Gingival Melanin Depigmentation Using a Diode 808-nm Laser: A Case Series
Journal of Lasers in Medical Sciences,
Vol. 13 (2022),
10 Dey 2022
,
Page e41
Abstract
Abstract Introduction: Gingival hyperpigmentation is caused by an increase in the amount of melanin production or the number of melanocytes in the epithelium, which can impair smile esthetics. The current study aimed to report the experience of using a diode laser for gingival depigmentation of three different patients. Case Presentation: Three adult patients are presented with hyperpigmentation in labial gingivae of both jaws. The depigmentation was done using a diode laser at a wavelength of 808 nm, fiber diameter of 300 μm, and power of 1 W and in continuous mode. All three patients showed proper resolution of hyperpigmented areas in short- and long-term follow-up sessions. However, degrees of recurrence were noticeable in two cases. Conclusion: The 808-nm diode laser can be utilized safely and efficiently in gingival depigmentation, resulting in an acceptable cosmetic outcome. Doi:https:doi.org/10.34172/jlms.2022.41 Keywords: Hyperpigmentation; Laser therapy; Diode laser; Melanocytes; Cosmetic dentistry.
Keywords:
- Hyperpigmentation
- Laser Therapy
- Diode Laser
- Melanocytes
- Cosmetic Dentistry
How to Cite
Esmaeili, S., Shahbazi, S., & Asnaashari, M. (2022). Gingival Melanin Depigmentation Using a Diode 808-nm Laser: A Case Series. Journal of Lasers in Medical Sciences, 13, e41. Retrieved from https://journals.sbmu.ac.ir/jlms/article/view/36617
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10. Kumar S, Bhat GS, Bhat KM. Comparative Evaluation of Gingival Depigmentation using Tetrafluoroethane Cryosurgery and Gingival Abrasion Technique: Two Years Follow Up. J Clin Diagnostic Res. 2013;7(2):389-94.
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14. Kumar S, Bhat S, Bhat K. Development in techniques for gingival depigmentation – An update. Indian J Dent. 2012;3.
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18. Nagati RR, Ragul M, Al Qahtani NA, KS R. Clinical effectiveness of gingival depigmentation using conventional surgical scrapping and diode laser technique: a quasi experimental study. Glob J Health Sci. 2017;9(3):296-303.
19. Chandna S, Kedige SD. Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. J Indian Soc Periodontol. 2015;19(1):49-55.
20. Monteiro LS, Costa JA, da Câmara MI, Albuquerque R, Martins M, Pacheco JJ, et al. Aesthetic depigmentation of gingival smoker’s melanosis using carbon dioxide lasers. Case Rep Dent. 2015;2015.
21. Murthy MB, Kaur J, Das R. Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series. J Indian Soc Periodontol. 2012;16(4):614-9.
22. Gholami L, Moghaddam SA, Rigi Ladiz MA, Molai Manesh Z, Hashemzehi H, Fallah A, et al. Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up. Lasers Med Sci. 2018;33(8):1647-56.
23. Hegde R, Padhye A, Sumanth S, Jain AS, Thukral N. Comparison of surgical stripping; erbium-doped:yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study. J Periodontol. 2013;84(6):738-48.
24. Elemek E. Gingival melanin depigmentation by 810 nm diode laser. Eur J Dent. 2018;12(1):149-52.
25. Lee KM, Lee DY, Shin SI, Kwon YH, Chung JH, Herr Y. A comparison of different gingival depigmentation techniques: ablation by erbium:yttrium-aluminum-garnet laser and abrasion by rotary instruments. J Periodontal Implant Sci. 2011;41(4):201-7.
26. Chagra J, Bouguezzi A, Sioud S, Hentati H, Selmi J. Gingival Melanin Depigmentation by 808 nm Diode Laser: Report of a Case. Case Rep Dent. 2020;2020:8853086.
27. Fitzpatrick TB, Szabo G. The melanocyte: cytology and cytochemistry. J Invest Dermatol. 1959;32(2, Part 2):197-209.
28. Seker BK. Treatment of gingival melanin hyperpigmentation with Er,Cr:YSGG laser: Short-term follow-up of patient. J Cosmet Laser Ther. 2018;20(3):148-51.
29. Suragimath G, Lohana MH, Varma S. A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser. J Lasers Med Sci. 2016;7(4):227-32.
30. Almas K, Sadig W. Surgical treatment of melanin-pigmented gingiva; an esthetic approach. Indian J Dent Res. 2002;13(2):70-3.
31. Fowler EB, Breault LG, Galvin BG. Enhancing physiologic pigmentation utilizing a free gingival graft. Pract Periodontics Aesthet Dent. 2000;12(2):193-6.
32. Pourreau-Schneider N, Ahmed A, Soudry M, Jacquemier J, Kopp F, Franquin JC, et al. Helium-neon laser treatment transforms fibroblasts into myofibroblasts. Am J Pathol. 1990;137(1):171-8.
33. Schoop U, Kluger W, Dervisbegovic S, Goharkhay K, Wernisch J, Georgopoulos A, et al. Innovative wavelengths in endodontic treatment. Lasers Surg Med. 2006;38(6):624-30.
34. Zahra ALT, Alhabeel M. Laser Dental Treatment Techniques. 2019. p. 2-16.
35. Jokar L, Bayani M, Hamidi H, Keivan M, Azari-Marhabi S. A Comparison of 940 nm Diode Laser and Cryosurgery With Liquid Nitrogen in the Treatment of Gingival Physiologic Hyperpigmentation Using Split Mouth Technique: 12 Months Follow Up. J Lasers Med Sci. 2019;10(2):131-8.
36. Mojahedi SM, Bakhshi M, Babaei S, Mehdipour A, Asayesh H. Effect of 810 nm diode laser on physiologic gingival pigmentation. Laser Ther. 2018;27(2):99-104.
37. Simşek Kaya G, Yapici Yavuz G, Sümbüllü MA, Dayi E. A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(3):293-9.
38. Bakhshi M, Mojahedi SM, Asnaashari M, Rahmani S, Namdari M. Gingival depigmentation by Er,Cr:YSGG laser and diode laser: a split mouth, clinical trial study. Laser Ther. 2018;27(3):203-13.
39. Rastegar S, Jacques S, Motamedi M, Kim B-M. Theoretical analysis of equivalency of high-power diode laser (810 nm) and Nd:YAG laser (1064 nm) for coagulation of tissue: predictions for prostate coagulation: SPIE; 1992.
40. El Shenawy HM, Nasry SA, Zaky AA, Quriba MAA. Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes. Open Access Maced J Med Sci. 2015;3(3):447-54.
41. Vassoler F, Magro ED, Magro AK-D, de-Lacerda RRP, Paranhos LR, Santos PL, et al. Gingival Melanin Depigmentation With Diode Laser-Case Report. Int J Odontostomat. 2019;13:481-5.
42. Pindado-Ortega C, Alegre-Sánchez A, Robledo-Sánchez A, Tormo-Alfaro I, Boixeda P. Treatment of gingival pigmentation with a 755-nm alexandrite picosecond laser. J Cosmet Laser Ther. 2020;22(1):39-41.
43. Perlmutter S, Tal H. Repigmentation of the gingiva following surgical injury. J Periodontol. 1986;57(1):48-50.
44. Azzeh MM. Treatment of gingival hyperpigmentation by erbium-doped:yttrium, aluminum, and garnet laser for esthetic purposes. J Periodontol. 2007;78(1):177-84.
45. Bakutra G, Shankarapillai R, Mathur L, Manohar B. Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study. Int J Health Sci (Qassim). 2017;11(2):51-8.
46. Alhabashneh R, Darawi O, Khader YS, Ashour L. Gingival depigmentation using Er:YAG laser and scalpel technique: A six-month prospective clinical study. Quintessence Int. 2018;49(2):113-22.
2. Namdeoraoji Bahadure R, Singh P, Jain E, Khurana H, Badole G. Management of pigmented gingiva in child patient: a new era to the pediatric dentistry. Int J Clin Pediatr Dent. 2013;6(3):197-200.
3. Granstein RD, Sober AJ. Drug- and heavy metal--induced hyperpigmentation. J Am Acad Dermatol. 1981;5(1):1-18.
4. Pavlic V, Brkic Z, Marin S, Cicmil S, Gojkov-Vukelic M, Aoki A. Gingival melanin depigmentation by Er:YAG laser: A literature review. J Cosmet Laser Ther. 2018;20(2):85-90.
5. Atsawasuwan P, Greethong K, Nimmanon V. Treatment of gingival hyperpigmentation for esthetic purposes by Nd:YAG laser: report of 4 cases. J Periodontol. 2000;71(2):315-21.
6. Nammour S, El Mobadder M, Namour M, Namour A, Rompen E, Maalouf E, et al. A Randomized Comparative Clinical Study to Evaluate the Longevity of Esthetic Results of Gingival Melanin Depigmentation Treatment Using Different Laser Wavelengths (Diode, CO(2), and Er:YAG). Photobiomodul Photomed Laser Surg. 2020;38(3):167-73.
7. Malhotra S, Sharma N, Basavaraj P. Gingival esthetics by depigmentation. J Periodontal Med Clin Pract. 2014;1(1):79-84.
8. Gul M, Hameed MH, Nazeer MR, Ghafoor R, Khan FR. Most effective method for the management of physiologic gingival hyperpigmentation: A systematic review and meta-analysis. J Indian Soc Periodontol. 2019;23(3):203-15.
9. Hirschfeld I, Hirschfeld L. Oral pigmentation and a method of removing it. Oral Surg Oral Med Oral Pathol. 1951;4(8):1012-6.
10. Kumar S, Bhat GS, Bhat KM. Comparative Evaluation of Gingival Depigmentation using Tetrafluoroethane Cryosurgery and Gingival Abrasion Technique: Two Years Follow Up. J Clin Diagnostic Res. 2013;7(2):389-94.
11. Surve P, Mudda J, Patil V, Desai S, Agarwal P, Mustafa M. Gingival Depigmentation Using Surgical Scalpel and Sieve Method of Diode Laser Techniques - A Comparative Clinical Intervention Study. J Evol Med Dent Sci. 2020;9:2063-7.
12. Franck P, Henderson PW, Rothaus KO. Basics of Lasers: History, Physics, and Clinical Applications. Clin Plast Surg. 2016;43(3):505-13.
13. De Felice E. Shedding light: laser physics and mechanism of action. Phlebology. 2010;25(1):11-28.
14. Kumar S, Bhat S, Bhat K. Development in techniques for gingival depigmentation – An update. Indian J Dent. 2012;3.
15. Bakhshi M, Rahmani S, Rahmani A. Lasers in esthetic treatment of gingival melanin hyperpigmentation: a review article. Lasers Med Sci. 2015;30(8):2195-203.
16. Basha MI, Hegde RV, Sumanth S, Sayyed S, Tiwari A, Muglikar S. Comparison of Nd:YAG Laser and Surgical Stripping for Treatment of Gingival Hyperpigmentation: A Clinical Trial. Photomed Laser Surg. 2015;33(8):424-36.
17. Khalilian F, Nateghi Z, Janbakhsh N. Gingival Depigmentation Using Lasers: A Literature Review. Br J Med Med Res. 2016;12:1-7.
18. Nagati RR, Ragul M, Al Qahtani NA, KS R. Clinical effectiveness of gingival depigmentation using conventional surgical scrapping and diode laser technique: a quasi experimental study. Glob J Health Sci. 2017;9(3):296-303.
19. Chandna S, Kedige SD. Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. J Indian Soc Periodontol. 2015;19(1):49-55.
20. Monteiro LS, Costa JA, da Câmara MI, Albuquerque R, Martins M, Pacheco JJ, et al. Aesthetic depigmentation of gingival smoker’s melanosis using carbon dioxide lasers. Case Rep Dent. 2015;2015.
21. Murthy MB, Kaur J, Das R. Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series. J Indian Soc Periodontol. 2012;16(4):614-9.
22. Gholami L, Moghaddam SA, Rigi Ladiz MA, Molai Manesh Z, Hashemzehi H, Fallah A, et al. Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up. Lasers Med Sci. 2018;33(8):1647-56.
23. Hegde R, Padhye A, Sumanth S, Jain AS, Thukral N. Comparison of surgical stripping; erbium-doped:yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study. J Periodontol. 2013;84(6):738-48.
24. Elemek E. Gingival melanin depigmentation by 810 nm diode laser. Eur J Dent. 2018;12(1):149-52.
25. Lee KM, Lee DY, Shin SI, Kwon YH, Chung JH, Herr Y. A comparison of different gingival depigmentation techniques: ablation by erbium:yttrium-aluminum-garnet laser and abrasion by rotary instruments. J Periodontal Implant Sci. 2011;41(4):201-7.
26. Chagra J, Bouguezzi A, Sioud S, Hentati H, Selmi J. Gingival Melanin Depigmentation by 808 nm Diode Laser: Report of a Case. Case Rep Dent. 2020;2020:8853086.
27. Fitzpatrick TB, Szabo G. The melanocyte: cytology and cytochemistry. J Invest Dermatol. 1959;32(2, Part 2):197-209.
28. Seker BK. Treatment of gingival melanin hyperpigmentation with Er,Cr:YSGG laser: Short-term follow-up of patient. J Cosmet Laser Ther. 2018;20(3):148-51.
29. Suragimath G, Lohana MH, Varma S. A Split Mouth Randomized Clinical Comparative Study to Evaluate the Efficacy of Gingival Depigmentation Procedure Using Conventional Scalpel Technique or Diode Laser. J Lasers Med Sci. 2016;7(4):227-32.
30. Almas K, Sadig W. Surgical treatment of melanin-pigmented gingiva; an esthetic approach. Indian J Dent Res. 2002;13(2):70-3.
31. Fowler EB, Breault LG, Galvin BG. Enhancing physiologic pigmentation utilizing a free gingival graft. Pract Periodontics Aesthet Dent. 2000;12(2):193-6.
32. Pourreau-Schneider N, Ahmed A, Soudry M, Jacquemier J, Kopp F, Franquin JC, et al. Helium-neon laser treatment transforms fibroblasts into myofibroblasts. Am J Pathol. 1990;137(1):171-8.
33. Schoop U, Kluger W, Dervisbegovic S, Goharkhay K, Wernisch J, Georgopoulos A, et al. Innovative wavelengths in endodontic treatment. Lasers Surg Med. 2006;38(6):624-30.
34. Zahra ALT, Alhabeel M. Laser Dental Treatment Techniques. 2019. p. 2-16.
35. Jokar L, Bayani M, Hamidi H, Keivan M, Azari-Marhabi S. A Comparison of 940 nm Diode Laser and Cryosurgery With Liquid Nitrogen in the Treatment of Gingival Physiologic Hyperpigmentation Using Split Mouth Technique: 12 Months Follow Up. J Lasers Med Sci. 2019;10(2):131-8.
36. Mojahedi SM, Bakhshi M, Babaei S, Mehdipour A, Asayesh H. Effect of 810 nm diode laser on physiologic gingival pigmentation. Laser Ther. 2018;27(2):99-104.
37. Simşek Kaya G, Yapici Yavuz G, Sümbüllü MA, Dayi E. A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(3):293-9.
38. Bakhshi M, Mojahedi SM, Asnaashari M, Rahmani S, Namdari M. Gingival depigmentation by Er,Cr:YSGG laser and diode laser: a split mouth, clinical trial study. Laser Ther. 2018;27(3):203-13.
39. Rastegar S, Jacques S, Motamedi M, Kim B-M. Theoretical analysis of equivalency of high-power diode laser (810 nm) and Nd:YAG laser (1064 nm) for coagulation of tissue: predictions for prostate coagulation: SPIE; 1992.
40. El Shenawy HM, Nasry SA, Zaky AA, Quriba MAA. Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes. Open Access Maced J Med Sci. 2015;3(3):447-54.
41. Vassoler F, Magro ED, Magro AK-D, de-Lacerda RRP, Paranhos LR, Santos PL, et al. Gingival Melanin Depigmentation With Diode Laser-Case Report. Int J Odontostomat. 2019;13:481-5.
42. Pindado-Ortega C, Alegre-Sánchez A, Robledo-Sánchez A, Tormo-Alfaro I, Boixeda P. Treatment of gingival pigmentation with a 755-nm alexandrite picosecond laser. J Cosmet Laser Ther. 2020;22(1):39-41.
43. Perlmutter S, Tal H. Repigmentation of the gingiva following surgical injury. J Periodontol. 1986;57(1):48-50.
44. Azzeh MM. Treatment of gingival hyperpigmentation by erbium-doped:yttrium, aluminum, and garnet laser for esthetic purposes. J Periodontol. 2007;78(1):177-84.
45. Bakutra G, Shankarapillai R, Mathur L, Manohar B. Comparative evaluation of diode laser ablation and surgical stripping technique for gingival depigmentation: A clinical and immunohistochemical study. Int J Health Sci (Qassim). 2017;11(2):51-8.
46. Alhabashneh R, Darawi O, Khader YS, Ashour L. Gingival depigmentation using Er:YAG laser and scalpel technique: A six-month prospective clinical study. Quintessence Int. 2018;49(2):113-22.
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