الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
O
ral melanin pigmentation has been observed in all races and is usually limited to the keratinized mucosa. It can become an aesthetic issue for many a patient, especially when it is located in the anterior labial gingiva, is not uniform in appearance, and is associated with a high smile line.
Gingival depigmentation is a periodontal plastic surgical procedure whereby the gingival hyperpigmentation is removed or reduced with the help of various techniques. The first and foremost indication for depigmentation is the patient demand for improved aesthetics.
The surgical methods of depigmentation include the scalpel surgical technique, cryosurgery and electrosurgery. Recently, lasers of different varieties such as neodymium, aluminum-yttrium-garnet (Nd-YAG) lasers, diode lasers, erbium-YAG lasers, and carbon dioxide (CO2) laser have been introduced. Also, bur abrasion chemical methods of depigmentation, referred to as chemoexfoliation, have been employed which use agents such as 90% alcohol and 95% phenol.
Other techniques aimed at masking the pigmented gingival from the less pigmented area have used free gingival grafts and acellular dermal matrix allografts.
The present study was conducted on thirty two individuals who have gingival melanin hyperpigmentation; eight individuals managed by scalpel scrapping, eight individuals managed by cryotherapy, eight individuals managed by diode laser and eight individuals managed by topical vitamin c application. The study included males and females with an age range from 18 to 40 years old.
Various clinical parameters were recorded before and after depigmentation procedures such as DOPI assessment, melanin pigmentation index, recurrence rate …etc
Biopsy samples were taken from all subjects to compare melanin in tissues before and after depigmentation using the four different modalities.
In the current study, all surgical techniques showed the best results regarding depigmentation results together with high patient satisfaction outcomes while, the non surgical vitamin c topical application showed promising results although failing to completely eradicate the gingival melanin hyperpigmentation.