COMPARATIVE EVALUATION OF GINGIVAL DEPIGMENTATION TECHNIQUES IN 50 PATIENTS WITH DIVERSE ETIOLOGIES: A PROSPECTIVE CLINICAL STUDY

Background: There are many etiologies which can contribute it manifestation, one of which is melanin deposition in the basal epithelial layer of the ging that occurs due to the physiological, systemic and environmental factors such as long-standing smoking. While medically benign, marked pigmentation—particularly on the anterior segment—can be a marked esthetic concern with implications for psychosocial health. Conventional treatment options, e.g. scalpel excision provide for a simple solution, although intraoperative bleeding, postoperative pain and recurrences often occur. Diode laser as a less invasive method has appeared to be better in results. PURPOSE: The purpose of this study was to compare the clinical efficacy of scalpel and diode laser techniques for gingival depigmentation among patients with different etiologies of pigmentation. Materials and Methods: Fifty patients (25 males and 25 females; aged 18–55 years) with gingival pigmentation were selected for this prospective, randomized clinical study. Participants were assigned to two groups: Group A (scalpel) and Group B (980nm diode laser). Clinical outcomes evaluated included the Dummett-Gupta Oral Pigmentation (DOPI) Index, Melanin Pigmentation Index (MPI), Healing Index, Visual Analogue Scale (VAS), and 5-level Likert satisfaction scale. Results: The diode laser group showed significantly better results in all variables. Laser compared scalpel group with regard to quicker healing (Healing Index: 4.00 vs. 1.15), less postoperative pain (VAS: 2.72 vs. 0.42), higher satisfaction (Likert: 3.60 vs. 0.73) and higher pigment clearance (MPI: 3.24 vs. 1.73), all p < 0.001. Conclusion: The diode laser can be claimed as a clinically better surgical tool than the scalpel in the treatment of gingival depigmentation, with better healing, minimal pain and better esthetic results.