Efficacy Of Scalpel And Diode Laser On Gingival Depigmentation – A Systematic Review

Abstract

Background: Gingival hyperpigmentation, common in African, Asian, and Mediterranean populations due to increased melanin production, is often a cosmetic concern. Among various treatment options, the traditional scalpel technique and the newer diode laser have both shown efficacy in reducing pigmentation. However, comparative results remain inconsistent. Hence, this systematic review aims to evaluate the efficacy of scalpel and diode laser on gingival depigmentation.

Methods: A systematic review was conducted following PRISMA guidelines. PROSPERO registration was done (ID: CRD42024613206). A comprehensive search strategy was employed across electronic databases, including PubMed/Medline, Embase, Scopus, and Web of Science. The systematic review was conducted using CADIMA software, with critical appraisal of included studies performed using the JBI tool.

Results: Out of62 initially identified reports, only 3 split-mouth Randomized Controlled Trials met the inclusion criteria. Across all three studies, diode laser treatment significantly reduced immediate postoperative pain compared to the scalpel technique; however, pain levels were similar for both methods by the 1-week follow-up. No significant difference was observed between the two techniques in preventing gingival repigmentation across follow-up periods. Bleeding was consistently lower with the diode laser, while healing outcomes were comparable.

Conclusion: The diode laser obtained better results in terms of intraoperative bleeding and perception of pain for the patient. However, there were no differences in depigmentation and wound healing intensity.