Comparison of Er,Cr:YSGG Laser and Diode Laser in the Treatment of Gingival Melanin Pigmentation
Condition: Pigmentation
Study type: Interventional

Summary: 
      The main aim of this paper is to explore the efficiancy on the extention and density of
      pigmentation between diode and Er,Cr:YSGG lasers. The second aim of this study was to
      investigate the lasers effects of patient pain and comfort.
    

Detailed description: 
      Recently, soft tissue aesthetics has become an important issue in dentistry. The normal
      physiological color of the gingiva is coral pink or pale pink. The color of gingiva is
      determined by several factors, including thickness of ephitelium, degree of keratinization,
      the number and size of underlying blood vessels and pigments within the epithelium. Gingival
      hyperpigmentation is caused by excessive deposition of melanin located in the basal and
      suprabasal cell layers of the epithelium. Many etiological factors such as smoking can
      stimulate melanin pigmentation. It has been reported that polycyclic amines such as nicotine
      and benzopyrene, which are known to penetrate melanocytes and bind to melanin, in cigarettes
      cause stimulation of melanocytes and as a result increase melanin production. Smoker
      melanocyte pigmentation was described first time by Hedin in 1977 as 'a local benign melanin
      pigmentation often seen in the attached gingiva'. Although physiologic melanin pigmentation
      and smoker melanosis are not medical problems, patients seek treatment for esthetic purposes.
      Various depigmentation techniques are employed to address the aesthetic concerns of
      individuals. Methods used for depigmentation: Chemical treatment, electrosurgery, abrasion
      with diamond tools, scalpel technique, gingivectomy, gingival graft, cryosurgery and lasers.
      Which method to choose depends on clinical experience and individual preferences. However,
      most researchers consider laser ablation to be more effective, convenient, and safer for
      gingival depigmentation. Many laser systems such as CO2 laser, Diyot laser, Neodymium
      Doped:Yttrium Aluminum Garnet(Nd:YAG) laser, Erbium Doped:Yttrium Aluminum Garnet(Er:YAG)
      laser and Erbium Chromium-Doped:Yttrium, Scandium, Gallium, Garnet(Er,Cr:YSGG) are used for
      this purpose. In melanin depigmentation with laser, the ability melanocytes which containing
      melanin to absorb the laser beam depends on the wavelength and water. The wavelength of the
      Er,Cr:YSGG laser is 2780nm, while the wavelength of the diode laser is 810-980nm.10 While
      diode laser is used for soft tissue surgery, Er,Cr:YSGG laser is used for soft and hard
      tissue surgery. Although there are more case reports regarding the use of diode lasers in
      gingival depigmentation, only a few focus on the use of Er, Cr:YSGG laser. In this study; in
      the treatment of gingival depigmentation by use of Er, Cr: YSGG laser and Diode laser to
      patients, it was aimed to evaluate the satisfaction of the patients during and after the
      operation, to evaluate the change in gingival tissue thickness and to evaluate the rate of
      repigmentation.
    

Intervention name(s): laser
Intervention type(s): Device
Intervention description(s): these lasers are routinely used in dental practice
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Er,Cr:YSGG laser; Diode Laser; Gingival pigmentation