Background

Gingival melanin pigmentation is a common esthetic concern, especially in patients with high smile lines. Laser therapy has emerged as a preferred treatment modality due to its precision, minimal invasiveness, and patient acceptance.

Objective

To compare the clinical effectiveness, healing outcomes, patient satisfaction, and recurrence rates following gingival depigmentation using Er:YAG (2940 nm) and diode (980 nm) lasers.

Methods

A split-mouth, prospective clinical trial was conducted on 14 adult patients with bilateral physiological gingival pigmentation. Each patient received Er:YAG laser treatment on one side and diode laser on the contralateral side. Laser parameters were standardized. Clinical outcomes were assessed using Dummett Oral Pigmentation Index (DOPI), Hedin Melanin Index (HMI), wound healing status, bleeding during treatment, pain using a Visual Analog Scale (VAS), and photographic documentation. Follow-ups were conducted at 1, 3, and 6 months.

Results

Both lasers effectively removed gingival pigmentation with high patient satisfaction. Er:YAG showed reduced postoperative pain (VAS 0–2) but higher intraoperative bleeding. Diode laser achieved superior hemostasis with moderate pain scores (VAS 2–3). Healing was completed within 7–10 days in both groups. Mild recurrence (DOPI score 1) was observed in 3 smokers for both modalities. No significant difference in long-term pigmentation recurrence was observed.

Conclusion

Both Er:YAG and diode lasers are effective and safe for gingival depigmentation. The diode laser demonstrated clinical advantages in hemostasis and procedural efficiency, while Er:YAG offered reduced postoperative discomfort. The choice of laser may depend on device availability, clinician experience, and cost considerations.

Keywords: Gingival depigmentation, melanin, diode laser, Er:YAG laser, laser dentistry.