Management of gingival hyperpigmentation using microneedling with ascorbic acid vs. scalpel technique: A comparative split-mouth study.

Background: In enhancing smile aesthetics, managing gingival hyperpigmentation has become increasingly important. Gingival hyperpigmentation can often affect individuals psychologically, prompting many individuals to seek treatment. Microneedling (MN) is emerging as a popular solution for minimizing gingival hyperpigmentation through a minimally invasive approach. In contrast, the scalpel technique is an established surgical intervention to remove pigmented tissue directly. This study investigated the effectiveness of these two techniques in terms of clinical and patient-related outcomes.

Methods: This randomized control clinical study included 20 subjects with hyperpigmentation in both maxillary and mandibular arches. One arch of each subject was randomly allocated to MN using the coin toss method, and the other arch was assigned to the scalpel technique. Intraoperative bleeding, postoperative pain scores, wound healing index, Dummett oral pigmentation index (DOPI), and Hedin melanin index (HMI) were evaluated.

Results: MN showed significantly better results in terms of pain, bleeding scores, DOPI, and HMI (P<0.01). In contrast, the scalpel technique revealed significantly superior results in terms of wound healing.

Conclusion: Being a gold standard, the scalpel technique offers precision but is accompanied by more bleeding and less patient compliance due to its invasiveness. Conversely, the MN technique emerges as an advanced technique, demonstrating less pain and bleeding, thus enhancing patient comfort and overall satisfaction, aligning with the evolving preferences for minimally invasive dental procedures.