Pink esthetics in periodontics - Gingival depigmentation: A case series

Abstract

Smile expresses a feeling of joy, success, sensuality, affection, and courtesy, and reveals self-confidence and kindness. The harmony of the smile is determined not only by the shape, the position, and the color of the teeth, but also by the gingival tissues. Although melanin pigmentation of the gingiva is completely benign and does not present a medical problem, complaints of “black gums” are common, particularly in patients having a very high smile line. Thus, perio-esthetic treatment modalities strive to achieve a harmonious inter-relationship of the pink with white, which is imperative of all treatment procedures. For depigmentation of gingival, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery, and laser. In the present case series, scraping, electrosurgery, and diode laser have been tried for depigmentation, which are simple, effective, and yield good results, along with good patient satisfaction.

Systematic Review of Treatment Modalities for Gingival Depigmentation: A Random‐Effects Poisson Regression Analysis

“…The bur abrasion method had the highest Rr (8.99%; 95% confidence interval [CI]: 2.52–32.08%). Twenty‐three publications reported depigmentation including scalpel surgery . Eight of these studies reported recurrent pigmentation at 4.6 to 90 months of follow‐up time.…”

“…Five of these studies reported recurrent repigmentation cases. Nine publications on electrosurgery were included . Only one of these studies showed repigmentation at 12 months after surgery .…”

“…Twenty‐seven publications were included in the laser group . Applying carbon dioxide (CO 2 ), diode, neodymium‐doped YAG (Nd : YAG), Er : YAG and Er, chromium : yttrium, scandium, gallium, garnet lasers, all exhibited the possibility of clinically removing gingival pigmentation. Among all of these studies, three studies using a CO 2 laser, one study using a diode laser, two studies using an Nd : YAG laser, and three studies using an Er : YAG laser reported gingival repigmentation.…”

“…Gingival pigmentation can be removed for esthetic reasons, and various therapeutic methods are used, including cauterization by using chemical agents, bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques . Most treatments were case reports or case series.…”

“…8 Although melanocytes in other sites of the body interact with surrounding cells in a manner distinct from those in the epidermis, the essential factors and processes involved in melanin production, the synthesis of organelles within melanosomes, and the regulation of melanogenesis are comparable. 9 Gingival pigmentation can be removed for esthetic reasons, and various therapeutic methods are used, including cauterization by using chemical agents, 10 bur abrasion, [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] scalpel surgery, 12,[15][16][17]21,23,25,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43] cryosurgery, 19,25,[44][45]…”