title: Restoring lost gingival pigmentation in the esthetic zone: A case report.
abstract: BACKGROUND
  There is insufficient literature on the lack of oral pigmentation in the esthetic zone. The aim of this case report was to illustrate the potential impact of loss of gingival pigmentation in the esthetic zone, describe its surgical treatment, and discuss the limited literature on this topic.
  
  
  METHODS
  An African American woman with high smile line had localized loss of gingival melanin pigmentation as a complication after implant failure and attempted guided bone regeneration in site 8. A highly pigmented free gingival graft was collected from the facial-attached gingiva of the maxillary posterior teeth and placed onto the previously de-epithelialized recipient bed in the maxillary front. Some pigmentation of the graft was preserved and was visible a few weeks after surgery; some pigmentation recovered over time. At 6 months after surgery, the patient was satisfied with the esthetics. Complete recovery of pigmentation took 12 months, at which time the patient was ready to proceed with the final prosthetic work.
  
  
  CONCLUSIONS
  Gingival pigmentation can be restored using a free gingival graft from a highly pigmented area. When surgical procedures are performed in such cases, loss of gingival pigmentation should be part of the informed consent. However, further research, including histology, is needed.
authors.forename: Thomas
authors.initials: T
authors.lastname: Spinell
authors.forename: Dennis
authors.initials: D
authors.lastname: Tarnow
mesh_terms: D000328:Adult; D015921:Dental Implants / Q000009:adverse effects; D004955:Esthetics, Dental; D005260:Female; D005881:Gingiva / Q000637:transplantation; D005882:Gingival Diseases / Q000209:etiology / Q000601:surgery*; D016557:Guided Tissue Regeneration, Periodontal / Q000009:adverse effects; D006801:Humans; D008548:Melanosis / Q000209:etiology / Q000601:surgery*
chemical_list: D015921:Dental Implants
keywords: Gingiva; esthetics; free gingival graft; high smile line; melanocytes; pigmentation