Gingival melanin depigmentation by 810 nm diode laser

Blue laser-assisted depigmentation of gingiva using non-ablative technique

Diode lasers are one of the most widely used modalities in soft tissue dental surgery. Recent advancements have expanded the clinically useful emission spectrum of diode lasers to include the blue light region, corresponding to wavelengths such as 445 and 450 nm. The melanin present in hyperpigmented gingiva acts as a chromophore and absorbs laser energy, thus facilitating the denaturing of melanin-containing cells in the gingiva. This paper presents a case of ethnicity-related gingival hyperpigmentation that was successfully treated using a 445 nm blue wavelength soft tissue diode laser by non-ablative technique. The treated area showed no recurrence of pigmentation up to 9 months postoperatively.

Evaluation of Three Methods for the Treatment of Dentin Hypersensitivity: A Randomised Clinical Trial

OBJECTIVES

In this study, we aimed to compare the effectiveness of Gluma and high-power 980-nm diode laser, alone or in combination, in the treatment of cervical dentin hypersensitivity.

METHODS

A total of 20 patients (5 men and 15 women), aged 25 to 60 years, who met the inclusion criteria, were enrolled in this study. A total of 60 teeth were randomly divided into 4 groups: G1, 980 nm diode laser (in 2 sessions within a 1-week interval); G2, Gluma (in 2 sessions within a 1-week interval); G3, 980 nm diode laser plus Gluma; and G4: control. Thermal (cold spray) and air blast (air syringe of dental unit) stimuli were used to evaluate cervical dentin hypersensitivity in the patients. Their pain response was assessed using a visual analogue scale (VAS) before treatment (baseline), in the first treatment session (15 minutes after treatment), in the second treatment session (after 1 week), and in 2-week, 1-month, and 3-month follow-up sessions. The obtained data were analysed using non-parametric tests, including Kruskal-Wallis test, Friedman test, Mann-Whitney test, and Wilcoxon test, in SPSS Version 22 at a significance level of P < .05.

RESULTS

Based on the results, there was a significant difference in the average VAS scores for cold and air blast stimuli between the 4 groups 1 month after the intervention (P < .05). Meanwhile, the laser group had the lowest VAS score for cold and air stimuli. On the contrary, no significant difference was found between the 4 groups 3 months after the intervention (P ˃ .05).

CONCLUSION

The present results showed that 980-nm diode laser alone was more effective than the other 2 intervention methods for 1 month.

TRIAL REGISTRATION

The study was registered in the Iranian Registry of Clinical Trials (IRCT20120901010703N5).

Double Arch Gingival Depigmentation With a Diode Laser for an Aesthetically Concerned Female: A Case Presentation

The color of the gingiva is one of the gingival properties that affects soft tissue aesthetics and the general look of a smile. Demands for a pleasing smile that includes a healthy dentition and an aesthetically enhanced gingival component are rising. Melanocytes are the cells that are mostly found in the basal and suprabasal layers of the epithelium. Melanocytes deposit melanin on the gingiva that results in gingival depigmentation or hyperpigmentation of the gingiva. It's turning into a social stigma for which people are getting different treatments. Since the invention of laser (light amplification by stimulated emission of radiation), it has been employed extensively in both surgery and medicine. The use of a laser for depigmentation is rapid and easy. This case study describes a laser-assisted gingival depigmentation procedure performed on a 25-year-old female patient who complained of dark-colored gingiva when she visited the periodontology department. It was decided to treat the maxillary and mandibular arches by depigmentation using a laser diode, with one week's interval between treatments. The patient was reviewed after one week and after three months of follow-up, the patient did not exhibit any repigmentation. The primary reason for depigmentation is the patient's desire for a more attractive appearance. Individual preferences and clinical background should always be taken into consideration when selecting a technique because these elements produce more effective outcomes.

Laser Depigmentation: A Case Report

The pigmented lesions of the oral cavity may be endogenous or exogenous. Among the options for depigmenting these areas, laser therapy stands out for being a minimally invasive procedure. This study aims to report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior maxillary region, for the ablation of the pigmented tissue to improve gingival aesthetics. The patient had an aesthetic complaint of the darkened aspect of the gingiva in the anterior maxillary portions. After local anesthesia, we started depigmentation with a high-power diode laser and performed ablation from the attached gingiva toward the free marginal gingiva. The patient returned after 30 and 180 days presenting healthy gingiva and absence of melanin repigmentation. Thus, we concluded that the diode laser was a good alternative for melanin depigmentation because it is a procedure with lower morbidity and satisfactory results.

Laser-Assisted Gingival Depigmentation: A Case Report

The gingiva's colour varies in different individuals and is assumed to be related to cutaneous pigmentation. The most frequent natural pigment causing endogenous gingival pigmentation is melanin, a brown pigment. Depigmentation is a therapy of choice when individuals are concerned about their appearance and demand it for their aesthetic satisfaction. It is not a clinical indication. This article demonstrates gingival depigmentation using a laser diode with a 90-day follow‑up. A 23-year-old male patient visited the Periodontology Department, complaining of poor aesthetics owing to dark-coloured gums. Depigmentation with a laser diode was selected as the treatment plan for both the maxillary and mandibular arches, at an interval of a week. The choice of a procedure is largely influenced by the gingival thickness, the clinician's experience, the patient's preferences, and the rate of recurrence. According to reports, using lasers produces better aesthetic outcomes and has a low recurrence rate.

Comparison of the Diode Laser Wavelengths 445 nm and 810 nm in Gingival Depigmentation - A Clinical Evaluation

Introduction: Nowadays, esthetic appearance plays an important role in the field of dentistry. Discolorations and pigmentations of the gingiva reduce the appearance of a healthy-looking smile. On this occasion, the use of lasers shows a promising approach for a fast and non-aggressive treatment in this field. Different laser wavelengths are being used for gingival depigmentation this clinical study aimed to investigate the effect of the novel laser wavelength (445 nm) in this field and compare it with an 810 nm diode laser. Methods: Two diode laser wavelengths (445 nm and 810 nm) were used for depigmentation. The laser output power chosen was 1 W. An optical fiber with a diameter of 400 µm was used. 21 patients with pigmented gingiva were selected. Depigmentation was carried out in a split-mouth design for a direct comparison of the clinical effect. Outcomes were documented by photograph after one month and six months of follow-up. Results: For each wavelength, 21 volunteers evaluated 21 clinical cases of depigmentation, which means that 441 comparisons were carried out in total regarding the color change from brownish to pinkish. A 100% clarification was achieved for 445 nm. In the 810 nm group, the color change in 44 of 441 cases (10%) could not be clearly identified. No statistically significant difference in pain experience was reported for both laser treatments. Conclusion: The clinical evaluation showed that within the limitations of this study, most of the clinical outcome parameters were highly acceptable by the patients due to mild pain and discomfort for both laser systems.

A Comparative Histological Study of Gingival Depigmentation by 808 and 445 nm Diode Lasers

Introduction: Using lasers in melanin depigmentation is one of the main fields of interest for dental practitioners and patients. However, it is important to know what would happen inside the tissue and how the cells would interact inside the tissue with a laser. Methods: In this study, we used both wavelengths of 445 nm and 808 nm on sheep gingiva to find out the effects and side effects of these diode lasers while using them for gingival depigmentation. Results: After microscopic evaluation, we concluded that 808 nm and 445 nm lasers with a power of 1 W are safe enough to use in the depigmentation of gingiva, and both lasers are highly effective in melanin pigments which are located in basal membrane. Conclusion: The 445 nm blue laser produced a less thermal effect, which means it is safer to be used in gingival hyperpigmentation than a diode laser.

Long-Term Esthetically Depigmented Gingiva in a Short Operative Duration, Using Two Modes of 940 nm Diode Lasers-A Randomized Clinical Trial

AIM

This study aims to compare the effectiveness of the two modes of 940 nm diode lasers on gingival depigmentation.

METHODS

Twenty patients (11 females and 9 males) participated in this study; they were free of any systemic or local condition and randomly assembled into two groups: continuous wave (CW) and pulsed groups, in contact modes. The diode laser was of 940 nm wavelength and 1-2 W irradiation power for the two modes in all cases. A single session of irradiation was applied to the facial gingivae of the upper and lower anterior segments. Photographs were taken preoperatively and postoperatively for all patients, and a questionnaire and follow-up were carried out for the next four weeks and after three years.

RESULTS

The intraoperative duration of both modes was considerably short, with a short chair time subsequently. A statistically significant decrease in the intensity of pain, discomfort, and bleeding (p ≤ 0.05) was noticed during the first week of follow-up within each group. Nonetheless, the two groups showed a close pattern of decline with no statistically significant differences between them. It was also clear that pain and discomfort were strongly correlated with each other within each group, and the correlation was statistically significant. On the other hand, carbonization was minimal in a few cases treated with CW mode but still not statistically significant. Finally, although the gingival pigmentation index (GPI) differences were not statistically significant between the two groups, they were significant within each group.

CONCLUSIONS

The diode laser (940 nm) offered an effective and safe modality, providing an optimal aesthetic result that can meet patient satisfaction with minimal pain, bleeding, discomfort, intraoperative time, and the possibility of recurrence in the treatment of gingival hyperpigmentation.

Comparison of the Effectiveness of CO2 and Diode Lasers for Gingival Melanin Depigmentation: A Randomized Clinical Trial

Introduction: Gingival hyperpigmentation is an esthetic concern for some individuals. This study compared the effectiveness of CO2 and diode lasers for gingival depigmentation. Methods: This randomized, split-mouth, clinical trial consisted of 12 patients with the chief complaint of hyperpigmented gingival areas. The upper right and left anterior segments and the mandibular anterior segment were randomly allocated to one of the treatment groups. The segments in group 1 underwent gingival depigmentation with a diode laser (810 nm) at 6 W and pulsed mode, whereas group 2 was ablated with a diode laser at 3 W and continuous mode. The removal of gingival pigments in group 3 was contemplated with a CO2 laser (10600 nm, 3 W, continuous mode). The operation chair time, bleeding during the procedure and post-operative pain were recorded. The gingival color and esthetic appearance were measured before the operation and at 1 week and 6 months later. Results: There was no significant difference in the bleeding scores, pain level, and color alteration values between the groups (P>0.05). The operation chair time was significantly shorter when the diode laser was applied at pulsed mode (P<0.05). The segments treated with the diode laser (pulsed or continuous mode) showed a higher esthetic appearance at the 6-month follow-up compared to those ablated with the CO2 laser (P<0.05). Conclusions: Higher esthetic appearance is expected when using the diode laser for gingival depigmentation compared to the CO2 laser. The application of the diode laser at pulsed mode could be recommended for gingival depigmentation, as it produced pleasing esthetic outcomes at reduced chair time.

Gingival Depigmentation Using Diode 980 nm and Erbium-YAG 2940 nm Lasers: A Split-Mouth Clinical Comparative Study

Background

Gingival hyperpigmentation, “black gum,” refers to black discrete single or multiple pigments on the gingiva. Several factors may play a role in gingival hyperpigmentation ranging from physiologic pigmentation to manifestations of systemic diseases. Several techniques have been used for gingival depigmentation to lighten its color.

Methods

Fifteen patients exhibiting nonsmoking melanin hyperpigmentation, with the mean age of 28.6 ± 7.8 years, were recruited. The facial gingiva of the anterior teeth and premolars of each jaw was divided into two halves. The right or left side of each jaw quadrant randomly received either diode laser operating at 980 nm wavelength or erbium-YAG laser at 2940 nm. Parameters such as degree of gingival depigmentation, bleeding, pain, patient satisfaction, and wound healing were assessed and compared between the two techniques. The subjects were followed up to six months for melanin pigmentation recurrence.

Results

Both techniques were efficient for gingival depigmentation. Nevertheless, bleeding during surgery was statistically higher for Er:YAG laser technique as compared to diode laser. Wound healing showed statistically nonsignificant differences between the two lasers, although Er:YAG seems to give better outcomes than the diode. The patients were satisfied with both laser techniques during and after gingival depigmentation. However, the pain score was higher for Er:YAG laser than for diode laser.

Conclusion

This study demonstrated that both lasers' techniques are efficient for gingival depigmentation. However, diode laser seems to show less painful experience and relatively better bleeding control.

Treatment of the amalgam tattoo in the esthetic zone

OBJECTIVE

When pigmentations appeared in the esthetic zone and were visible during the patient's smile, they were very disconcerting. There are multiple techniques to eradicate or ameliorate these discolorations. This article will address those pigmentations caused by amalgam particles.

CLINICAL CONSIDERATIONS

Keratinized gingival grafts were used to cover and mask these pigmentations. In addition, connective tissue grafts were used to aid in the elimination of the external pigmentation.

CONCLUSIONS

Both techniques were shown to be very effective in masking or eliminating these unesthetic pigmentations. Long-term follow-up has shown these results to be stable with no recurrence of the pigmentation.

CLINICAL SIGNIFICANCE

Unesthetic pigmentations in the esthetic zone that are visible during a patient's smile are very disconcerting. Elimination of these unesthetic discolorations can make a dramatic improvement in the patient's smile.

A Single Case Report of Granular Cell Tumor of the Tongue Successfully Treated through 445 nm Diode Laser

Oral granular cell tumor (GCT) is a relatively rare, benign lesion that can easily be misdiagnosed. Particularly, the presence of pseudoepitheliomatous hyperplasia might, in some cases, lead to the hypothesis of squamous cell carcinoma. Surgical excision is the treatment of choice. Recurrence has been reported in up to 15% of cases treated with conventional surgery. Here, we reported a case of GCT of the tongue in a young female patient, which was successfully treated through 445 nm diode laser excision. Laser surgery might reduce bleeding and postoperative pain and may be associated with more rapid healing. Particularly, the vaporization effect on remnant tissues could eliminate GCT cells on the surgical bed, thus hypothetically leading to a lower rate of recurrence. In the present case, complete healing occurred in 1 week, and no recurrence was observed after 6 months. Laser surgery also allows the possibility to obtain second intention healing. Possible laser-induced histopathological artifacts should be carefully considered.

Gingival Melanin Depigmentation by 808 nm Diode Laser: Report of a Case

Gingival hyperpigmentation frequently poses an aesthetic problem, especially in patients with gingival smile. This paper presents the use of a 808 nm pulsed diode laser for gingival depigmentation in a 22-year-old male patient, with a frequency of 20,000 Hz, a peak power of 5 W, and a pulse width of 26 microseconds, using a 400 nm flexible optic fiber. The hyperpigmented gingival tissue was removed without bleeding or postoperative pain. Three weeks later, the gum resumed its normal, firm, and pink appearance. No significant recurrence was noted after a follow-up of 4 months. However, perfect control of this device is necessary to avoid certain consequences such as bone exposure or gingival fenestrations.