Evaluation of Gingival Depigmentation by Different Surgical Techniques and Prevention of Repigmentation using Vitamin C and its Correlation with Tyrosinase Gene Activity

Abstract

Title: Evaluation of Gingival Depigmentation by Different Surgical Techniques and Prevention of Repigmentation using Vitamin C and its Correlation with Tyrosinase Gene Activity newlineAbstract newlineBackground newlineGingival depigmentation is a periodontal plastic surgical procedure for removing or reducing unesthetic melanin hyperpigmentation. Reappearance of the melanin pigmentation after gingival depigmentation has been reported. Vitamin C has been routinely used for management of hyperpigmentation in dermatology. However, very few studies have been conducted on the use of Vitamin C for management of gingival hyperpigmentation. Further, the use of Vitamin C to prevent recurrence of pigmentation after its surgical removal has not been reported. Hence the present study was conducted. newlineAim newlineTo assess the efficacy of Vitamin C application for prevention of repigmentation of gingiva after surgical depigmentation and its correlation with Tyrosinase gene activity newlineMethods newline64 sites in subjects aged 20-45 years with chief complaint of black looking gums were selected. Scaling and root planing was done. Gingival depigmentation was performed using scalpel / laser technique under adequate local anesthesia. Gingival pigmentation index (DOPI), Visual Analogue Scale (VAS), Surface area of Pigmentation and Tyrosinase levels were assessed. Vitamin C was administered 2weeks after surgical depigmentation and then monthly intervals for 6months. newlineResults newlineThere was a statistically significant decrease in DOPI score, surface area of pigmentation from baseline to one year (plt0.000) and VAS score at laser treated sites as compared to scalpel treated sites at 1month (plt0.000). Tyrosinase levels decreased at 1year follow-up as compared to baseline. newlineConclusion newlineLaser depigmentation is minimally invasive and preferred. Recurrence of gingival pigmentation can be minimized by administration of Vitamin C. newlineKey-words: Melanin, gingival melanin hyperpigmentation, gingival depigmentation, scalpel depigmentation, laser depigmentation, Vitamin C, tyrosinase.