Esthetic treatment of gingival melanin hyperpigmentation with Er:YAG laser:: Short-term clinical observations and patient follow-up

Background: Recently, the erbium-doped:yttrium, aluminum, and garnet (Er:YAG) laser has been applied effectively for periodontal soft tissue management. The purpose of this study was to report removal of gingival melanin pigmentation using an Er. YAG laser in a short-term clinical observation. Methods: Five patients with gingival melanin pigmentation participated in this study. Irradiation was performed at 64.0 mJ/pulse (8.5 J/cm(2) per pulse) and 10 Hz under water spray in contact mode. Clinical parameters, such as bleeding, swelling, redness, and healing, were evaluated immediately after the surgery and 24 hours, I and 4 weeks, and 3 months later. A visual analog scale was used to evaluate the pain level experienced. Results: The Er:YAG laser effectively ablated the epithelial tissue containing melanin pigmentation. At I week, gingiva showed fast epithelization with a healthy appearance in all cases. At 2 weeks, gingiva showed satisfactory healing with significant improvement in color and recovery of the tissue thickness. At I month, complete healing was observed; after the 3-month evaluation, no gingival deformity or recession was observed. However, there was a slight recurrence in one case. Conclusion: Removal of gingival melanin pigmentation can be performed safely by Er:YAG laser resulting in an esthetically signiflcant improvement of gingival discoloration.