Treatment of severe physiologic gingival pigmentation with free gingival autograft

Melanin is normally found in the skin of all people, and normal pigmentation of the intraoral tissues is a relatively frequent finding. The highest rate of gingival pigmentation has been observed at the incisors. Until recently, however, very little attention has been paid to the esthetic treatment of severe gingival pigmentation. To answer the cosmetic demand for a pleasing smile, pigmented gingiva was replaced with an unpigmented free gingival autograft in 10 patients. At least two areas in each patient were grafted. In all 10 areas in which the recipient site received full-thickness bed preparation, no evidence of repigmentation was found after 4.5 years. Of the 10 areas that received partial-thickness bed preparation, only one exhibited repigmentation (after 1 year).