aim: Gingival hyperpigmentation is an esthetic problem. The aim of the present study was to identify most effective treatment modality for managing generalized physiological gingival pigmentation. Materials and Methods: A systematic review and meta-analysis were done (1919 to October 2018) using PubMed, CINHAL, Dental and Oral Science, and manual searches. Twenty-five articles were finally reviewed. Only human clinical trials were considered with physiological gingival pigmentation treated with different depigmentation methods and compared with surgical stripping. The outcome was the achievement of gingival depigmentation and its recurrence. RevMan software was used for data analysis. Results: Of 26,132 articles, 25 met the inclusion criteria. Seventeen were randomized control trials and 8 were nonrandomized control trials. Most of the studies were on laser. The control group was scalpel surgery. Majority of studies showed no difference in compared treatment modality. A meta-analysis compared laser ablation with surgical stripping revealed a nonsignificance difference regarding recurrence (P = 0.75) and depigmentation (P = 0.23) and a statistically significant difference regarding postoperative pain favoring laser ablation (P ≤ 0.05). Conclusions: Surgical stripping has been the conventional treatment of choice, but our review showed that new techniques are equally effective or even better. Laser especially diode laser was the most frequently used technique and showed better esthetic outcomes, less pain, faster healing, and patients' preference and satisfaction after treatment. However, laser showed more regimentation at 6-month evaluation. More good quality randomized controlled trials with different depigmentation methods are needed to draw strong conclusions.
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Affiliation(s)
- Meisha Gul
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Hasan Hameed
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Muhammad Rizwan Nazeer
- Department of Operative Dentistry, Bahria University Medical and Dental College, Karachi, Pakistan
| | - Robia Ghafoor
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Section of Dentistry, JHS Building, Aga Khan University Hospital, Karachi, Pakistan
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Minimally invasive non-surgical locally injected vitamin C versus the conventional surgical depigmentation in treatment of gingival hyperpigmentation of the anterior esthetic zone: A prospective comparative study. CLINICAL NUTRITION EXPERIMENTAL 2019. [DOI: 10.1016/j.yclnex.2018.12.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Bakhshi M, Mojahedi SM, Asnaashari M, Rahmani S, Namdari M. Gingival depigmentation by Er,Cr:YSGG laser and diode laser: a split mouth, clinical trial study. Laser Ther 2018; 27:203-213. [PMID: 32158066 DOI: 10.5978/islsm.27_18-or-19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background and aims The Aim of this study was to evaluate the effectiveness of Diode laser and Er,Cr:YSGG laser ablation on the treatment of physiologic gingival melanin hyperpigmentation. Materials and methods This research design was split mouth, double blind, and clinical trial. The power of the diode laser was set at 1 W, fiber 320 µ, irradiation mode: continuous-wave with treatment mode of contact tip and Er,Cr:YSGG laser (2780 nm) was set at 100 MJ, frequency of 15 Hz, total power of 1.75 W, 10% water and 20% air. Bleeding, pain, healing, Dummett oral pigmentation index (DOPI) and Hedin melanin score changes and repigmentation were assessed. Patients were followed for 6 months. Results A total number of 14 patients were involved in this study. There were statistically significant differences in reduction of DOPI and Hedin melanin score in each treatment groups separately while diode laser group had better results (P < 0.0001). There was no statistically significant difference between groups in terms of repigmentation. There was more pain in diode laser group (P < 0.0001) and there was more bleeding in Er,Cr:YSGG laser group (P = 0.0156). Gingival healing was more in Er,Cr:YSGG laser group (P < 0.0001). Conclusion Diode laser had more efficiency for reduction of DOPI and Hedin melanin index scores.
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Affiliation(s)
- Mahin Bakhshi
- Oral Medicine Department. School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Mojahedi
- Department of laser. School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Rahmani
- Oral Medicine Department. School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Community Oral Health. School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Chandna S, Kedige SD. Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. J Indian Soc Periodontol 2015; 19:49-55. [PMID: 25810593 PMCID: PMC4365157 DOI: 10.4103/0972-124x.145823] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 02/13/2014] [Indexed: 11/30/2022] Open
Abstract
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.
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Affiliation(s)
- Shalu Chandna
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Haryana, India
| | - Suresh Dyamappa Kedige
- Department of Periodontology and Oral Implantology, Maharishi Markandeshwar College of Dental Sciences and Research, Mullana, Haryana, India
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Gupta G, Kumar A, Khatri M, Puri K, Jain D, Bansal M. Comparison of two different depigmentation techniques for treatment of hyperpigmented gingiva. J Indian Soc Periodontol 2014; 18:705-9. [PMID: 25624625 PMCID: PMC4296453 DOI: 10.4103/0972-124x.147404] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 02/10/2014] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Demand for cosmetic therapy of gingival melanin pigmentation is common. Re-pigmentation after gingival depigmentation is an important point. The aim of this study is to evaluate the effect of surgical scraping and electrosurgery on postoperative pain, healing and recurrence of pigmentation. MATERIALS AND METHODS Fifteen patients with esthetic concern related to black gums were selected and treated by surgical scraping with respect to right quadrant and electrosurgery with respect to left quadrant. Patients were recalled post-operatively to evaluate healing and recurrence of pigmentation. Each patient was asked to complete the Visual Analogue Scale (VAS) index cards 2 and 24 hours postoperatively. RESULTS In the initial post-operative period, VAS index cards showed that the discomfort and pain level associated with electrosurgery was significantly higher than conventional scalpel surgery (P < 0.05). Clinically delayed healing was observed in the electrosurgically treated site. Electrosurgery showed better results as compared to epithelial excision for recurrence of pigments. At the end of 15 months, 7 sites in the scalpel excision group showed recurrence, whereas only 4 site showed recurrence in the electrosurgically treated group. CONCLUSION The methods used here produced desired results and above all, the patients were satisfied with the outcome. Increased pain level and clinically delayed healing was associated with electrosurgery as compared to scalpel surgery, whereas repigmentation occurred more frequently in scalpel-treated sites.
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Affiliation(s)
- Geeti Gupta
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Ashish Kumar
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Manish Khatri
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Komal Puri
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Deept Jain
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
| | - Mansi Bansal
- Department of Periodontics, Institute of Dental Studies and Technologies, Modinagar, Uttar Pradesh, India
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Lin YH, Tu YK, Lu CT, Chung WC, Huang CF, Huang MS, Lu HK. Systematic review of treatment modalities for gingival depigmentation: a random-effects poisson regression analysis. J ESTHET RESTOR DENT 2014; 26:162-78. [PMID: 24418367 DOI: 10.1111/jerd.12087] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Repigmentation variably occurs with different treatment methods in patients with gingival pigmentation. A systemic review was conducted of various treatment modalities for eliminating melanin pigmentation of the gingiva, comprising bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques, to compare the recurrence rates (Rrs) of these treatment procedures. MATERIAL AND METHODS Electronic databases, including PubMed, Web of Science, Google, and Medline were comprehensively searched, and manual searches were conducted for studies published from January 1951 to June 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A Poisson regression was used to analyze the outcome of depigmentation using the various treatment methods. RESULTS The systematic review was based on case reports mainly. In total, 61 eligible publications met the defined criteria. The various therapeutic procedures showed variable clinical results with a wide range of Rrs. A random-effects Poisson regression showed that cryosurgery (Rr = 0.32%), electrosurgery (Rr = 0.74%), and laser depigmentation (Rr = 1.16%) yielded superior result, whereas bur abrasion yielded the highest Rr (8.89%). CONCLUSIONS Within the limit of the sampling level, the present evidence-based results show that cryosurgery exhibits the optimal predictability for depigmentation of the gingiva among all procedures examined, followed by electrosurgery and laser techniques. CLINICAL SIGNIFICANCE It is possible to treat melanin pigmentation of the gingiva with various methods and prevent repigmentation. Among those treatment modalities, cryosurgery, electrosurgery, and laser surgery appear to be the best choices for treating gingival pigmentation.
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Affiliation(s)
- Yi Hung Lin
- Division of Periodontics, Department of Dentistry, Changhua Christian Hospital, Changhua, Taiwan
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Comparison of recurrent rate of gingival pigmentation after treatment by liquid nitrogen and cryoprob in 18 months follows-up. Dent Res J (Isfahan) 2014; 11:592-8. [PMID: 25426152 PMCID: PMC4241614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Cryosurgery is one of the simplest, most effective gingival depigmentation methods. Repigmentation may happen after a while in each method. The aim of this study is to compare the recurrence rate after treatment by liquid nitrogen swap and a cryoprob in 18 months. MATERIALS AND METHODS A total of 26 patients with physiologic gingival pigmentation were selected. The anterior sextant was divided into left and right segments; each segment was treated randomly by swap technique or cryoprob. Standard photos were evaluated with photoshop software (Red, Green, Blue, Cyan, Magenta, Yellow, Black [RGB, CMYK]) before and at 2 week, 1, 3, 6, 9, 12, 15, 18 months after the treatment. The results were compared, by the independent t-test and repeated measure ANOVA thereafter least significant difference post-hoc. The viewpoints of patients and physicians regarding the treatment outcomes were obtained by a questionnaire and consequently evaluated qualitatively by McNemar test (P < 0.05 was considered as significant level). RESULTS The statistical analysis showed a significant difference in color change after the treatment during 18 months, in each group (P < 0.001). The mean values of RGB had significantly increased after 2 weeks in both methods (P < 0.001), but the differences from 2 weeks to 18 months after treatment were not significant (P > 0.05). The mean values of CMYK significantly decreased after 2 weeks in both methods (P < 0.001), but the differences from 2 weeks to 18 months after treatment were not significant (P > 0.05). Qualitative evaluation showed the preference of the cryosurgery with swap method (P < 0.001). No significant recurrence was observed during 18 months follow-up. CONCLUSION Both methods of cryosurgery are appropriate in treatment of gingival depigmentation because no significant recurrence was observed during 18 months follow-up.
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