Pigmented gingival tissue or gingival melanin pigmentation (GMP) is a common appearance in parts of the world populated predominantly by non-Caucasians, such as the Middle East and Asia. Literature review shows that the traditional treatment of this phenomenon has been surgical intervention, done in a number of methods 1. However, the use of mechanical intervention can cause a severe trauma for the patient and does not treat the melanocytes, which are the actual cause of the problem. Moreover, with the traditional surgical treatment, the patient largely suffers for relatively small effect/success, with pigmentation returning back within a few months. Carbon dioxide and Er:YAG lasers 2 treatments are shown to be effective and less traumatic than the mechanical interventions, but still with up to a 30% recurrence rate of GMP in 6 months (Er:YAG laser). On the other hand, diode lasers (810nm) seem to show a marked advantage over Er:YAG 3,4. This case review looks at the non-surgical use of a digitally pulsed diode laser for GMP removal 5,6.
My former dental nurse, a Fillipino national, demonstrates a good example of extensive intrinsic gingival pigmentation (Fig 1), which she has had since birth. Often within the Middle East we see more localised gingival pigmentation, which is relatively easier to treat.
The treatment protocol that was used for this treatment was published in the Laser Journal, in February 20095, by Kenneth Luk, a Hong Kong based Dentist. It was based on laser treatment, with the use of elexxion claros 30W, digitally pulsed laser we have at our clinic.