Melanin Hyperpigmentation Clinical Trial
Official title:
Minimally Invasive Non-surgical Vitamin C Injection Versus the Conventional Surgical Depigmentation in Treatment of Gingival Hyperpigmentation of the Anterior Esthetic Zone: Prospective Study
Although physiologic gingival hyperpigmentation is not a pathologic condition, it is considered one of the main esthetic problems in dentistry. It was found that the attached gingiva is the most frequently pigmented intraoral tissues followed by the papillary gingiva and the alveolar mucosa
In addition to all of the previously mentioned actions of vitamin C, it was found to be
involved in depigmentation due to several factors that not only depend on its direct effect
on melanin and melanocytes but also due to the overall effect on the applied tissues. Melanin
is one of the main reservoir for ROS, copper and calcium in the tissue cells . Once vitamin C
is introduced to the target tissue, it binds efficiently to melanin due to the ROS, calcium
and copper content which causes intracellular deficiency of these items and the inability of
the cells to produce melanin. Calcium deficiency causes failure of melanocytes to perform
cellular adhesion to keratinocytes as calcium is essential to form cadherins . Adhesion to
keratinocytes is important stimulator to melanocytes in order to produce melanin, format
dendrites and transfer the produced melanin to neighboring cells . Shortage of the
intercellular copper limits the formation of tyrosin, tyrosinase enzyme and peroxidase enzyme
which in turn stops the melanin production .
Therefore, the aim of the present study is to compare the clinical efficiency of the
non-surgical intraepidermal injection of vitamin C in comparison to the gold standard
surgical technique (scalpel technique) for gingival depigmentation.
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