Gum grief: Unprecedented fenestration post microneedling procedure for gingival depigmentation – A case report

: A harmonious appearance of the teeth and gingiva, including the colour of the gingiva, is crucial in smile aesthetics. There are various treatment options for gingival hyperpigmentation, with surgical intervention being the gold standard procedure. This study aims to explore microneedling procedure as a minimally invasive, painless and comfortable treatment option and highlights the shortcomings of the established protocol for the procedure through a case report where the patient develops a fenestration defect post microneedling procedure. : A healthy 24-year old male patient had a gingival pigmentation score of 1 according to the Dummett oral pigmentation index (DOPI), 1964, in the mandibular anterior region. Microneedling technique was performed in the mandibular anterior region using a Dermapen under local anaesthesia until mild micro bleeding points were clearly visible in the area. : The patient was re-evaluated at regular intervals where he demonstrated noticeable improvement in the pigmentation score but the patient had developed fenestration and gingival recession post the microneedling procedure. : Microneedling using dermapen is a simple, minimally invasive and effective treatment option for gingival hyperpigmentation. However, there is a need to revise the standard protocol for microneedling procedure when used intraorally along with a need of a design better suited for intraoral usage.