The objectives of the present study are to: 1. Evaluate the effect of I-PRF injection following laser gingival depigmentation technique on the healing period as a primary objective. 2. Assess patient satisfaction following the procedure in terms of pain and esthetic outcome as a secondary objective.
Dental esthetic needs are increasing in recent years with a greater demand on pleasant appearance; including a healthy set of dentitions but also esthetically improved gingival appearance, especially when it is located in the anterior labial region. Physiologic gingival hyperpigmentation affects numerous people of different ethnic backgrounds. Gingival depigmentation is defined as a periodontal plastic surgical procedure that are aimed at removing the pigmented gingiva and methods aimed at masking the pigmented gingiva. Techniques of gingival depigmentation can be classified as; chemical methods mainly by ascorbic acids, surgical methods, electrosurgery, cryosurgery, radiosurgery, and lasers. The study was conducted on eight patients seeking treatment for their gingival hyperpigmentation for esthetic reasons. A total number of 16 sites of facial gingival hyperpigmentation were treated, two in each patient in a split mouth technique. * Group I (LASER with I-PRF): Included eight sites that were treated with laser technique for gingival depigmentation, followed by intramucosal field injection of I-PRF (as study group). * Group II (LASER): Included eight sites that were treated with laser technique for gingival depigmentation (as a control group). The clinical outcomes were assessed for each patient: at baseline (pre-operative), post-operative, one week, one month. Clinical assessment was done by measuring DOPI, clinical wound healing, VAS and patient satisfaction questionnaire.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
8
* Local anesthesia was achieved using field block technique. * A soft tissue diode surgical laser unit was used in a contact method using a flexible fiber optic hand piece with initiated tip. * Laser irradiation parameters were adjusted as follows: Wavelength \[940 ± 10 nm\], irradiation mode \[contact continuous wave\], Power \[2 W\] and 300 μm fiber tip diameter (Jokar et al., 2019). * The treatment was depigmentation by laser thin injection by I-PRF Post-operative instructions Instruct the patients to avoid tooth brushing on the day of surgical treatment to prevent mechanical trauma and allow re-epithelialization.
Local anesthesia was achieved using field block technique. * A soft tissue diode surgical laser unit was used in a contact method using a flexible fiber optic hand piece with initiated tip. * Laser irradiation parameters were adjusted as follows: Wavelength \[940 ± 10 nm\], irradiation mode \[contact continuous wave\], Power \[2 W\] and 300 μm fiber tip diameter (Jokar et al., 2019). Post-operative instructions Instruct the patients to avoid tooth brushing on the day of surgical treatment to prevent mechanical trauma and allow re-epithelialization.
Faculty of Dentistry Ain Shams University
Cairo, Egypt
Dummet oral pigmentation index
the degree of gingival pigmentation will be scored as: 0 = pink tissue \[no clinical pigmentation\]; 1 = mild light brown tissue \[mild clinical pigmentation\]; 2 = medium brown or mixed brown and pink tissue \[moderate clinical pigmentation\]; or 3 = deep brown/ blue-black tissue \[heavy clinical pigmentation\]
Time frame: 1 month
Clinical wound healing
scored as follows: 1\) Complete reepithelialization, 2) Incomplete reepithelialization, 3) ulcer and 4) tissue defect or necrosis
Time frame: 1 week
Satisfaction questionnaire
score the degree of satisfaction about cosmetic outcomes of treatment
Time frame: 1month
Visual analogue scale (VAS) score for pain assessment
Pain assessment will be performed using a 10-cm (100 mm) horizontal continuous scale marked "no pain" on the left and "maximum pain" on the right side of the scale. The scores were as follows: no pain (0), slight pain (0.1-3.0 mm), moderate pain (3.1-6.0 mm), and severe pain (6.1-10 mm)
Time frame: 1month
Histological assessment
The mean of epithelial thickness for each case was calculated
Time frame: 1 week
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