title: Spontaneous pigmentation of non-pigmented palatal tissue after periodontal surgery.
abstract: BACKGROUND
  A 22-year-old African American female was referred for augmentation of keratinized gingiva around implants at the right and left maxillary second premolar sites. Presurgical evaluation revealed generalized melanosis of the buccal gingiva and a lack of keratinized tissue around implants at sites #4 and #13. No pigmentation was noted on the palatal tissues.
  
  
  METHODS
  Thick free gingival grafts were harvested bilaterally from the non-pigmented palate and secured to the recipient sites with bioabsorbable sutures. Hemostasis was achieved at the palatal donor sites with moistened gauze, and an acrylic stent was delivered for patient comfort.
  
  
  RESULTS
  Both palatal donor sites healed with spontaneous pigmentation. The pigmentation intensified with time but resulted in no adverse outcome.
  
  
  CONCLUSIONS
  Post-surgical healing in patients with gingival pigmentation is not entirely predictable, as multiple studies have demonstrated widely inconsistent results in regards to gingival pigmentation upon healing. When performing periodontal plastic surgery in patients with pigmented oral tissues, it is important to discuss all possible outcomes, including spontaneous pigmentation.
authors.affiliation: Private practice, Austin, TX, USA. dholtzclaw@jiacd.com
authors.forename: Dan
authors.initials: D
authors.lastname: Holtzclaw
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Toscano
authors.forename: Haim
authors.initials: H
authors.lastname: Tal
mesh_terms: D015921:Dental Implants; D005260:Female; D005881:Gingiva / Q000502:physiology*; D005889:Gingival Recession / Q000601:surgery*; D006801:Humans; D009061:Mouth Mucosa / Q000502:physiology / Q000637:transplantation*; D010159:Palate; D010858:Pigmentation / Q000502:physiology*; D016378:Tissue Transplantation / Q000502:physiology; D014945:Wound Healing / Q000502:physiology*; D055815:Young Adult
chemical_list: D015921:Dental Implants