title: Esthetic treatment of gingival hyperpigmentation with Nd:YAG laser or scalpel technique: a 6-month RCT of patient and professional assessment.
abstract: This double-masked, randomized controlled trial with a split-mouth design aimed to compare patient- and professional-centered outcomes using different therapeutic approaches-neodymium-yttrium aluminum garnet (Nd:YAG) laser or scalpel technique-for gingival depigmentation. Patients presenting bilateral melanin gingival hyperpigmentation and who requested cosmetic therapy were recruited. Contralateral quadrants were randomly assigned to receive Nd:YAG laser (settings: 6 W, 60 mJ/pulse, and 100 Hz) or scalpel technique. Patient morbidity experienced at intratherapy and during the first postoperative week was evaluated. In addition, after 6 months, the cosmetic results achieved for the different therapeutic approaches were evaluated by patients and professionals. The chair time of each technique was also calculated. Patient-oriented outcomes concerning intratherapy morbidity did not demonstrate any differences between groups (p > 0.05), although a higher extent of discomfort/pain was experienced in the side treated by the scalpel technique compared to the Nd:YAG laser procedure during the first posttherapy week (p < 0.05). Regarding to cosmetic outcomes, no differences between techniques were observed for patient and professionals (p > 0.05). Significantly higher chair time was required for the scalpel technique than for the Nd:YAG laser therapy (p < 0.05). The Nd:YAG laser or the scalpel technique may be successfully used for the treatment of melanin gingival hyperpigmentation. However, the use of the Nd:YAG laser has presented advantages in terms of less discomfort/pain during the posttherapy period and a reduction of treatment chair time.
authors.affiliation: Dental Research Division, School of Dentistry, Paulista University, Av. Dr. Bacelar, 1212, 4° andar, Vila Clementino, 04026-002, São Paulo, São Paulo, Brazil, fernanda@ribbeiro.com.
authors.forename: Fernanda V
authors.initials: FV
authors.lastname: Ribeiro
authors.forename: Clara P
authors.initials: CP
authors.lastname: Cavaller
authors.forename: Renato C V
authors.initials: RC
authors.lastname: Casarin
authors.forename: Márcio Z
authors.initials: MZ
authors.lastname: Casati
authors.forename: Fabiano R
authors.initials: FR
authors.lastname: Cirano
authors.forename: Maristela
authors.initials: M
authors.lastname: Dutra-Corrêa
authors.forename: Suzana P
authors.initials: SP
authors.lastname: Pimentel
mesh_terms: D000328:Adult; D005260:Female; D005882:Gingival Diseases / Q000601:surgery*; D006801:Humans; D017495:Hyperpigmentation / Q000601:surgery; D053685:Laser Therapy / Q000379:methods; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011182:Postoperative Care; D011184:Postoperative Period; D013518:Surgery, Plastic / Q000379:methods*; D016896:Treatment Outcome