Academy of Laser Dentistry

C A S E R E P O R T S
Advantages of 980-nm Diode Laser Treatment
in the Management of Gingival Pigmentation
Mihir Khakhar, BDS, Postgraduate Student; Richa Kapoor, BDS, Postgraduate Student; N.D.
Jayakumar, BDS, MDS, Professor; O. Padmalatha, BDS, MDS, Professor; Sheeja S. Varghese, BDS,
MDS, Professor; M. Sankari, BDS, MDS, Assistant Professor
Department of Periodontics, Saveetha Dental College, Chennai, India
J Laser Dent 2011;19(3):283-285
Mihir Khakhar, BDS
I N T R O D U C T I O N
The color of the gingiva is determined
by several factors, including the
number and size of the blood vessels,
epithelial thickness, quantity of keratinization
and pigments within the
epithelium. Melanin, carotene,
reduced hemoglobin, and oxyhemoglobin
are the major pigments that
contribute to the normal color of the
oral mucosa. 1 Frequently, gingival
hyperpigmentation is caused by
heavy melanin deposition by
melanocytes located in the basal
layers of the epithelium. 2 Demand for
cosmetic therapy of gingival melanin
pigmentation is common and various
methods have been used for depigmentation,
each with its own merits
and limitations. With the recent
advances and developments in a wide
range of laser wavelengths and
different delivery systems, research
suggests that lasers could be applied
to periodontal, restorative, and
surgical treatments.
Lasers have the advantages of
easy handling, short treatment
time, hemostasis, and bactericidal
effects. They are used extensively
for soft tissue surgical procedures
such as gingivectomy, frenectomy,
sulcular debridement, and exci-
sional and incisional biopsies. In
the present case series an attempt
was made to compare the healing,
pain levels, and patient satisfaction
during the treatment of gingival
depigmentation using lasers,
scalpel surgery, and electrocautery.
Figure 1: Laser Depigmentation
Figure 1a: Preoperative view showing
diffuse melanin pigmentation
Figure 1b: Intraoperative view showing
de-epithelization performed with the
laser in the maxillary and mandibular
anterior region
Figure 1c: Six-month postoperative view
showing complete re-epithelization has
occurred
A B S T R A C T
Gingival pigmentation is an
aesthetic problem that often
requires surgical removal. Recently
there has been an increased use
of hard and soft tissue lasers in
the field of dentistry. In the
present case series, three cases
which have been treated for
gingival depigmentation using
laser, scalpel surgery, and electrocautery
techniques are presented.
Healing, pain levels, and patient
satisfaction in all three techniques
are evaluated and compared.
K E Y W O R D S
Depigmentation, melanin pigmentation,
electrocautery, laser
C A S E 1
A 25-year-old male presented with
melanin pigmentation (Figure 1a).
Topical anesthesia (lignocaine [lidocaine]
hydrochloride, Lox 2% jelly,
Neon Laboratories, India) was
applied in the maxillary and
mandibular anterior region.
Depigmentation was carried out
using a 980-nm diode laser
(SIROLaser, Sirona Dental
Systems, Bensheim, Germany) set
at a power of 2 W, in continuous
mode, with a 300-micron fiber. The
fiber tip was moved in a sweeping
motion continuously from one site
to another to avoid heat accumulation
which could cause a
postoperative burning sensation.
Care was taken to maintain the
physiologic contour of the gingiva
during the procedure. All
Khakhar, et al.
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