Gingival Hyperpigmentaion Clinical Trial
Official title:
Ascorbic Acid Versus Diode Laser in the Treatment of Gingival Hyperpigmentation: Histological and Clinical Randomized Study
Vitamin C affect the melanocytes function not the number while diode laser cause melanocytes destruction. Although diode laser and vitamin C have proved their effectiveness in depigmentation in previous studies, there are no published studies compared the effect of diode laser and vitamin C on melanocytes and melanosomes clinically and histologically.
Cosmetic dentistry is usually centered on aesthetic restorative procedures but it may also
involve the appearance of the gingiva, especially when it is located in the anterior labial
region. Oral pigmentation may be physiological or pathological in nature. Better esthetics
results of depigmentation were achieved with diode laser than conventional scalpel and with
rotary abrasion, also diode laser is effective and safe in removal of gingival
hyperpigmentation and repigmentation doesn't occur.When choosing a depigmenting agent, it is
important to differentiate between substances that are toxic to the melanocyte and substances
that interrupt the key steps of melanogenesis. Vit. C interacts with copper ions at the
tyrosinase-active site and inhibits action of the enzyme tyrosinase, thereby decreasing the
melanin formation.
This randomized comparative clinical study was conducted on ten patients attending the
outpatient clinic of the Oral Medicine and Periodontology department, Faculty of Dentistry,
Ain Shams University and seeking treatment for their gingival hyperpigmentation for esthetic
reason.
The study was conducted after receiving an ethical clearance from the Research Ethics
Committee of Ain Shams University, Faculty of Dentistry; that the study follows the ethical
guidelines of research. The patients clearly understood the purpose of this study and signed
an informed consent.
According to the study results, vit C treated patients showed no or little repigmentation
after six months post treatment. Conversely, diode laser treated patients showed significant
recurrence of gingival pigmentation after six months post treatment. These could be
attributed to the blocking effect of vitamin C on the existing melanocytes to form new
melanoseomes, however diode laser cause removal of the existing melanocytes that may cause
formation of new melanocytes (migrating from neighboring melanocytes from the adjacent area
of the gingiva) with the ability of forming new melanosomes and causing repigmentation.
Histopathological assessment revealed that both treatment modalities caused significant
reduction in MAF after six months post treatment.
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