IADR Abstract Archives
Surgical Versus Non-Surgical Gingival Depigmentation Technique: a Comparative Preliminary Case Series
Objectives: The surgical scalpel method is considered the gold standard for treating gingival depigmentation but is associated with fear, bleeding, pain, large operative wound, a higher rate of repigmentation, and bone exposure in thin gingival biotype. Thus, therapeutic modalities should be explored that are easy to use, minimally invasive, and not only mechanically remove melanocytes but also interfere with the steps of melanogenesis. Vitamin C is widely used in dermatology for skin depigmentation. However, there are very few clinical studies on the efficacy of vitamin C (ascorbic acid) as a depigmenting agent for gingiva. The objective of this preliminary case series is to compare the clinical efficacy and patient-reported outcomes of the non-surgical intra-epidermal (mesotherapy) vitamin C method with surgical scalpel technique for gingival depigmentation in Indian patients.
Methods: 10 patients with hyperpigmented gingiva were randomly assigned for Vitamin C (n=5) intra-epidermal injection (1/week for4 weeks) or surgical scalpel technique(n=5). Depigmentation effect was evaluated using Dummett oral pigmentation index(DOPI), Gingival pigmentation index(GPI) and gingival Luminiscance (L* value). Parameters were recorded at baseline,1 and 3 months. Pain, color change and patient satisfaction scores were also assessed
Results: At baseline and 3 months, there was no statistically significant difference between both groups in median DOPI, GPI, and L* value. At 1 month, a significant difference was reported for DOPI (p=0.01) and L* (p=0.05). Color change (p=0.002) and overall patient satisfaction (p=0.03) was reported higher for the surgical group at 1 month. No significant difference was observed in overall patient satisfaction at 3 months.
Conclusions: The surgical technique revealed better results at one month but at three months vitamin C showed comparable results and thus can be used as a substitution or as an adjunct to surgical procedure. Indian patients were satisfied with the overall experience of both techniques. Future studies with larger sample sizes and long-term follow-up are needed to validate these preliminary findings.
Methods: 10 patients with hyperpigmented gingiva were randomly assigned for Vitamin C (n=5) intra-epidermal injection (1/week for4 weeks) or surgical scalpel technique(n=5). Depigmentation effect was evaluated using Dummett oral pigmentation index(DOPI), Gingival pigmentation index(GPI) and gingival Luminiscance (L* value). Parameters were recorded at baseline,1 and 3 months. Pain, color change and patient satisfaction scores were also assessed
Results: At baseline and 3 months, there was no statistically significant difference between both groups in median DOPI, GPI, and L* value. At 1 month, a significant difference was reported for DOPI (p=0.01) and L* (p=0.05). Color change (p=0.002) and overall patient satisfaction (p=0.03) was reported higher for the surgical group at 1 month. No significant difference was observed in overall patient satisfaction at 3 months.
Conclusions: The surgical technique revealed better results at one month but at three months vitamin C showed comparable results and thus can be used as a substitution or as an adjunct to surgical procedure. Indian patients were satisfied with the overall experience of both techniques. Future studies with larger sample sizes and long-term follow-up are needed to validate these preliminary findings.