Chandra Ganachari Bharath, VinayKumar Malleshappa Bhairammanavar, Walavalkar Narayan Narendra, Vandana Kharidhi Laxman, Vardhan Pabbati Krishna
Department of Periodontics, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India.
Department of Periodontics, College of Dental Sciences, Davangere, Karnataka, India.
J Indian Soc Periodontol. 2020 Jan-Feb;24(1):47-53. doi: 10.4103/jisp.jisp_186_19. Epub 2020 Jan 2.
"Black gums" due to melanin pigmentation of the gingiva is one reason for the demand of cosmetic therapy. Clinicians are often faced with challenge to achieve gingival esthetics in such cases because of its recurrence. Although many procedures were described in literature for gingival depigmentation, only few are mentioning about the intensity of repigmentation. Hence, this study was designed to compare two different techniques for treatment of gingival melanin pigmentation.
Twenty patients who were not esthetically pleased with the color of gingiva were selected. A randomized, split-mouth, depigmentation procedure was performed using surgical scalpel and diode laser techniques. Clinical parameters such as plaque and gingival index, bleeding, pain perception, wound healing, recurrence, and intensity of repigmentation were evaluated. Paired -test and Chi-square test were used for analysis of data.
No bleeding was reported in patients treated with diode laser. Moderate pain was reported by patients treated with surgical scalpel, whereas none was reported in diode laser group. No statistically significant difference was observed for both treatment techniques in terms of wound healing, reappearance of gingival pigmentation, and intensity of the same at the end of 6 and 9 months postsurgically.
Similar outcomes were observed for both the techniques. Few patients who resulted in no recurrence at 9 months were followed even up to 3 years. Hence, further studies should be done to know the underlying mechanisms. Keeping in mind of armamentarium and cost, surgical scalpel technique remained as the "gold standard" procedure for treatment of gingival melanin pigmentation.
牙龈因黑色素沉着导致的“黑牙龈”是美容治疗需求的一个原因。在这种情况下,临床医生常常面临实现牙龈美观的挑战,因为其容易复发。尽管文献中描述了许多牙龈色素沉着去除的方法,但只有少数提到了再色素沉着的强度。因此,本研究旨在比较两种不同的牙龈黑色素沉着治疗技术。
选择20例对牙龈颜色不满意的患者。采用手术刀和二极管激光技术进行随机、双侧对照的色素沉着去除手术。评估菌斑和牙龈指数、出血、疼痛感知、伤口愈合、复发以及再色素沉着强度等临床参数。采用配对检验和卡方检验进行数据分析。
二极管激光治疗的患者未报告出血情况。手术刀治疗的患者报告有中度疼痛,而二极管激光组未报告疼痛。在术后6个月和9个月时,两种治疗技术在伤口愈合、牙龈色素沉着再现及其强度方面均未观察到统计学上的显著差异。
两种技术观察到相似的结果。少数在9个月时未复发的患者随访至3年。因此,应进一步开展研究以了解其潜在机制。考虑到设备和成本,手术刀技术仍是治疗牙龈黑色素沉着的“金标准”方法。