Bakutra Gaurav, Shankarapillai Rajesh, Mathur Lalit, Manohar Balaji
Department of Periodontics and Oral Implantology, Manubhai Patel Dental College & Hospital, Vadodara, Gujarat, India.
Department of Periodontics and Oral Implantology, Pacific Dental College & Hospital, Udaipur, Rajasthan, India.
Int J Health Sci (Qassim). 2017 Apr-Jun;11(2):51-58.
There are various treatment modalities to remove the black patches of melanin pigmentation. The aim of the study is to clinically compare the diode laser ablation and surgical stripping technique for gingival depigmentation and to evaluate their effect on the histological changes in melanocyte activity.
A total of 40 sites of 20 patients with bilateral melanin hyperpigmentation were treated with the surgical stripping and diode laser ablation technique. Change in Hedin index score, change in area of pigmentation using image analyzing software, pain perception, patient preference of treatment were recorded. All 40 sites were selected for immunohistochemical analysis using HMB-45 immunohistochemical marker.
At 12 months post-operative visit, in all sites, repigmentation was observed with different grades of Hedin index. Paired -test, analysis of variance, and Chi-square tests were used for statistical analysis. Repigmentation in surgical stripping is significantly lesser compared to laser ablation. Lesser numbers of melanocytes were found on immunohistological examination at 12 months postoperatively. Comparison for patient preference and pain indices give statistically significant values for diode laser techniques.
Gingival hyperpigmentation is effectively managed by diode laser ablation technique and surgical stripping method. In this study, surgical stripping technique found to be better compared to diode laser ablation.
有多种治疗方式可去除黑色素沉着的黑斑。本研究的目的是在临床上比较二极管激光消融术和手术剥离术治疗牙龈色素沉着的效果,并评估它们对黑素细胞活性组织学变化的影响。
对20例双侧黑色素沉着过多患者的40个部位采用手术剥离术和二极管激光消融术进行治疗。记录赫丁指数评分的变化、使用图像分析软件测量的色素沉着面积变化、疼痛感知以及患者对治疗方法的偏好。选取所有40个部位,使用HMB - 45免疫组化标记物进行免疫组化分析。
术后12个月随访时,所有部位均观察到不同程度赫丁指数的色素沉着再发。采用配对检验、方差分析和卡方检验进行统计学分析。手术剥离术后的色素沉着再发明显少于激光消融术。术后12个月免疫组织学检查发现黑素细胞数量较少。患者对治疗方法的偏好和疼痛指数比较显示,二极管激光技术具有统计学显著差异。
二极管激光消融术和手术剥离术均可有效治疗牙龈色素沉着。在本研究中,手术剥离术的效果优于二极管激光消融术。