Vitamin C Depigmenattion Versus Conventional Technique

Study Overview
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Brief Summary
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Although physiologic gingival hyperpigmentation is not a pathologic condition, it is considered one of the main esthetic problems in dentistry. It was found that the attached gingiva is the most frequently pigmented intraoral tissues followed by the papillary gingiva and the alveolar mucosa

Detailed Description
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In addition to all of the previously mentioned actions of vitamin C, it was found to be involved in depigmentation due to several factors that not only depend on its direct effect on melanin and melanocytes but also due to the overall effect on the applied tissues. Melanin is one of the main reservoir for ROS, copper and calcium in the tissue cells . Once vitamin C is introduced to the target tissue, it binds efficiently to melanin due to the ROS, calcium and copper content which causes intracellular deficiency of these items and the inability of the cells to produce melanin. Calcium deficiency causes failure of melanocytes to perform cellular adhesion to keratinocytes as calcium is essential to form cadherins . Adhesion to keratinocytes is important stimulator to melanocytes in order to produce melanin, format dendrites and transfer the produced melanin to neighboring cells . Shortage of the intercellular copper limits the formation of tyrosin, tyrosinase enzyme and peroxidase enzyme which in turn stops the melanin production . Therefore, the aim of the present study is to compare the clinical efficiency of the non-surgical intraepidermal injection of vitamin C in comparison to the gold standard surgical technique (scalpel technique) for gingival depigmentation.

Official Title
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Minimally Invasive Non-surgical Vitamin C Injection Versus the Conventional Surgical Depigmentation in Treatment of Gingival Hyperpigmentation of the Anterior Esthetic Zone: Prospective Study

Conditions
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Melanin Hyperpigmentation

Intervention / Treatment
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* Dietary Supplement: vitamin c depigementation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 18-50 y medically free; physiologic gingival hyperpigmentation related to esthetic region were selected. Exclusion Criteria: All the reasons that could provoke an inflammatory reaction were excluded such as: systemic diseases (especially auto-immune diseases and chemotherapy uptake); pregnant and lactating mothers; usage of chlorhexidine or povidone iodine; Local causes (smoking and periodontitis).

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: non-surgical vitamin c depigmentation<br>locally injected vitamin c is used to depigment the hyperpigmented gingival tissues | Dietary Supplement: vitamin c depigementation<br>* locally injected vitamin c depigementation<br>|
| Active Comparator: surgical depigmentation<br>the conventional scalpel surgical technique is used to depigment the hyperpigmented gingival tissues | Dietary Supplement: vitamin c depigementation<br>* locally injected vitamin c depigementation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| gingival color change | the degree of gingival color is determined by 2 different color indices | 6 months |