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.