Management of Gingival Hyperpigmentation Using Surgical Blade and Diode Laser Therapy: A Comparative Study

Abstract

Summary: Melanin, a nonhemoglobin-derived brown pigment, is the most common of the endogenous pigments and is produced by melanocytes present in the basal layer of the epithelium. 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 (gummy smile). Gingival hyperpigmentation is caused by excessive deposition of melanin located in the basal and suprabasal cell layers of the epithelium. Various depigmentation techniques have been employed, such as scalpel surgery, gingivectomy, gingivectomy with free gingival autografting, cryosurgery, electrosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond burs, Nd:YAG laser, semiconductor diode laser, and CO2 laser. The present case series describes two simple and effective surgical depigmentation techniques – scalpel blade surgery and semiconductor diode laser surgery – for gingival depigmentation, which have produced good results with patient satisfaction. The diode laser is a solid-state semiconductor laser that typically uses a combination of Gallium (Ga), Arsenide (Ar), and other elements, such as Aluminum (Al) and Indium (In), to change electrical energy into light energy. In this report, better results were achieved with semiconductor diode laser than conventional scalpel blade surgery.