J Periodontol. 2013 Jul 4. [Epub ahead of print] Authors: Giannelli M, Formigli L, Bani D. Source: Odontostomatologic Laser Therapy Center, Florence, Italy. Abstract: Background: The use of lasers in periodontology is a matter of debate, mainly due to the lack of consensual therapeutic protocols. In this randomized split-mouth trial we have compared the clinical efficacy of 2 different photoablative dental lasers, Er:YAG and diode, for the treatment of gingival hyper-pigmentation. Methods: Twenty-one patients requiring treatment for mild to severe gingival hyper-pigmentation were enrolled. Maxillary or mandibular left or right quadrants were randomly subjected to photoablative de-epithelization with either Er:YAG or diode laser. Blinded clinical assessments of each laser quadrant were made at admission and day 7-30-180 post-operatively by an independent observer. Histological examination was performed prior, and soon after treatment, and 6 months post-irradiation. Patients also compiled a subjective evaluation questionnaire. Results: Both diode and Er:YAG lasers gave excellent results in gingival hyper-pigmentation. However, Er:YAG laser induced deeper gingival tissue injury than diode laser, as judged by bleeding at surgery, delayed healing and histopathological analysis. The use of diode laser showed additional advantages over Er:YAG in terms of less postoperative discomfort and pain. Conclusions: This study highlights the efficacy of diode laser for photoablative de-epithelization of hyper-pigmented gingiva. We suggest that this laser can represent an effective and safe therapeutic option for gingival photoablation.
