Post Gingival Depigmentation Assessment: Comparison of Surgical Stripping vs (Er,Cr:YSGG) Laser
Condition: Pigmentation; Gingiva
MeSH terms: Hypopigmentation
Study type: Interventional

Summary: 
      The appearance and health of the gingiva significantly contribute to an aesthetically
      pleasing smile. Pink gingiva indicates healthy gums and is generally preferred over dark or
      mixed colors. However, gingival color varies among individuals based on factors such as race,
      geography, gum health, epithelial thickness, vascular supply, keratinization level, and
      pigments in the epithelium layers.

      Four primary pigments define mucosa color: melanin, oxygenated hemoglobin (Hb), carotenoids,
      and reduced Hb. Melanin notably affects excessive gingival pigmentation. Gingival melanin
      hyperpigmentation, sometimes called racial pigmentation, is a genetic trait present in many
      ethnic groups due to excess melanin deposition in the epithelial layers. While not a medical
      concern, this hyperpigmentation can be unattractive, especially for those with a gummy smile.
      As a result, many seek treatments to reduce or eliminate this pigmentation.

      Various methods for gingival depigmentation exist, including surgical scraping, scalpel
      technique, bur abrasion, free gingival graft, gingivectomy, cryosurgery, electrosurgery,
      chemical treatments, and lasers. A significant challenge with these treatments is gingival
      repigmentation or the reappearance of melanin post-procedure.

      For years, the scalpel technique was the standard. It's a straightforward and economical
      method that involves removing the gingival epithelium and some underlying tissue. Although it
      promotes quick healing, the procedure can cause bleeding, necessitating local anesthesia and
      post-operative dressings. Due to the associated discomfort, researchers have sought equally
      effective alternatives.

      Laser ablation has become a popular choice among dental professionals and patients. Lasers
      like carbon dioxide (CO2), diode, argon, ruby, Nd:YAG (neodymium-doped yttrium aluminum
      garnet) , and Er:YAG (erbium-doped yttrium aluminium garnet) have been proven effective
      through numerous studies. Lasers present benefits such as minimal post-operative pain, ease
      of use, and quicker treatment times. Recurrence rates post-laser surgery (1.16%) are lower
      than with the scalpel technique (4.25%). However, lasers also have downsides, including high
      costs, potential for thermal damage, and the risk of deep penetration.

      One laser, the Erbium-chromium:yttrium-scandium-gallium-garnet (Er,Cr:YSGG), has been
      FDA-approved for certain dental procedures but hasn't been widely used for gingival
      depigmentation. Preliminary findings suggest it offers advantages like reduced pain and
      faster healing compared to other lasers. In a case study involving two patients, the
      Er,Cr:YSGG laser effectively removed gingival pigmentation, with no recurrence observed after
      six months.

      This clinical trial aimed to compare the efficacy and recurrence rates between the
      conventional scalpel technique and the Er,Cr:YSGG laser technique. The hypothesis suggests
      that the Er,Cr:YSGG laser might be a superior treatment for gingival hyperpigmentation
      compared to other methods.
    


Intervention name(s): Gingival depigmentation
Intervention type(s): Procedure
Intervention description(s): Gingival depigmentation is the most widely used periodontal procedure to remove or reduce the melanotic areas. Various techniques can be employed to effectively carry out the depigmentation procedure, including surgical scraping, scalpel technique, bur abrasion, free gingival graft, gingivectomy, cryosurgery, electrosurgery, chemical therapies, and different types of lasers
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: gingival pigmentation; depigmentation; Er,Cr:YSGG; laser