Gingival Melanin Depigmentation Using Pulsed 450 nm Diode Laser: A Split-Mouth Randomized Clinical Trial Comparing Ablative Versus Non-Ablative Techniques.

OBJECTIVE

This study aimed to compare the clinical outcomes and patient comfort levels after gingival depigmentation using ablative and non-ablative 450 nm diode lasers.

BACKGROUND

Gingival pigmentation is a common esthetic concern that affects patients' self-confidence. Laser-assisted depigmentation has emerged as a popular treatment, with both ablative and non-ablative techniques showing promising results. However, limited comparative data exist regarding their relative efficacy and patient experience.

METHODS

A split-mouth, single-blind, randomized controlled trial was conducted on 20 patients with physiological gingival pigmentation scores of ≥2, based on the Dummett Oral Pigmentation Index (OPI). Each participant received ablative laser treatment on one side of the mouth and non-ablative treatment on the contralateral side. Outcome measures included changes in OPI and Melanin Pigmentation Index at baseline, 1 month, 6 months, and 12 months. Patient-reported pain and discomfort were assessed using a modified McGill Pain Questionnaire.

RESULTS

Both techniques achieved successful depigmentation. Ablative laser treatment resulted in immediate pigment removal with lower repigmentation rates but was associated with higher intraoperative discomfort. Non-ablative treatment caused less pain and faster healing but required multiple sessions to achieve comparable results. Statistical analysis confirmed significant differences in repigmentation rates and patient comfort levels between the two modalities.

CONCLUSIONS

Both ablative and non-ablative 450 nm diode lasers are effective for gingival depigmentation. The choice of technique should be tailored to patient preferences, with ablative lasers favored for immediate results and non-ablative lasers preferred for enhanced comfort and faster recovery.