Esthetic treatment of gingival melanin hyperpigmentation with a Nd:YAG laser and high speed rotary instrument: Comparative case report

Purpose: The purpose of this study was to evaluate the clinical effectiveness of and patient's satisfaction with treatment of gingival melanin hyperpigmentation with a Nd:YAG laser and a high speed rotary instrument. Methods: Three patients with melanin hyperpigmentation in the anterior parts of the gingiva were chosen for this case study. Clinical photographs were taken at the preoperative state and three patients were treated under local anesthesia. In the maxilla, the gingival deepithelization was conducted with a high speed diamond bur, whereas, in the mandible with a Nd:YAG laser. Clinical photographs were taken immediately after the procedures and at the 1st, 2nd, and 4th week to evaluate clinical color changes. A week after the procedure, the patients filled out a questionnaire about any pain or discomfort. At the 4th week after the procedure, the patients filled out questionnaires about esthetic aspects of the results of treatment. Results: In all cases, both anterior gingival areas were depigmented with satisfaction and the patients did not complain of severe pain or discomfort. At the 1st week of healing, the gingiva showed moderate to fast epithelization. Two weeks after the procedure, clinically, the gingiva showed almost complete healing. Four weeks after the procedure, there was significant improvement in gingival melanin hyperpigmentation. Conclusions: The Nd:YAG laser and the high speed rotary instruments seem to be effective for the esthetic treatment of gingival melanin hyperpigmentation.