"Laser assisted gingival melanin depigmentation using diode 450 nm; ablative vs. non-ablative techniques: randomized clinical trial"

Gingival pigmentation is a common cosmetic concern that can negatively impact a patient's smile aesthetics. Laser-assisted depigmentation has emerged as a reliable and effective treatment modality. The study aimed to compare the efficacy, comfortability of the patient, and the post-operative outcomes among patients who underwent either an ablative or a non-ablative diode 450 nm laser for gingival depigmentation. A split-mouth, single-blind, randomized controlled trial was conducted on 20 subjects exhibiting physiological pigmentation scores of 2 or more, as assessed by the Dummett index. A diode laser emitting 450 nm wavelength was employed. One side of each subject's mouth was randomly assigned to receive ablative laser treatment, while the contralateral side received non-ablative treatment. Primary outcome measures included changes in Oral Pigmentation Index and Melanin Pigmentation Index scores at baseline and at 1, 6, and 12 months' post-treatment. Patient perception of pain and discomfort was assessed using a modified McGill Pain Questionnaire. Both ablative and non-ablative techniques demonstrated significant reductions in OPI and MPI scores at all follow-up time points. Immediate and total depigmentation was achieved using ablative techniques, which showed fewer rates of re-pigmentation but higher intraoperative discomfort. In contrast, non-ablative techniques result in less pain but required more sessions to obtain optimal results. The choice of technique should be individualized based on patient preferences and clinician expertise. Non-ablative treatment may be preferred for patients seeking minimal discomfort and rapid healing, while ablative treatment may be suitable for patients who prioritize complete pigment removal in one session.