Gingival Depigmantation
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Describing the nature of melanin , its role in gingival hyper pigmentation , the available therapeutic modalities for this condition along with a case report of surgical gingival depigemnation .
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Gingival Depigmantation
- 2. Melanos
- 3. Physiologic pigmentation in the oral cavity Melanin Carotene Oxyhea- moglobin
- 6. Impart Color
- 8. العدم من تخلق ال و تفنى ال الطاقة شكل من تحول بلالخر
- 12. I don't like the color of my gingiva !!
- 14. Methods of Depigmentation 1. Chemical agents (1964) 2. Gingivectomy 4. Free gingival graft & Acellular dermal matrix allograft (ADMA) 5. Electrosurgery 6. Cryosurgery 8. Laser 9. De-epithelisation (Split thickness epithelial excision technique).
- 15. Split thickness epithelial excision technique
- 17. GINGIVECTOMY
- 18. GINGIVAL GRAFT
- 19. CRYOSURGERY
- 21. ELECTROSURGERY
- 22. Laser
- 24. Case Report • Age : 23 • Gender: Female • Chief Complaint: Dark Gingival Color • Medical History: Healthy • Non smoker • Dummet Gupta Gingival Pigmentation Classification (1946) : Score 3
- 25. Armamentarium Surgical Scalpel + Blade No. (15) Or (15c) + Kirkland Knife + Curette + Chisel
- 28. Be carful not to do.. 1 2 3
- 29. Healing : Uneventful Complication : None Pain: 0-2 on VAS Patient Satisfaction : Completely Satisfied Result : Stable Based On 6 Months Follow Up Surgical Outcome
- 30. CONCLUSIONS • Depigmentation is quite valuable for persons who are conscious about their appearance and personality, especially females. • Split epithelial excision by surgical blade is successful as : • Healing is faster than other modalities including lasers • Less postoperative pain • Maximum tactile sansation • minimal tissue loss. • satisfactory results . • delicate yet easy to master & perform. • Repigmantation rate is 21.4% • cost-effective. • can be safely repeated. • Does not require sophisticated armamentarium, performed with material & instruments available in every dental practice.
- 31. Take Home Note Work on a Solid Ground
- 32. Thank you
Editor's Notes
- in the dental office this translated in the following conversation : Dentist:what is your complaint? Patient:I don’t like my gingival color. Here we rea dealing with physiologic melanin pigmentation (not the one induced by smoking, drug, systemic diseases.
- All are targeting the melanin contacting area (epithelium)
- chances of repigmantation after scalpel technique are 21.4%, and that of laser therapy are 22.8%.
- 0 — no clinical pigmentation (pink gingiva) 1 — mild clinical pigmentation (mild light brown color) 2 — moderate clinical pigmentation (medium brown or mixed pink and brown color) 3 — heavy clinical pigmentation (deep brown or bluish black color)
- Start by the blade and then finish by Kirkland (which is useful in posterior region), currete and even periodontal chisel scaler to depigment the remaining spots.