Carbon dioxide laser or cold scalpel on the removal of gingival melanin pigmentation

Abstract

Melanin pigmentation is the result of melanin granules produced by melanocytes present in the basal layer of the oral epithelium. Gingival physiological melanin pigmentation is symmetric and persistent, may cause esthetic problems especially in individuals with a gummy smile. Various techniques have been described for the removal of melanin pigmentation from the gingival epithelium and partial thin connective tissue, as chemical agents, cryosurgery, surgery and gingival grafts. Recently, lasers systems have been used to coagulate and vaporize cells, promoting controlled gingival ablation. This study compares clinical efficiency to removal gingival melanin pigmentation in 20 patients with dioxide carbon laser, and 20 patients with cold scalpel during 30 days after surgery. A dioxide carbon laser (output = 5W; superpulse = 0,5s; spot size = 2,5mm defocused; focal distance = 5,5cm, Intensity = 102 W/cm2) was irradiated on gingival mucosal surface. Both techniques presented epithelialization in 15 days. Both systems are considered effective for removal melanin pigments. Patient's evaluation with postoperative pain found the carbon dioxide laser technique superior to the cold scalpel one. After 30 days, the repigmentation occured in 45% of the dioxide carbon laser patients, and 80% of the cold scalpel patients.