Using Platelet-Rich Fibrin to Remove Graphite Tattoos May Yield Excellent Long-Term Result

Area of Science:

• Oral and Maxillofacial Surgery
• Periodontology
• Regenerative Medicine

Background:

• Graphite tattoos are rare oral pigmentations typically caused by childhood injuries involving pencils penetrating the oral mucosa.
• These tattoos stain deeper than typical pigmentations, appearing as grayish-black macules on the gingiva.
• Aesthetic concerns often prompt treatment for these lesions.

Observation:

• A 41-year-old male presented with a graphite tattoo on the labial gingiva near maxillary incisors, linked to a childhood habit of chewing pencils.
• The lesion was diagnosed as a graphite tattoo based on history and clinical appearance.
• Surgical excision of the pigmented gingiva was performed.

Findings:

• A novel approach involved covering the exposed bone with two layers of platelet-rich fibrin (PRF) membrane.
• The PRF membrane served to protect the bone and provide a matrix for gingival fibroblast migration.
• Healing was monitored over 8 weeks, showing satisfactory clinical and aesthetic outcomes.
• Long-term follow-up at 8 years revealed creeping attachment and no recurrence over 13 years.

Implications:

• This case demonstrates a successful and durable treatment for graphite tattoos using a combination of surgical excision and PRF.
• The use of PRF offers a regenerative approach to protect exposed bone and promote mucosal healing after tattoo removal.
• This technique provides a viable option for improving aesthetics and function in patients with oral graphite tattoos.