Transepithelial Gingival Depigmentation Using a New Protocol with Q-Switched Nd:YAG: An In Vivo Observational Study

Abstract

Gingival melanin hyperpigmentation is a para-physiological condition that may have a negative impact on smile esthetics. In the present study, the use of the Q-Switched Nd:YAG laser, according to a defined protocol, was proposed to treat Gingival Melanin Hyperpigmentation with a transepithelial approach. A total of 10 Patients with different grades of gingival hyperpigmentation were treated with Q-Switched Nd:YAG in one to four laser sessions without local anesthesia. The grade of depigmentation was evaluated by comparing Oral Pigmentation Index (OPI) and Melanin Pigmentation Index (MPI) at baseline and three weeks after the laser session. Additionally, oral discomfort rated by the Numeric Rating Scale (NRS) was recorded one, three, and five days after the procedure. Complete depigmentation was achieved in all cases. Patients reported no-little discomfort (NRS 0 to 3) during the laser session that lasted a maximum of five days. No major complications were reported, and no recurrences were observed at least after one year of follow-up. In addition, patients were available to be re-treated if necessary. These findings suggested that the Q-Switched Nd:YAG could be an effective and well-tolerated approach in the treatment of gingival melanin hyperpigmentation.

Keywords: Nd:YAG laser; esthetic; gingival hyperpigmentation; laser; melanin.

Figure 1

Patient no. 3: Preoperative optical findings (a); optical findings just after the laser application (b); frosting at higher magnification (c); optical findings immediately before the third laser application (d); 2 years after the treatment (e).

Figure 2

Patient no. 1: Preoperative clinical aspect (a) and follow-up 1 year after laser application (one session) (b).

Figure 3

Patient no. 6: Preoperative clinical aspect (a) and follow-up 1 year after laser application (two sessions) (b).