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The effects of applying hyaluronic acid gel after gingival depigmentation using a scalpel or diode laser: a
Objective:
The aim was to evaluate the impact of cross-linked hyaluronic acid (HA) gel on the clinical outcomes of gingival depigmentation using scalpel or diode laser techniques.
Method And Materials:
In this single-blinded, prospective, randomized clinical trial, 44 patients who had maxillary gingival pigmentation were allocated into a test group (HA+) that had HA gel applied, and a control group (HA-). Depigmentation was performed using a scalpel or a 940-nm diode laser (0.8 W) in a split-mouth design. The follow-up visits were at 3, 7, 14, and 30 days. Clinical measurements included the Wound Healing Index (WHI), digital measurement of the non-healed remaining area (NRA), pigmentation, pain, and Bleeding Index.
Results:
At 30 days, WHI and NRA showed similar results in both HA- and HA+ groups (P > .05). In contrast, the diode laser had significantly improved mean WHI by day 7 and 14, and mean NRA by day 3 and 7 (WHI = 1.55 and 1.02; NRA = 28.7% and 2.1%, respectively) in comparison to the scalpel (WHI = 1.70 and 1.14; NRA = 52.6% and 5.0%, respectively). The decrease in pigmentation intensity and distribution was highly significant (P .001) and similar between the HA-, HA+, scalpel, and laser groups at 1 month (P > .05). The pain did not differ significantly between HA- and HA+ groups (P > .05). However, pain was significantly less with the diode laser than the scalpel (P .05). Significantly less bleeding occurred with the diode laser than the scalpel (P .001).
Conclusion:
HA did not confer additional benefits to promote wound healing and reduce pain in depigmentation. Diode laser is a convenient method of depigmentation that improves initial healing and decreases initial pain, with reduced bleeding. Gingival hyperpigmentation is a major esthetic issue for many individuals. Laser and scalpel treatments produce equivalent esthetic outcomes.
