Case Report on Gingival Depigmentation with Scalpel Technique

Physiological pigmentation of the oral mucosa appears as multifocal or widespread melanin pigmentation, varying in intensity across different ethnic groups (Cicek, 2003) [4]. The main factors influencing gingival color include the thickness of the gingival epithelium, the quantity and size of blood vessels, the degree of keratinization, and the presence of various pigments. Melanin, a brown pigment, is the most common endogenous pigment responsible for natural gingival pigmentation. The gingiva is the most frequently pigmented part of the oral mucosa. Melanin pigmentation occurs in the basal layer of the gingival epithelium, where melanin granules produced by melanoblasts become interspersed among epithelial cells. While melanin hyperpigmentation of the gingiva does not pose any medical risk, many individuals perceive dark gums as aesthetically displeasing. This concern becomes more prominent in those with a "gummy smile" or excessive gingival exposure during smiling. Gingival depigmentation is a periodontal plastic surgery procedure aimed at eliminating or reducing gingival hyperpigmentation through various techniques. This procedure is typically performed based on the individual's aesthetic concerns rather than clinical necessity. Multiple depigmentation methods are available, including chemical agents like phenol, alcohol, and ascorbic acid; conventional techniques such as scalpel surgery, gingival abrasion, and free gingival grafting; as well as advanced methods like acellular dermal matrix allografts, laser depigmentation, electrosurgery, cryosurgery, and radiosurgery. The current case report presents a straightforward and efficient surgical depigmentation technique that delivers aesthetically pleasing outcomes and ensures patient satisfaction without the need for advanced instruments or equipment.