Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes




diode laser, gingival, hyperpigmentation, melanin


BACKGROUND: Gingival hyperpigmentation is a common esthetical concern in patients with gummy smile or excessive gingival display. Laser ablation has been recognized recently as the most effective, pleasant and reliable technique. It has the advantage of easy handling, short treatment time, hemostasis, decontamination, and sterilization effect.

AIM: In the present study we wanted to explore the efficacy of a 980 nm wavelength diode laser in gingival depigmentation clinically by using both VAS and digital imaging method as means of assessment.

METHODS: Diode laser ablation was done for 15 patients who requested cosmetic therapy for melanin pigmented gums. The laser beam delivered by fiberoptic with a diameter of 320 µm, the diode laser system has 980 nm wave lengths and 3 W irradiation powers, in a continuous contact mode in all cases, the entire surface of each pigmented maxillary and mandibular gingiva that required treatment was irradiated in a single session. Clinical examination and digital image analysis were done and the patients were followed up for 3 successive months.

RESULTS: There was a statistically significant change in prevalence of bleeding after treatment, as none of the cases showed any signs of bleeding 1 week, 1 month and 3 months after ablation. No statistically significant change was observed in the prevalence of swelling after treatment The VAS evaluation demonstrated that only 4 patients complained of mild pain immediately after the procedure. No pain was perceived from the patients in the rest of the follow up period. There was no statistically significant change in prevalence of pain immediately after treatment compared to pain during treatment. There was a decrease in cases with mild pain after 1 week, 1 month as well as 3 months compared to pain during treatment and immediately after treatment.

CONCLUSION: Within the limitations of this study, the use of diode laser was shown to be a safe and effective treatment modality that provides optimal aesthetics with minimal discomfort in patients with gingival hyperpigmentation.


Download data is not yet available.


Metrics Loading ...

Plum Analytics Artifact Widget Block

Author Biography

Hanaa M. El Shenawy, National Research Center, Cairo

Associate Professor, Orodental Division department, National Research Centre, Cairo, Egypt.


Dummett CO, Gupta OP. Estimating the epidemiology of oral pigmentation. J Natl Med Assoc. 1964; 56:419–20.

Hegde R, Padhye A, Sumanth S, Jain AS, Thukral N. Comparison of surgical stripping; erbium-doped: yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study. J Periodontol. 2013; 84(6):738-48.

Ciçek Y, Ertaş U. The normal and pathological pigmentation of oral mucous membrane: a review. J Contemp Dent Pract. 2003;4(3):76-86.

Rosa DS, Aranha AC, Eduardo Cde P, Aoki A. Esthetic treatment of gingival melanin hyperpigmentation with Er:YAG laser: short-term clinical observations and patient follow-up. J Periodontol. 2007;78(10):2018-25.

Tal H, Oegiesser D, Tal M. Gingival depigmentation by erbium:YAG laser: Clinical observations and patient response. J Periodontol. 2003;74:1660-1667.

Esen E, Haytac MC, Oz IA, ErdoÄŸan O, Karsli ED. Gingival melanin pigmentation and its treatment with the CO2 laser. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(5):522-7.

Tamizi M, Taheri M. Treatment of severe physiologic gingival pigmentation with free gingival autograft. Quintessence Int. 1996;27(8):555-8.

Bergamaschi O, Kon S, Doine AI, Ruben MP. Melanin repigmentation after gingivectomy: a 5-year clinical and transmission electron microscopic study in humans. Int J Periodontics Restorative Dent. 1993;13(1):85-92.

Gnanasekhar JD, al-Duwairi YS. Electrosurgery in dentistry. Quintessence Int. 1998;29(10):649-54.

Yeh CJ. Cryosurgical treatment of melanin-pigmented gingiva. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86(6):660-3.

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.

Giannelli M, Formigli L, Bani D. Comparative evaluation of photoablative efficacy of erbium: yttrium-aluminium-garnet and diode laser for the treatment of gingival hyperpigmentation. A randomized split-mouth clinical trial. J Periodontol. 2014;85(4):554-61.

Giannelli M, Bani D, Tani A, et al. In vitro evaluation of the effects of low-intensity Nd:YAG laser irradiation on the inflammatory reaction elicited by bacterial lipopolysaccharide adherent to titanium dental implants. J Periodontol. 2009;80:977-984.

Nishidate I, Maeda T, Niizeki K, Aizu Y. Estimation of Melanin and Hemoglobin Using Spectral Reflectance Images Reconstructed from a Digital RGB Image by the Wiener Estimation Method. Sensors. 2013; 13; 7902-7915.

O'Doherty J, McNamara P, Clancy NT, Enfield JG, Leahy MJ. Comparison of instruments for investigation of microcirculatory blood flow and red blood cell concentration. J Biomed Opt. 2009;14(3):034025.

Jakovels D, Spigulis J. 2-D mapping of skin chromophores in the spectral range 500 - 700 nm. J Biophotonics. 2010;3(3):125-9.

Dummett CO, Gupta OP. Estimating the epidemiology of oral pigmentation. J Natl Med Assoc. 1964;56:419–20.

Grover HS, Dadlani H, Bhardwaj A, Yadav A, Lal S. Evaluation of patient response and recurrence of pigmentation following gingival depigmentation using laser and scalpel technique: A clinical study. J Indian Soc Periodontol. 2014;18(5):586-92.

Huskisson EC. Measurement of pain. J Rheumatol. 1982;9:768-769.

Singh V, Gillyar, Kumar S, Bhat M. Comparative evaluation of gingival depigmentation by diode laser and cryosurgery using tetrafluoroethane: 18 month follow up. CAP. 2012;2(3): 129-133.

Berk G, Attici K, Berk N. Treatment of gingival pigmentation with Er, Cr: YSGG laser. J Oral Laser Applications. 2005;5:249–53.

Ishii S, Aoki A, Kawashima Y, Watanabe H, Ishikawa I. Application of an Er: YAG laser to remove gingival melanin hyperpigmentation – Treatment procedure and clinical evaluation. J Jpn Soc Laser Dent. 2002;13:89-96.

Giannelli M, Formigli L, Lasagni M, Bani D. A new thermographic and fluorescent method for tuning photoablative laser removal of the gingival epithelium in patients with chronic periodontitis and hyperpigmentation. Photomed Laser Surg. 2013;31(5):212-8.

Kishore A, Kathariya R, Deshmukh V, Vaze S, Khalia N, Dandgaval R. Effectiveness of Er:YAG and CO2 lasers in the management of gingival melanin hyperpigmentation. Oral Health Dent Manag. 2014;13(2):486-91.

Khakar M, Kapoor R, Jayakumar, Padmalatha O, Varghese SS, Sankari M. Advantages of 980nm diode laser treatment in the management of gingival pigmentation J Laser Dent. 2011;19(3):283-285.

Ozbayrak S, Dumlu A, Ercalik-Yalcinkaya S.Treatment of melanin-pigmented gingiva and oral mucosa by CO2 laser.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000 Jul;90(1):14-5.

Ribeiro FV, Cavaller CP, Casarin RC, Casati MZ, Cirano FR, Dutra-Corrêa M, Pimentel SP. Esthetic treatment of gingival hyperpigmentation with Nd:YAG laser or scalpel technique: a 6-month RCT of patient and professional assessment. Lasers Med Sci. 2014;29(2):537-44.

Simşek Kaya G, Yapici Yavuz G, Sümbüllü 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(3):293-9.

Yamamoto T, Takiwaki H, Arase S, Ohshima H. Derivation and clinical application of special imaging by means of digital cameras and Image J freeware for quantification of erythema and pigmentation. Skin Res Technol. 2008;14(1):26-34.

Villegas C, Climent J, Villegas CR. Using Skin Melanin Layer for Facial Pore Identification in RGB Digital Images. International Journal of Emerging Technology and Advanced Engineering. 2014; 4(8):335-342.

Anderson RR, Margolis RJ, Watenabe S, Flotte T, Hruza GJ, Dover JS. Selective photothermolysis of cutaneous pigmentation by Q-switched Nd: YAG laser pulses at 1064, 532, and 355 nm. J Invest Dermatol. 1989;93(1):28-32.



How to Cite

El Shenawy HM, Nasry SA, Zaky AA, Quriba MA. Treatment of Gingival Hyperpigmentation by Diode Laser for Esthetical Purposes. Open Access Maced J Med Sci [Internet]. 2015 Aug. 7 [cited 2021 Dec. 7];3(3):447-54. Available from:



D - Dental Sciences