COMPARATIVE EVALUATION OF MICRONEEDLING WITH TRIPHALA CURNA, MICRONEEDLING WITH VITAMIN C, AND 445 NM DIODE LASER FOR GINGIVAL DEPIGMENTATION: A RANDOMIZED 6-MONTH CLINICAL TRIAL

<ns3:p> Objective Physiologic gingival pigmentation may negatively impact smile esthetics, particularly in individuals with high smile lines. This randomized clinical trial aimed to compare the clinical effectiveness of three minimally invasive depigmentation techniques: microneedling with Triphala Curna, microneedling with vitamin C, and 445-nm diode laser ablation. Materials and Methods Eighteen systemically healthy patients with physiologic gingival pigmentation were enrolled and allocated into three groups (n = 6 each) via block randomization. Group 1 received microneedling followed by topical Triphala Curna application; Group 2 received microneedling with vitamin C; and Group 3 underwent diode laser depigmentation at a wavelength of 445 nm. In Groups 1 and 2, the procedure was repeated after two weeks. Clinical assessments were performed at baseline, 3 months, and 6 months for gingival pigmentation (Peeran Index), gingival thickness, and patient satisfaction (VAS scores). Statistical analysis included paired and independent t tests, chi-square tests, and descriptive statistics, with significance set at <ns3:italic>p</ns3:italic> &lt; 0.05. Results All the groups showed progressive clinical improvement. Complete depigmentation (grade 0) at 6 months was observed in 66.7% of patients in the Triphala group, 50.0% in the vitamin C group, and 33.3% in the laser group. Gingival thickness increased significantly in all groups, with the greatest increase observed in the Triphala group (from 1.10 ± 0.36 mm to 1.95 ± 0.41 mm, <ns3:italic>p</ns3:italic> &lt; 0.001). Patient satisfaction also improved across all groups, with Triphala receiving the highest mean VAS score. No adverse events or pigmentation relapses were reported during study period. Conclusion Microneedling-assisted gingival depigmentation using Triphala Curna demonstrated the most favourable clinical and esthetic outcomes among the tested modalities. Results of vitamin C treatment were comparable to those of diode laser therapy, suggesting that herbal therapies combined with microneedling can serve as viable, biologically compatible alternatives to conventional laser techniques. Trial registration: CTRI/2025/09/095158. </ns3:p>