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Non-Ablative Gingival Depigmentation
Diode Laser 450 nm
Walid Altayeb DDS, MSc, PhD
This report presents a clinical case of successful gingival hyperpigmentation management in a 31-year-old female, utilizing non-ablative laser depigmentation with a 450-nm diode laser, eliminating the need for anesthesia and surgical intervention.
Patient Presentation
The patient presented to the clinic with the chief complaint of darkened gum. This aesthetic concern was further exacerbated by the patient's excessive gingival display, leading to heightened awareness and dissatisfaction with her smile.
Diagnosis
Physiological gingival hyperpigmentation
Treatment Planning
Laser-Assisted Gingival Depigmentation
Non-ablative gingival depigmentation relies on selective photothermolysis utilizing specific laser wavelength of 450 nm, that is absorbed by melanin. This process effectively disrupts the pigmentation without necessitating the surgical removal of gingival tissues.
Laser Wavelength & Parameters
The diode multiwavelength laser device (S3™, Pioon, China) was selected, specifically utilizing the 450 nm wavelength. This choice was based on the 450 nm demonstrate superior absorption in melanin compared to other diode laser wavelengths commonly used in dentistry.
Non-ablative depigmentation parameters
A 400 μm tip was utilized with a average power of 0.8 W in pulsed mode, a duty cycle of 15%, a pulse duration of 150 μs, a frequency of 1000 Hz, and a fluence of 19 J/cm² at the tissue surface.
Clinical Technique
The spot size was controlled by transparent space maintainer at a distance of 5 mm from the gingival surface
Laser irradiation was performed using a circular motion of the laser tip. No anesthesia was administered.
The change to gray color of pigmented area immediately after laser irradiation.
Treatment Outcomes
Immediate postoperative view after laser irradiation.
At the one-week follow-up post-non-ablative depigmentation, clinical examination revealed some residual pigmentation spots.
One week post-initial treatment, the residual pigmentation spots were re-treated using the same laser settings.
Treatment Outcomes
The clinical appearance of the gingiva exhibited a normal pink color at 2-week postoperative follow-up.
Conclusion & Future Implications
In conclusion, this case report demonstrates the efficacy of the 450 nm diode laser for gingival depigmentation through a non-ablative technique. This technique offers a compelling alternative to traditional surgical ablative laser procedures for managing physiological hyperpigmentation.
Advantages of the non-ablative technique:
  • Minimally invasive, non-surgical technique.
  • Anesthesia-free procedure due to reduced intraoperative discomfort.
  • Minimal to no postoperative pain.
  • Effective depigmentation with targeted melanin absorption.
  • Positive patient aesthetic outcomes.
Walid Altayeb DDS, MSc, PhD
President of Academy of Laser Dentistry 2024-2025
• Master of Science in Periodontics in 2004 ,Doctorate of Philosophy PH.D in Periodontics in 2007, Master of Academy of Laser Dentistry in 2014
• Guest Professor Faculty of Dental Medicine, Istanbul Ayden University, Istanbul, Turkey
• Prof. a c at Master Laser Dentistry Università Cattolica del Sacro Cuore di Roma, Italy
• Over the last seven years, he has provided more than 1574 CPD hours in the field of Esthetic Periodontics, Implantology, and Laser Dentistry.
• Dr. Altayeb is working in private as Periodontist and Implantologist in Tamim Dental Polyclinic, Doha, Qatar & Dr. Imran Aestheticare Center, Dubai, UAE.