Comparative evaluation of Er,Cr:YSGG and Diode lasers for physiologic gingival pigmentation treatment

Introduction: Removal of dark physiologic melanin pigmentation has become a cosmetic demand in many patients. Different Lasers have recently been used for this treatment. The aim of this study was to comparatively evaluate the clinical effectiveness of gingival melanin depigmentation using a 940nm diode laser with a good absorption in melanin and the Er,Cr:YSGG laser with a selective and controlled ablation property Methods: In this split mouth randomized clinical trial study 22 patients (44 split mouthed sides) requesting cosmetic gingival depigmentation therapy were included. Patients were randomly divided into two split mouth groups, group A was treated by Er,Cr:YSGG laser in the right side and Diode laser in the left side. Group B was vise versa. Er,Cr:YSGG laser was set at 4 w, 50Hz, H mode and a 1.5 w, CW setting was used for diode laser. Results : Pain was assessed using VAS (visual analogue scale) immediately, 1 day and 7 days after treatment After one day the Diode group showed a significantly greater VAS scores. (P=.000) however seven days later no significantly difference was observed.(P=.135) Treatment time and bleeding during treatment was significantly less in the Diode group. Immediately after treatment patients were asked for their preferred treatment, 13 patients (59,1%) preferred the Diode laser. Significantly better healing results were found in the Er,Cr:YSGG group aon days 1,3,7 compared to the diode laser(P≤0.05). Recurrence was assessed using Dummet and Hedin indces. Result showed no significant recurrent after 1 month for both groups. (P=1.000) After 6 months mild recurrence was found in both groups, a tendency for more recurrence in sides treated with Er,Cr:YSGG laser was seen. although not statistically significant (P=.070) Conclusion : : Both treatment methods could be considered safe and effective. Slightly better results in terms of recurrence were observed in diode treated sites.