Microneedling Technique with Vitamin C Versus Surgical Abrasion in the Treatment of Gingival Racial Pigmentation: RCT

The normal color of gingival tissues is pale pink, but part of the population has a gingival melanin pigmentation caused by excessive melanin deposition by the melanocytes mainly located in the basal and suprabasal cell layers of the epithelium.That varies according to the degree of keratinization, the thickness of the gingiva, the degree of vascularization and the presence of melanocytic cells. The gingiva may be pigmented either physiologically or pathologically, such as drugs, heavy metal ingestions/poisonings, endocrine disturbances, exposure to ultraviolet (UV) rays, inflammation, benign and malignant lesions, cultural intentional tattooing, and smoking .But, the most common pigmentations affecting the protective gingiva are lesions of melanocytic origin, or melanocytic pigmentation. For depigmentation of gingiva, different treatment modalities have been reported, such as bur abrasion, scraping, partial thickness flap, cryotherapy, electrosurgery and diode laser have been tried for depigmentation. The surgical approaches although the most commonly used to manage gingival hyperpigmentation are accompanied by fear, bleeding, pain, large postoperative wound and recurrence. In contrast to any other depigmentation procedure, in micro needling technique the patient was able to see these excellent aesthetic results after 3 days. However, healing after scalpel depigmentation takes 7-10 days, and other procedures take more than 2 weeks to heal. In addition, a dressing is not necessary after the procedure since microholes are created without perfused bleeding and heal quickly. It is reported that derma pen with ascorbic acid has been used very successfully in ginigval depigmention. Based on this background, the aim of this study was to evaluate and compare the effects of the surgical abrasion and microneedling technique with ascorbic acid for gingival depigmentation.