TREATMENT OF GINGIVAL
HYPERPIGMENTATION WITH LASERS
Gingival Hyperpigmentation is a condition that is a
major concern for a large number of patients, due to esthetic
reasons. Gingival melanin hyperpigmentation is clinically described
as “Black Gum” which is not essentially a medical issue but
purely an esthetic one. It is particularly of concern to those
patients who have a “gummy smile” [ display of excessive gums
while smiling.]
Various treatment modalities have been tried for
cosmetic removal of the pigmented area including abrasion by diamond
burs, surgical,etc.But Laser Ablation seems to be so far the most
effective ,reliable and satisfactory method for treating melanin
hyperpigmentation of the gums.
The melanin pigment is produced by melanocyte from
tyrosine through the action of tyrosinase and stored in the form of
melanosomes.Clinically melanin hyperpigmentation is presented as dark
brown and in some tissues as blue black area mostly located in facial
aspect of the gingiva.Attached gingiva is the most common site.The
contour is often diffuse, symmetric, ribbon like dark band or
irregularly shaped patch with a well demarcated border.
Besides the pigment density ,the depth of the pigments
in the gingival layer also makes clinical difference in colour.The
number of melanocytes in different population are comparable but
melanocyte activites vary causing difference in colour.The prevalence
of melanin pigmentation varies regarding ethnic factors and smoking
habits.Gingival melanin hyperpigmentation is very prevalent in the
Indian population.
CASE
:
This
patient,Male, 26 years, presented with the complaint of excessive
visibility of gums and hyperpigmentation of labial gingiva. Treatment
for the upper labial gingiva was carried out using a Diode Laser
under application of topical anaesthesia. The laser beam was set at 1
Watt. The "brush" technique was applied until the gingival
surface appeared clinically free of pigmentation. The procedure took
about 30 minutes.The healing was uneventful, and there was hardly any
need for any analgesics. The patient could report for work the next
day.
Laser Ablation is a very simple,cost effective and
less painful procedure.The amount of tissue removed is also less.The
procedure can be repeated without complication if the pigmentation in
any area re-occurs.