Ceramic Soft Tissue Trimming Bur versus Conventional Scalpel Technique in Gingival Depigmentation Procedure: A Split-mouth Randomized Clinical Trial

Abstract

Objectives: Ceramic soft tissue trimming bur (Cerabur) was primarily launched to be used in gingivoplasty but has been used recently in gingival depigmentation. Cerabur depigmentation has the advantage of good hemostasis because of blood coagulation by frictional heat. This study aimed to compare the efficacy of depigmentation using the novel cerabur versus the gold-standard surgical scalpel technique. Materials and methods: Eight healthy, non-smokers with moderate to severe gingival hyperpigmentation in both arches were randomly assigned for cerabur depigmentation in one arch [test group (TG)] and scalpel depigmentation in the opposite arch [control group (CG)]. Pigmentation indices, pain levels, patient satisfaction, treatment time as well as re-pigmentation rates were the assessed parameters. The assessment was at baseline, 1 week, 1 month, and 3 months. Results: At all the assessment visits the pigmentation intensity represented by Dummet oral pigmentation index (DOPI), and distribution represented by Hedin melanin index (MI) were significantly less than baseline (p <0.001) in both groups. When comparing both groups, Scalpel depigmentation had better initial clinical outcomes, while Cerabur had less visible re-pigmentation, pain Scores, and treatment time, along with more patient satisfaction. However, all these differences were statistically insignificant. Conclusion: Both techniques successfully removed the gingival hyperpigmentation with comparable clinical outcomes. Cerabur depigmentation was favored by the patients. Clinical relevance: Gingival hyperpigmentation is an esthetic problem for many individuals. Investigating a simple, cost-effective, and bloodless depigmentation technique would be beneficial to both the clinician and the patient.