Professional Documents
Culture Documents
Journal of
Dental Science
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ESTHETIC GINGIVAL
DEPIGMENTATION :
A CASE REPORT
Case
Report
Abstract : Physiological gingival pigmentation is not a medical problem but it may pose
esthetic concern for many people. Esthetic gingival depigmentation can be performed in
such patients. Here we present a case in which a simple and effective depigmentation
using scalpel was performed without the use of any sophisticated apparatus.
Introduction:
Physiological pigmentation of the oral mucosa is clinically
manifested as multifocal or diffuse bluish/black pigmentation
with variable amount in different ethnic groups. 1 It occurs
due to presence of melanin pigment. Patients usually
complain of blackening of gums. It can be reduced or
eliminated by a periodontal plastic Surgical procedure known
as Gingival Depigmentation. Various methods can be
employed for this procedure. 2 In present case, we used
Surgical scalpel technique which is very simple and effective
treatment for gingival pigmentation.
KEY WORDS :
Depigmentation, Gingiva,
Scalpel Surgery, Physiologic
Pigmentation, Melanin.
Source of support: Nil
Conflict of interest: Nil
Case Report:
A 15 year old male patient visited department of Periodontics
with the chief complaint of "black" colored gums (Fig. 1). His
oral examination revealed that he had a generalized black
pigmented upper gingiva. Lower anterior gingiva was
hyperplastic and pigmented from right canine to left canine.
The patient requested for any kind of esthetic treatment which
could make her "black" colored gums look better.
Gingivectomy of lower anterior gingiva and de-epithelization
using a scalpel was planned to perform the depigmentation.
The entire procedure was explained to the patient and written
consent was obtained. A complete medical, family history
and blood investigations were carried out to rule out any
contraindication for Surgery.
Local anesthesia was infiltrated (Lignocaine with
adrenaline in the ratio 1:100000 by weight). A Bard Parker
handle with a No.15 blade was used to remove the pigmented
epithelial layer. Gingivectomy and gingival contouring was
performed. (Fig 2) Complete de-epithelization was done.
(Fig. 3) Pressure was applied with sterile gauze to control
hemorrhage. Entire pigmented epithelium along with a thin
layer of connective tissue was removed with the scalpel and
the exposed surface was irrigated with saline. Care was taken
Fig. 1: Pre-operative
photo showing gingival
pigmentation
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Fig. 3: No.15 blade being used for gingivectomy and deepithelization of pigmented mandibular gingiva.
Conclusion:
The depigmentation procedure was successful and the patient
was satisfied with the result. Thus, we conclude that
depigmentation of hyper pigmented gingiva by scalpel
Surgery with bur abrasion is simple, easy to perform, cost
effective and above all it causes less discomfort and is
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case report. Dental Update, 1994; 21(6):236-237.
Stabholz A, Zeltser R, Sela M, Peretz B, Moshonov J,
Ziskind D, Stabholz A.: The use of lasers in dentistry:
principles of operation and clinical applications.
Compendium of Continuing Education in Dentistry
2003; 24(12): 935-948.
9. Ozbayrak S, Dumlu A, Ercalik-Yalcinkaya S: Treatment
of melanin-pigmented gingiva and oral mucosa by CO2
laser. Oral Surgery Oral Medicine Oral Patholology Oral
Radiology & Endodontics, 2000; 90 (1) :14-15.
10. Almas K, Sadiq W: Surgical Treatment of Melanin
Pigmented Gingiva: An Esthetic Approach. Indian
Journal of Dental Research, 2002; 13( 2): 70-73.
11. M o k e e m S A : M a n a g e m e n t o f G i n g i v a l
Hyperpigmentation by Surgical Abrasion: Report of
Three Cases. Saudi Dental Journal, 2006 ; 18( 3) , 162166.
8.
Correspondence :
Dr. Neha Bansal,
Post Graduate student,
Department of Periodontics & Community Dentistry,
Dr. Ziauddin Ahmad Dental College,
Aligarh Muslim University, Aligarh - 202002, India.
Email:- nehabansal2k5@gmail.com,
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