J Periodontal Implant Sci.  2011 Aug;41(4):201-207. 10.5051/jpis.2011.41.4.201.

A comparison of different gingival depigmentation techniques: ablation by erbium:yttrium-aluminum-garnet laser and abrasion by rotary instruments

• Lee KM
• Lee DY
• Shin SI
• Kwon YH
• Chung JH
• Herr Y

• KMID: 2094720
• DOI: http://doi.org/10.5051/jpis.2011.41.4.201

Abstract

PURPOSE
The aim of this study is to compare two different gingival depigmentation techniques using an erbium:yttrium-aluminum-garnet (Er:YAG) laser and rotary instruments.
METHODS
Two patients with melanin pigmentation of gingiva were treated with different gingival depigmentation techniques. Ablation of the gingiva by Er:YAG laser was performed on the right side, and abrasion with a rotary round bur on the opposite side.
RESULTS
The patients were satisfied with the esthetically significant improvement with each method. However, some pigment still remained on the marginal gingival and papilla. The visual analog scale did not yield much difference between the two methods, with slightly more pain on the Er:YAG laser treated site.
CONCLUSIONS
The results of these cases suggest that ablation of the gingiva by an Er:YAG laser and abrasion with a rotary round bur is good enough to achieve esthetic satisfaction and fair wound healing without infection or severe pain. Prudent care about the gingival condition, such as the gingival thickness and degree of pigmentation along with appropriate assessment is needed in ablation by the Er:YAG laser procedure.

Keyword

Hyperpigmentation; Lasers; Melanins; Pigmentation

MeSH Terms

Gingiva
Humans
Hyperpigmentation
Melanins
Pigmentation
Wound Healing
Melanins

Figure

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  Figure 1 Case 1: pre-operative view. Diffused melanin hyperpigmentation was observed.

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  Figure 2 Post-operative view.

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  Figure 3 Postoperative view (1 day later). The connective tissue was still exposed.

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  Figure 4 Postoperative view (1 week later).

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  Figure 5 Postoperative view (2 weeks later). Re-epithelization was almost complete but the epithelium had not yet recovered its thickness.

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  Figure 6 Postoperative view (upper jaw, 4 weeks later; lower jaw, 2 weeks later).

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  Figure 7 Postoperative view (upper jaw, 5 weeks later; lower jaw, 3 weeks later). The gingiva showed a normal appearance with a pink color and keratinization.

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  Figure 8 Case 2: preoperative view. The patient showed focal pigmentation.

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  Figure 9 Postoperative view. Exposure of underlying bone can be observed around the incisal area on the right mandible. Arrows show the exposed area.

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  Figure 10 Postoperative view (1 week later). Unfavorable healing is observed with the appearance of necrosis on the right side of the mandibular area.

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  Figure 11 Postoperative view (2 weeks later).

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  Figure 12 Post-operative view (4 weeks later). The wound healing was almost completed, but slight redness remained.

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