title: Comparative evaluation of photoablative efficacy of erbium: yttrium-aluminium-garnet and diode laser for the treatment of gingival hyperpigmentation. A randomized split-mouth clinical trial.
abstract: BACKGROUND
  The use of lasers in periodontology is a matter of debate, mainly because of the lack of consensual therapeutic protocols. In this randomized, split-mouth trial, the clinical efficacy of two different photoablative dental lasers, erbium:yttrium-aluminum-garnet (Er:YAG) and diode, for the treatment of gingival hyperpigmentation is compared.
  
  
  METHODS
  Twenty-one patients requiring treatment for mild-to-severe gingival hyperpigmentation were enrolled. Maxillary or mandibular left or right quadrants were randomly subjected to photoablative deepithelialization with either Er:YAG or diode laser. Masked clinical assessments of each laser quadrant were made at admission and days 7, 30, and 180 postoperatively by an independent observer. Histologic examination was performed before and soon after treatment and 6 months after irradiation. Patients also compiled a subjective evaluation questionnaire.
  
  
  RESULTS
  Both diode and Er:YAG lasers gave excellent results in gingival hyperpigmentation. However, Er:YAG laser induced deeper gingival tissue injury than diode laser, as judged by bleeding at surgery, delayed healing, and histopathologic analysis. The use of diode laser showed additional advantages compared to Er:YAG in terms of less postoperative discomfort and pain.
  
  
  CONCLUSIONS
  This study highlights the efficacy of diode laser for photoablative deepithelialization of hyperpigmented gingiva. It is suggested that this laser can represent an effective and safe therapeutic option for gingival photoablation.
authors.affiliation: Odontostomatologic Laser Therapy Center, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Giannelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Formigli
authors.forename: Daniele
authors.initials: D
authors.lastname: Bani
mesh_terms: D000293:Adolescent; D000328:Adult; D001707:Biopsy, Needle / Q000379:methods; D016063:Blood Loss, Surgical; D004848:Epithelium / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005881:Gingiva / Q000473:pathology; D005882:Gingival Diseases / Q000601:surgery*; D005884:Gingival Hemorrhage / Q000209:etiology; D005890:Gingivectomy / Q000295:instrumentation; D006801:Humans; D017495:Hyperpigmentation / Q000601:surgery*; D053685:Laser Therapy / Q000295:instrumentation*; D054023:Lasers, Semiconductor / Q000627:therapeutic use*; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D010149:Postoperative Pain / Q000209:etiology; D057240:Patient Preference; D019106:Postoperative Hemorrhage / Q000209:etiology; D062326:Re-Epithelialization / Q000502:physiology; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult