High-power laser in the treatment of gingival pigmentation: an integrative review of the literature

Lima, Johanna Vieira Costa; Rodrigues, Maria Helena Coelho; Pereira, Carla Kuroki Kawamoto; Pereira, Sérgio Luís da Silva

doi:10.1590/1981-86372024001020230016

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RGO - Revista Gaúcha de Odontologia

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Sumário

Original • Rev Gaúch. Odontol. 72 • 2024 • https://doi.org/10.1590/1981-86372024001020230016 copy

High-power laser in the treatment of gingival pigmentation: an integrative review of the literature

Laser de alta potência no tratamento da pigmentação gengival: uma revisão integrativa da literatura

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To perform an integrative literature review about effectiveness of high-power laser in the treatment of gingival melanin pigmentation.

Methods:

This research consists of an integrative review conducted from September 2021 to May 2022 seeking to answer the following question: “What is the clinical effectiveness of laser in the treatment of gingival melanin pigmentation?”. The articles were analyzed by two researchers and the information about these was collected with emphasis on the following data: authors, year of publication, study objectives, methodology, results and conclusion.

Results:

Of the 16 articles initially selected, 08 were excluded (3 literature reviews, 4 internship reports and 1 monography). Thus, 8 articles were selected.

Conclusion:

Among several types of lasers and techniques for its use, laser, especially diode laser, was the most used technique and presented better aesthetic results, less pain, faster healing, preference and patient satisfaction after treatment. More good quality randomized control trials are needed in different techniques currently used to generate conclusions with high scientific evidence.

Indexing terms
Gingival tissue; Laser therapy; Melanosis

Author	Year of publication	Títle	Objective	Conclusion
Mahajan et al. [11]	2017	To compare the gingival melanin repigmentation after diode laser application and surgical removal.	To compare the gingival melanin repigmentation after diode laser application and surgical removal.	The incidence of repigmentation was slightly lower at laser-treated sites compared to surgical depigmentation, although the difference was statistically significant at up to 3 months.
Bakhshi et al. [9]	2018	Gingival depigmentation by Er, Cr: YSGG laser and diode laser: a split mouth, clinical trial study Lasers in gingival depigmentation	To evaluate the efficacy of diode laser and Er,Cr:YSGG laser ablation in the treatment of physiological gingival melanin hyperpigmentation	The diode laser was more efficient in reducing the DOPI and Edin melanin index scores.
Gholami et al. [12]	2018	Comparison of gingival depigmentation with Er, Cr: YSGG laser and surgical stripping, a 12-month follow-up	To compare the surgical pattern/removal method with two different laser configurations Er,Cr:YSGG in order to find the best treatment method	Configuration 2 of the Er,Cr:YSGG laser, with longer pulse duration and less water spray, resulted in better coagulation effects and can be used to control hemorrhage whenever necessary in clinical practice
Mojahedi et al. [13]	2018	Effect of 810 nm diode laser on physiologic gingival pigmentation	To evaluate the efficacy of diode laser for the treatment of physiological gingival pigmentation	Diode laser therapy is an effective and minimally invasive modality for gingival depigmentation.
Vassoler et al. [14]	2019	Gingival melanin depigmentation with diode laser-case report	To report a clinical case of the gingival depigmentation technique using a high-power diode laser in the anterior region of the jaw, to ablate pigmented tissue to improve gingival aesthetics.	The diodo laser was a good alternative to melanin depigmentation because it is a procedure with lower morbidity and satisfactory postoperative results.
Nammour et al. [10]	2020	A randomized comparative clinical study to evaluate the longevity of esthetic results of gingival melanin depigmentation treatment using different laser wavelengths (diode, CO2, and Er: YAG).	To evaluate the longevity of gingival depigmentation and the consistency of aesthetic results using three wavelengths (Er:YAG laser, CO2 laser and diode laser, 980 nm) in two different groups (smokers and non-smokers).	The diode laser provides the longest-term stability in treatment. Smoking negatively affects the longevity of gingival depigmentation. The Er laser has the shortest time before the reappearance of gingival pigmentation.
Agha & Manaf [15]	2020	Laser treatment for melanin gingival pigmentations: a comparison study for 3 laser wavelengths 2780, 940, and 445 nm	To compare the results of three lasers (Er, Cr, YSGG 2780 nm, Diode 940 nm, and 445 nm) in the removal of gingival melanin depigmentation	All three wavelengths were fast, effective in removing pigmentation, and well tolerated by patients. The aesthetic results were excellent, and the patients were highly satisfied.
Altayeb et al. [16]	2021	Gingival depigmentation with diode and Er, Cr: YSGG laser: evaluating re-pigmentation rate and patient perceptions	To evaluate the efficiency of depigmentation, patient perception, and recurrence rates of physiological gingival pigments during a 2-year follow-up after ablative depigmentation using two laser wavelengths: diode 940 nm and Er,Cr:YSGG 2780 Nm.	Both lasers effectively removed gingival pigments. Diode laser treatment showed better long-term stability of gingival color, with a lower incidence of repigmentation.

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[1] Correspondence to: JVC Lima. E-mail: johannavcostalima@gmail.com.