A contemporary approach to management of gingival hyperpigmentation: a case series

Abstract

Purpose

Excessive pigmentation of the gingiva has a varied etiology and is often considered unesthetic. Depigmentation is a sought-after treatment and can be achieved by different techniques such as surgical blade, electrosurgery, and contemporary approaches such as the lasers. This case series aims to provide a clinical perspective on the use and efficacy of 940 nm diode laser for management of gingival hyperpigmentation.

Methods

Three patients with excessive gingival pigmentation as identified by using the Dummett-Gupta Oral Pigmentation Index were treated with diode laser (940 nm wavelength) with 2 W power in a continuous wave mode and 300/400-micron fiber. The laser was used in light contact with the gingiva with overlapping brush strokes being used to depigment the area by de-epithelialization of the site. The Dummett-Gupta Oral Pigmentation Index [DOPI] was assessed at baseline and three-month follow-up to assess and quantify the change in pigmentation achieved.

Results

The Dummett-Gupta Oral Pigmentation Index scores showed a change from 3 at baseline to 1 at 3 months post-surgery in most sites assessed (64.3%). In some sites, the post-operative scores at 3 months follow-up were 0 (35.7%).

Conclusion

The selective absorption of 940 nm diode laser into melanin allows for efficient depigmentation with low power settings and with minimal collateral tissue damage. Hence, 940 nm diode laser would be an optimum tool for clinical management of depigmentation.