Comparative Assessment of Gingival Depigmentation Using Laser Versus Micro Needling with Ascorbic Acid: A Randomised Controlled Clinical Trial

Abstract

Introduction - Physiological gingival pigmentation is harmless but may compromise smile aesthetics, particularly in individuals with a high smile line. Though it poses no oral health risk, dark gingiva can affect self-confidence, prompting patients to seek cosmetic improvement. Gingival depigmentation aims to achieve uniformly pink gums using techniques such as scalpel surgery, electrosurgery, cryosurgery, chemical methods, or lasers.
Objective -  To compare the effectiveness of gingival depigmentation using a diode laser versus microneedling with topical ascorbic acid in improving gingival aesthetics, as assessed by the Dummett–Gupta Oral Pigmentation Index (DOPI) over a three-month period.
Methodology - A randomized controlled clinical trial was conducted on 20 systemically healthy patients with physiological gingival hyperpigmentation and a high smile line. Participants were divided into two groups (n=10): Group A—diode laser depigmentation; Group B—microneedling with topical ascorbic acid. Pigmentation was assessed by DOPI at baseline and three months, and postoperative pain by Visual Analogue Scale (VAS) at 1, 2, and 3 weeks. Data were analyzed using SPSS v19 with significance at p<0.05.
Results:
Both methods significantly reduced pigmentation (p<0.05), but diode laser achieved greater mean DOPI reduction, faster healing, and lower VAS scores. Laser treatment required a single session with minimal bleeding and higher patient satisfaction, while microneedling needed multiple visits, affecting compliance.
Conclusion:
Both techniques effectively reduced gingival pigmentation; however, diode laser provided superior results with quicker depigmentation, less discomfort, and greater patient acceptance, making it a more efficient and patient-friendly option.