Comparative evaluation of laser-assisted ablative versus non ablative gingival depigmentation: a randomized clinical trial.

Abstract

To compare the clinical efficacy and patient-centered outcome after laser-assisted gingival depigmentation using ablative and non-ablative techniques at 940 nm and 445 nm wavelengths, respectively. A total of 30 participants aged between 18 and 35 years meeting the inclusion criteria were enrolled for the split-mouth randomized clinical trial. Two laser-assisted gingival depigmentation techniques were compared: Ablative gingival depigmentation procedure (AGDP) using a 940 nm diode laser and non-ablative gingival depigmentation procedure (NAGDP) using a 445 nm diode laser. Randomization was performed using the Sequentially Numbered Opaque Sealed Envelope (SNOSE) method while maintaining investigator and observer blinding. Periodontal health parameters Plaque Index (PI), Gingival Index (GI), and intensity of pigmentation, extent of pigmentation, and severity of gingival pigmentation using Dummet Gupta Oral Pigmentation Index (DOPI), Melanin Index (MI) and Gingival Pigmentation Index (GPI) were recorded. Patient Reported Outcome Measures (PROMS) in term of Patient Post-Surgical Discomfort Score (PPSDS), Patient Esthetic Score (PES) and Patient Satisfaction Score (PSS) were also recorded. All clinical outcomes, PES and PSS were recorded by a trained blinded observer at 1 week, 1 month and 3 months interval. PPSDS scores were recorded at 24 h after the intervention. Both the AGDP and NAGDP showed significant reduction in all clinical parameters (DOPI, MI and GPI scores). Sites treated with AGDP showed a greater mean reduction in DOPI, MI and GPI scores than NAGDP treated sites. NAGDP resulted in less post-operative pain and discomfort in terms of PPSDS compared to AGDP. Healing was uneventful in both the groups, but patients favored NAGDP due to reduced discomfort, despite comparable aesthetic outcomes in both groups. AGDP led to significantly better pigmentation reduction, whereas NAGDP revealed better acceptance in terms of PPSDS. The time taken to complete the procedure for AGDP was significantly longer than NAGDP.Registry: https://ctri.nic.in , CTRI: CTR063425567, Registration date: 10 April 2023.