Title: Gingival Depigmentation Using Surgical Excision Technique: A Histopathological Case Series
Authors: Dr RG Shiva Manjunath, Arijit Sarkar, Neeraj Chandra, Vartika Shrivastava, Akhilesh Shewale
DOI: http://dx.doi.org/10.18535/jmscr/v3i10.38
Melanin pigmentation of the gingiva occurs in all races. Melanin, a brown pigment, is the most common natural pigment contributing to endogenous pigmentation of gingiva and the gingiva is the most frequently pigmented intra oral site. According to the early prevalence studies the distribution of oral pigmentation in black individuals is as follows gingiva 60% hard palate, 61% mucous membrane,22% and tongue 15%. Gingival pigmentation occurs as a diffuse, deep-purplish discoloration or as irregularly shaped brown and light brown patches. It may appear in the gingiva as early as 3 hours after birth and often is the only evidence of pigmentation. Melanin pigmentation is the result of melanin granules produced by melanoblastsinterwined between epithelial cells at the basal layer of gingival epithelium. This case series presents a simple surgical technique of De-epithelization which has been successfully used to treat gingival hyperpigmentation caused by excessive melanin deposition and highlights the relevance of an esthetically pleasing smile specially in smile conscious individuals 1. Martini FH, Timmons MJ. Human Anatomy. New Jersey: Prentice Hall Publishers Company, 1995 2. Shafer WG, Hine MK, Levy BM. Text book of oral Pathology. Philadelphia: WB Saunders co; 1984; pp. 89-136 3. Unsal E, Paksoy C, Soykan E, Elhan AH, Sahin M. Oral melanin pigmentation related to smoking in a Turkish population. Community DentOralEpidemiol. 2001; 29:272–77 4. Meleti M, Vescovi P, Mooi WJ, van der Waal I. Pigmented lesions of the oral mucosa and perioral tissues: a flow-chart for the diagnosis and some recommendations for the management.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008 May;105(5):606-16. 5. Dummett CO: Oral pigmentation. First symposium of oral pigmentation. J Periodontol 1960;31:356 6. Marie-Françoise Liébart, Caroline Fouque-Deruelle, Alain Santini,François-Laurent Dillier, Virginie Monnet-Corti, Jean-Marc Glise et al . Smile Line and Periodontium Visibility. Perio 2004:Vol 1, Issue 1:17-25 7. Tal H, Landsberg J, Kozlovsky A. Cryosurgical depigmentation of the gingiva. A case report. J Clin Periodontol 1987;14:614–7. 8. Deepak P, Sunil S, Mishra R, Sheshadri P. Treatment of gingival pigmentation: a case series. Indian J Dent Res 2005;16:171–6. 9. Atsawasuwan P, Greethong K, Nimmanon V. Treatment of gingival hyperpigmentation for esthetic purposes by Nd : YAG laser: report of 4 cases. J Periodontol 2000;71:315–21. 10. Simsek Kaya G, Yapici Yavuz G, Sumbullu MA, Dayi E. A comparison of diode laser and Er : YAG lasers in the treatment of gingival melanin pigmentation. Oral Surg, Oral Med, Oral Pathol Oral Radiol 2012;113:293–9. 11. Nakamura Y, Hossain M, Hirayama K, Matsumoto K. A clinical study on the removal of gingival melanin pigmentation with the CO(2) laser. Lasers Surg Med 1999;25:140–7. 12. Mani A, Mani S, Shah S, Thorat V. Management of gingival hyperpigmen-tation using surgical blade, diamond bur and diode laser therapy: a case report. J Oral Laser Appl 2009;9:227–32. 13. Hirschfeld I, Hirschfeld L. Oral pigmentation and a method of removing it. Oral Surg Oral Med Oral Pathol 1951;4:1012–6. 14. Tamizi M, Taheri M. Treatment of severe physiologicgingival pigmentation with free gingival autograft. Quintessence Int 1996;27:555–8. 15. Novaes AB Jr, Pontes CC, Souza SL, et al. The use of acellular dermal matrix allograft for the elimination of gingival melanin pigmentation: case presentation with 2 years of follow-up. Pract Proced Aesthet Dent: PPAD 2002;14:619–23, quiz 24. 16. Perlmutter S, Tal H. Repigmentation of the gingiva following surgical injury. J Periodontol 1986;57:48–50. 17. Yi Hung Lin, , Yu Kang Tu, Chuntai Lu, Wen Chen Chung, Chiung Fang Huang, Mao Suan Huang et al . Systematic Review of Treatment Modalities for Gingival Depigmentation: A Random-Effects Poisson Regression Analysis. J Esthet Restor Dent 26:162–178, 2014.Abstract
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