Retrospective Comparison of Clinical Outcomes between Surgical Scalpel and Diode Laser Techniques for Gingival Depigmentation: A Five-Year Study

Abstract

Background: Gingival melanin pigmentation, while physiological, often presents as an aesthetic concern for patients with high smile lines. Various depigmentation methods exist, with the surgical scalpel being a conventional approach. Diode lasers, particularly at 940 nm, have emerged as a minimally invasive, efficient, and patient-friendly alternative.

Aim: To compare the clinical outcomes of gingival depigmentation using surgical scalpel versus diode laser (Biolase Epic X – 940 nm) techniques, focusing on healing time, post-operative discomfort, recurrence, and patient satisfaction.

Materials and Methods: This retrospective study included 60 patients, divided equally into scalpel (n=30) and diode laser (n=30) groups. Clinical parameters recorded included the Dummett Oral Pigmentation Index (DOPI), healing time, post-operative pain using the Visual Analog Scale (VAS), bleeding, need for sutures, recurrence of pigmentation, and overall patient satisfaction. The diode laser group was treated using Biolase Epic X at 940 nm, 1.2 W, continuous wave, in contact mode. Statistical analysis was performed using independent t-tests and Chi-square tests (p < 0.05).

Results: The diode laser group showed significantly faster healing (6.2 ± 1.4 days vs. 10.3 ± 2.1 days), lower VAS pain scores (2.1 ± 0.9 vs. 5.0 ± 1.1), and minimal bleeding. Recurrence was lower in the laser group (3.3%) compared to the scalpel group (13.3%). Patient satisfaction was also significantly higher in the diode laser group.

Conclusion: Diode laser depigmentation using Biolase Epic X (940 nm) demonstrated superior clinical outcomes over the scalpel technique. It is associated with faster healing, reduced discomfort, lower recurrence, and improved patient satisfaction, making it the preferred method for aesthetic gingival depigmentation