Management of Gingival Melanin Hyperpigmentation by Surgical Scraping, Cryotherapy, Diode Laser and Topical Ascorbic Acid Application; (Clinical and Histological Study)

Abstract

ral melanin pigmentation has been observed in all races and is usually limited to the keratinized mucosa. It can become an aesthetic issue for many a patient, especially when it is located in the anterior labial gingiva, is not uniform in appearance, and is associated with a high smile line. Gingival depigmentation is a periodontal plastic surgical procedure whereby the gingival hyperpigmentation is removed or reduced with the help of various techniques. The first and foremost indication for depigmentation is the patient demand for improved aesthetics. The surgical methods of depigmentation include the scalpel surgical technique, cryosurgery and electrosurgery. Recently, lasers of different varieties such as neodymium, aluminum-yttrium-garnet (Nd-YAG) lasers, diode lasers, erbium-YAG lasers, and carbon dioxide (CO2) laser have been introduced. Also, bur abrasion chemical methods of depigmentation, referred to as chemoexfoliation, have been employed which use agents such as 90% alcohol and 95% phenol. Other techniques aimed at masking the pigmented gingival from the less pigmented area have used free gingival grafts and acellular dermal m