Pain Assessment Using a Visual Analog Scale in Patients Undergoing Gingival Depigmentation by Scalpel and 970-nm Diode Laser Surgery

Gingival hyperpigmentation is seen as a genetic trait in some populations irrespective of age and gender, hence it is termed physiologic or racial gingival pigmentation. Melanin, a brown pigment, is the most common natural pigment contributing to endogenous pigmentation of gingiva and the gingiva is also the most predominant site of pigmentation on the mucosa. Melanin pigmentation is the result of melanin granules produced by melanocytes in the basal layer of gingival epithelium. Physiological pigmentation of the oral mucosa is clinically manifested as variable amounts of diffuse or multifocal melanin pigmentation in different ethnic groups. Although hyperpigmentation presents no medical problems, patients who display a high lip line frequently desire reduction of this pigmentation. Gingival depigmentation is a periodontal plastic surgical procedure which removes or reduces hyperpigmented gingiva. Various methods have been used for depigmentation, including gingivectomy, free gingival autograft, electrosurgery, cryosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond bur, CO2 laser, 9 Nd:YAG laser, and Er:YAG and diode lasers.