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Gingival Depigmentation Using CO₂ Laser and Scalpel Technique with PRF Membrane-A Clinical and Histological Study

Waqas N. Ansari*, Sangeeta D. Muglikar, Prerna S. Ghodke, Rashmi V. Hegde, Salika Sheikh, Hamed Badaam

Introduction: Gingival hyperpigmentation is the increase in pigmentation beyond the expected degree. There are various methods for the removal of pigmentation (depigmentation) which can be surgical stripping, use of lasers, chemicals etc. This is a spilt mouth study where surgical stripping and CO₂laser depigmentation along with the added benefits of Platelet-Rich Fibrin (PRF) membrane have been evaluated clinically and histologically.

Materials and Method: 40 sites from 10 patients who were aesthetically conscious of their dark gums were enrolled in the study and a spilt mouth treatment protocol was followed where there were 4 groups as follows: 1) Group 1: CO₂laser sites with PRF membrane (n=10). 2) Group 2: CO₂ laser sites without PRF membrane (n=10). 3) Group 3: Scalpel technique/surgical stripping sites with PRF membrane (n=10). 4) Group 4: Scalpel technique/surgical stripping sites without PRF membrane (n=10). All the above groups were performed on one patient in one single sitting and by a single operator and follow up were done at 1 day, 1 week and 10 days assessing the visual analogue scales and landrys wound healing index. Histological specimen was obtained on the 7^th day from the lateral incisor regions of all four groups.

Results: At day 1 of the follow up it was noticed that Group 1 had the least pain, followed by Group 3 and then the groups where PRF membrane was not used. At 10 days post operatively, all the groups showed no pain. Considering healing index, also the groups with PRF membrane showed better healing as compared to the groups where PRF membrane was not used. Therefore it was shown in the study that PRF membrane has helped in better healing as well and reducing the pain post operatively.

Conclusion: Within the limitations of the study, it can be concluded that, CO₂laser with PRF membrane has shown faster healing and lesser pain perception therefore it can be used as a routine procedure for depigmentation.