27Mar 2017

LASERS FOR ESTHETIC REMOVAL OF GINGIVAL HYPERPIGMENTATION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS.

  • Oral Surgery and Medicine Department, National Research Centre, Egypt.
  • Oral and Maxillofacial Radiology department, Faculty of oral and dental medicine, South Valley University, Egypt.
  • Orthodontic department, Faculty of oral and dental medicine, Assiut University, Egypt.
  • Oral and Maxillofacial Radiology Department, Faculty of Oral and Dental Medicine, Cairo University, Egypt.
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Background: Being a science of beauty, beautiful smile is an integral part of contemporary dental practice. Gingival hyperpigmentation is considered an esthetic problem that needs a patient centered management. Dental operators are attracted to laser benefits not only during surgery but also for postoperative status. This review aimed to assess laser use in esthetic removal of gingival hyperpigmentation in comparison to conventional methods. Materials and Methods: An electronic database search on PubMed and Cochrane library without date restriction was done and clinical studies in which laser was used for esthetic gingival depigmentation were selected and evaluated. Out of the initial search that yielded 183 studies, 21 were considered potentially relevant for the present review, out of which only 4 were finally selected. They studied the effect of laser on depigmentation, chair time, bleeding index, patient satisfaction and repigmentation. Results: The analysis of the results shows that the assessed studies are too limited in number beside exhibiting small sample sizes. They are clinically heterogeneous so that a solid evidence based conclusion cannot be reached. Conclusion: Researchers should be attracted to this research gap. Randomized clinical trials with a larger sample size, different laser parameters and longer follow up are strongly recommended.

  1. Arnabat-Domínguez, J., M. Bragado-Novel, A. J. España-Tost, L. Berini-Aytés and C. Gay-Escoda (2010). Advantages and esthetic results of erbium, chromium: yttrium–scandium–gallium–garnet laser application in second-stage implant surgery in patients with insufficient gingival attachment: a report of three cases. Lasers in medical science 25(3): 459-464.
  2. Atsawasuwan, P., K. Greethong and V. Nimmanon (2000). Treatment of gingival hyperpigmentation for esthetic purposes by Nd: YAG laser: Report of 4 cases. Journal of periodontology 71(2): 315-321.
  3. Azzeh, M. M. (2007). Treatment of gingival hyperpigmentation by erbium-doped: yttrium, aluminum, and garnet laser for esthetic purposes. Journal of periodontology 78(1): 177-184.
  4. Basha, M. I., R. V. Hegde, S. Sumanth, S. Sayyed, A. Tiwari and S. Muglikar (2015). comparison of Nd: YAG laser and surgical stripping for treatment of gingival hyperpigmentation: A clinical trial. Photomedicine and laser surgery 33(8): 424-436.
  5. Bergamaschi, O., S. Kon, A. Doine and M. Ruben (1993). Melanin repigmentation after gingivectomy: a 5-year clinical and transmission electron microscopic study in humans. International Journal of Periodontics & Restorative Dentistry 13(1).
  6. Berk, G., K. Atici and N. Berk (2005). Treatment of gingival pigmentation with Er, Cr: YSGG laser. J Oral Laser Applications 5(4): 249-253.
  7. Bin Cho, S., J. Hee Lee, W. Seo and D. Bang (2010). Use of 532-nm Q-switched Nd: YAG laser for smoker's gingival hyperpigmentation. Journal of Cosmetic and Laser Therapy 12(2): 77-80.
  8. Cercadillo-Ibarguren, I., A. España-Tost, J. Arnabat-Domínguez, E. Valmaseda-Castellón, L. Berini-Aytés and C. Gay-Escoda (2010). Histologic evaluation of thermal damage produced on soft tissues by CO2, Er, Cr: YSGG and diode lasers. Medicina oral, patologia oral y cirugia bucal 15(6): e912-918.
  9. Chandna, S. and S. D. Kedige (2015). Evaluation of pain on use of electrosurgery and diode lasers in the management of gingival hyperpigmentation: A comparative study. Journal of Indian Society of Periodontology 19(1): 49.
  10. Cicek, Y. and U. Ertas (2003). The normal and pathological pigmentation of oral mucous membrane: a review. J Contemp Dent Pract 4(3): 76-86.
  11. Cobb, C. M. (2006). Lasers in periodontics: a review of the literature. Journal of periodontology 77(4): 545-564.
  12. Coluzzi, D. J. (2004). Fundamentals of dental lasers: science and instruments. Dental Clinics of North America 48(4): 751-770.
  13. Convissar, R. A. (2004). The biologic rationale for the use of lasers in dentistry. Dental Clinics of North America 48(4): 771-794.
  14. Dummett, C. O. and G. Barens (1967). Pigmentation of the oral tissues: a review of the literature. Journal of periodontology 38(5): 369-378.
  15. Eisen, D. (2000). Disorders of pigmentation in the oral cavity. Clinics in dermatology 18(5): 579-587.
  16. El Shenawy, H. M., S. A. Nasry, A. A. Zaky and M. A. Quriba (2015). Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes. Open access Macedonian journal of medical sciences 3(3): 447.
  17. Esen, E., M. C. Haytac, I. A. Öz, Ö. Erdo?an and E. D. Karsli (2004). Gingival melanin pigmentation and its treatment with the CO 2 laser. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 98(5): 522-527.
  18. Giannelli, M., L. Formigli and D. Bani (2014). Comparative evaluation of photoablative efficacy of erbium: yttrium-aluminium-garnet and diode laser for the treatment of gingival hyperpigmentation. A randomized split-mouth clinical trial. Journal of periodontology 85(4): 554-561.
  19. Giannelli, M., L. Formigli, M. Lasagni and D. Bani (2013). A new thermographic and fluorescent method for tuning photoablative laser removal of the gingival epithelium in patients with chronic periodontitis and hyperpigmentation. Photomedicine and laser surgery 31(5): 212-218.
  20. Grover, H. S., H. Dadlani, A. Bhardwaj, A. Yadav and S. Lal (2014). Evaluation of patient response and recurrence of pigmentation following gingival depigmentation using laser and scalpel technique: A clinical study. Journal of Indian Society of Periodontology 18(5): 586.
  21. Gurumoorthy Kaarthikeyan, M., N. D. Jayakumar, M. Ogoti Padmalatha, M. Sheeja Varghese and R. Kapoor Pain Assessment Using a Visual Analog Scale in Patients Undergoing Gingival Depigmentation by Scalpel and 970-nm Diode Laser Surgery.
  22. Hanada, K., T. Baba, C. Sasaki and I. Hashimoto (1996). Successful treatment of mucosal melanosis of the lip with normal pulsed ruby laser. The Journal of dermatology 23(4): 263-266.
  23. Hegde, R., A. Padhye, S. Sumanth, A. S. Jain and N. Thukral (2013). Comparison of surgical stripping; erbium-doped: yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study. Journal of periodontology 84(6): 738-748.
  24. Higgins, J. P., D. G. Altman, P. C. Gotzsche, P. Juni, D. Moher, A. D. Oxman, J. Savovic, K. F. Schulz, L. Weeks and J. A. Sterne (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 343: d5928.
  25. Hujoel, P. P. (2004). Endpoints in periodontal trials: the need for an evidence?based research approach. Periodontology 2000 36(1): 196-204.
  26. Karydis, A., P. Bland and J. Shiloah (2011). Management of oral melanin pigmentation. The Journal of the Tennessee Dental Association 92(2): 10-15; quiz 16-17.
  27. Kaur, H., S. Jain and R. L. Sharma (2010). Duration of reappearance of gingival melanin pigmentation after surgical removal-A clinical study. Journal of Indian Society of Periodontology 14(2): 101.
  28. Kaya, G. ?., G. Y. Yavuz, M. A. Sümbüllü and E. Day? (2012). A comparison of diode laser and Er: YAG lasers in the treatment of gingival melanin pigmentation. Oral surgery, oral medicine, oral pathology and oral radiology 113(3): 293-299.
  29. Kishore, A., R. Kathariya, V. Deshmukh, S. Vaze, N. Khalia and R. Dandgaval (2014). Effectiveness of Er: YAG and CO2 lasers in the management of gingival melanin hyperpigmentation. Oral health and dental management 13(2): 486-491.
  30. Ko, H.-J., J.-W. Park, J.-Y. Suh and J.-M. Lee (2010). Esthetic treatment of gingival melanin hyperpigmentation with a Nd: YAG laser and high speed rotary instrument: comparative case report. Journal of periodontal & implant science 40(4): 201-205.
  31. Matys, J. and M. Dominiak (2016). Assessment of Pain When Uncovering Implants with Er: YAG Laser or Scalpel for Second Stage Surgery. Advances in clinical and experimental medicine: official organ Wroclaw Medical University 25(6): 1179.
  32. Moher, D., A. Liberati, J. Tetzlaff and D. G. Altman (2010). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg 8(5): 336-341.
  33. Nakamura, Y., M. Hossain, K. Hirayama and K. Matsumoto (1999). A clinical study on the removal of gingival melanin pigmentation with the CO2 laser. Lasers in surgery and medicine 25(2): 140-147.
  34. Ozbayrak, S., A. Dumlu and S. Ercalik-Yalcinkaya (2000). Treatment of melanin-pigmented gingiva and oral mucosa by CO 2 laser. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 90(1): 14-15.
  35. Ozcelik, O., M. C. Haytac and G. Seydaoglu (2007). Immediate post?operative effects of different periodontal treatment modalities on oral health?related quality of life: a randomized clinical trial. Journal of clinical periodontology 34(9): 788-796.
  36. Rathod, D. M. and S. Mulay (2013). Comparative evaluation of ER: YAG and Nd: YAG Laser for gingival depigmentation. Journal of Dental Lasers 7(1): 38.
  37. Ribeiro, F. V., C. P. Cavaller, R. C. Casarin, M. Z. Casati, F. R. Cirano, M. Dutra-Corrêa and S. P. Pimentel (2014). Esthetic treatment of gingival hyperpigmentation with Nd: YAG laser or scalpel technique: a 6-month RCT of patient and professional assessment. Lasers in medical science 29(2): 537-544.
  38. Romeo, U., F. Libotte, G. Palaia, A. Del Vecchio, G. Tenore, P. Visca, S. Nammour and A. Polimeni (2012). Histological in vitro evaluation of the effects of Er: YAG laser on oral soft tissues. Lasers in medical science 27(4): 749-753.
  39. Rosa, D. S. A., A. C. C. Aranha, C. de Paula Eduardo and A. Aoki (2007). Esthetic treatment of gingival melanin hyperpigmentation with Er: YAG laser: short-term clinical observations and patient follow-up. Journal of periodontology 78(10): 2018-2025.
  40. Roshna, T. and K. Nandakumar (2005). Anterior esthetic gingival depigmentation and crown lengthening: Report of a case. J Contemp Dent Pract 6(3): 139-147.
  41. Sharon, E., B. Azaz and M. Ulmansky (2000). Vaporization of melanin in oral tissues and skin with a carbon dioxide laser: a canine study. Journal of oral and maxillofacial surgery 58(12): 1387-1393.
  42. Soliman, M. M., Y. Al Thomali, A. Al Shammrani and H. M. Elgazaerly (2014). The use of soft tissue diode laser in the treatment of oral hyper pigmentation. International journal of health sciences 8(2).
  43. Sridharan, S., K. Ganiger, A. Satyanarayana, A. Rahul and S. Shetty (2011). Effect of environmental tobacco smoke from smoker parents on gingival pigmentation in children and young adults: a cross-sectional study. Journal of periodontology 82(7): 956-962.
  44. Tal, H., D. Oegiesser and M. Tal (2003). Gingival depigmentation by erbium: YAG laser: Clinical observations and patient responses. Journal of periodontology 74(11): 1660-1667.
  45. Thangavelu, A., S. Elavarasu and P. Jayapalan (2012). Pink esthetics in periodontics-Gingival depigmentation: A case series. Journal of Pharmacy And Bioallied Sciences 4(6): 186.
  46. Trelles, M., W. Verkruysse, J. Segui and A. Udaeta (1993). Treatment of melanotic spots in the gingiva by argon laser. Journal of oral and maxillofacial surgery 51(7): 759-761.
  47. Ünsal, E., C. Paksoy, E. Soykan, A. H. Elhan and M. ?ahin (2001). Oral melanin pigmentation related to smoking in a Turkish population. Community dentistry and oral epidemiology 29(4): 272-277.
                               

[Hanaa El-Shenawy, Ali Fahd, Mohamed Ellabban, Mushira Dahaba and Mohamed Khalifa. (2017); LASERS FOR ESTHETIC REMOVAL OF GINGIVAL HYPERPIGMENTATION: A SYSTEMATIC REVIEW OF RANDOMIZED CLINICAL TRIALS. Int. J. of Adv. Res. 5 (Mar). 1238-1248] (ISSN 2320-5407). www.journalijar.com

Ali Fahd
Faculty of oral and dental medicine, South Valley University, Qena, Egypt (83523)

DOI:

Article DOI: 10.21474/IJAR01/3629      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3629

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