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ePaper created 2018-03-14, 11:21:34 | version 1.38.0
case report | it was an aesthetic concern for our patient and appeared as darkened gingiva.1 Case report There are many techniques for the treatment of gin- gival hyperpigmentation, such as gingivectomy us- ing scalpel, rotary, electrosurgery, laser and chemical agents to resurface the gingiva and applying cryosur- gery to eliminate melanotic cells.2–4 These abrasive tech- niques involve a non-favourable appearance during the healing process. Even though depigmentation using a carbon dioxide laser provides less discomfort, wound coverage using a gingival dressing is still needed.4 Non-abrasive techniques that use laser for gingival de- pigmentation are worth investigating, as well as the technique of using a tissue testing patch for fulfilling aesthetic concerns. This case report presents a new non-abrasive tech- nique using an 808 nm diode laser in the case of physi- ological hyperpigmentation of the gingiva. The laser test patches were used before treating the whole area in order to gain greater patient satisfaction regarding the gingival colour. A 22-year-old Thai woman presented to the oral surgery clinic, faculty of dentistry at Khon Kaen University, com- plaining of brownish gingiva, particularly at the maxillary anterior teeth. The patient reported no underlying disease or any medicine allergy. Furthermore, she reported no his- tory of smoking. Extraoral examination found an oral pig- mented lesion at the lower lip (Fig. 1). Intraoral examination found pigmented lesions at the attached gingivae from the maxillary right canine to the maxillary left canine (Fig. 2). The patient was diagnosed with physiological pigmenta- tion of the gingiva and a melanotic macule on the lower lip. Incisional biopsy was conducted under local anaes- thesia at the attached gingiva between the maxillary left central incisor and the lateral incision in order to deter- mine the depth of the melanin pigment in the gingiva. Haemostasis was achieved using an 808 nm diode laser at 0.5 W for 5 seconds (Fig. 3). Then the two test patches were undertaken at the at- tached gingiva (Fig. 3) between the maxillary right lateral Fig. 5 Fig. 6 Fig. 7 Fig. 8 Fig. 5: The immediate post-laser depigmentation photograph showed no photo-ablative effect. Fig. 6: After seven days, the area treated showed partial re- covery with mildly reddened gingiva at the central incisors. There was no ulcerated area clinically. Fig. 7: After two weeks, the area treated showed complete healing of the gingiva. Fig. 8: After three weeks, the area treated showed uniformly normal-coloured gingiva. 09 1 2018