Comparison of gingival depigmentation with Er,Cr:YSGG laser and surgical stripping, a 12-month follow-up

  • Leila Gholami
  • Somayeh Ansari Moghaddam
  • Mohammad Ayoub Rigi Ladiz
  • Zohreh Molai Manesh
  • Hadi Hashemzehi
  • Alireza Fallah
  • Norbert Gutknecht
Original Article


Gingival melanin hyperpigmentation is an esthetic concern for many individuals. In this study, we compared the standard surgical removal method with two different Er,Cr:YSGG laser settings in order to find the best treatment method. In 33 dental arches, the following three treatment groups were comparatively evaluated: (1) surgical stripping, (2) removal with laser setting 1 (4.5 W, 50 Hz, 100% water, 80% air, 60 μs, 800 μm Tip; MZ8), and (3) laser setting 2 (2.5 W, 50 Hz, 20% water, 40% air, 700 μs, 800 μm Tip; MZ8). We comparatively evaluated pain, patient satisfaction and wound healing, treatment time, and the amount of bleeding. Re-pigmentation was evaluated after 1 and 12 months by Hedin and Dummet pigmentation scores. Laser setting 1 had the best results regarding pain and patient satisfaction, although not statistically significant (P > 0.05). Wound healing results were better using lasers compared to surgical stripping (P < 0.05). Laser setting 1 was a faster procedure with mild amounts of bleeding. The least amount of bleeding was seen with laser setting 2. After 1 month, only two cases of the laser setting 2-treated areas showed an isolated pigmented area in the papilla; at 12 months, the mean Hedin indexes were still less than 2 and mean Dummett index less than 1 in all treatment techniques, with the lowest scores seen in the laser setting 1 sites. Based on our results, Er,Cr:YSGG laser can be more convenient for gingival depigmentation compared to surgical blade. Although not statistically significant, laser setting 1 with shorter pulse duration and higher water spray showed better overall results. However, laser setting 2, with longer pulse duration and less water spray, resulted in better coagulative effects and can be used to control bleeding wherever necessary in clinical practice.


Laser Wound healing Surgical blade Gingival depigmentation 



The authors would like to thank the staff at the Oral and Dental Research Center of Zahedan University of Medical Sciences for their valuable contribution.

Compliance with ethical standards

Conflict of interest

This study was supported by a research grant from Zahedan University of Medical Sciences, Oral and Dental Research Center, and no external funding, apart from the support of this institution, was available for this study (Project Grant no. 7346). The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in this study on human participants were in accordance with the ethical standards of our institutional research committee (IR.Zaums.REC.1394.181), the 1964 Helsinki Declaration, and its later amendments. The study is registered in the Iranian Registry of Clinical Trials (IRCT ID IRCT2016113018493N3).

Informed consent

An informed consent was obtained from all participants.


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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Periodontology, Faculty of DentistryHamadan University of Medical SciencesHamadanIran
  2. 2.Oral and Dental research center, Department of Periodontology, Faculty of DentistryZahedan University of Medical SciencesZahedanIran
  3. 3.Dentist, Oral and Dental research centerZahedan University of Medical SciencesZahedanIran
  4. 4.Department of Oral and Maxillofacial Surgery, Faculty of DentistryHamadan University of Medical SciencesHamadanIran
  5. 5.Laser Dental CenterAachenGermany
  6. 6.Department of Conservative Dentistry, Periodontology and Preventive DentistryRWTH AachenAachenGermany

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