Background
depigmentation, Efficient coagulation, hyperpigmentation, pain
DEPIGMENTATION, HYPERPIGMENTATION, MELANIN HYPERPIGMENTATION
In today’s world, patients’ esthetic demands and expectations have greatly risen, with all current trends focusing on facial esthetics and smile design. A smile plays a vital role in non-verbal communication, and greatly influences an individual’s self-esteem. It holds significant value in social interactions impacting relationships, professional image, and personality development. Studies have consistently shown that individuals who are satisfied with their physical appearance, particularly their smile, tend to be more confident and successful. Conversely, a compromised smile negatively impacts personal image and overall quality of life [The role of pink esthetics in smile design cannot be overlooked, as the harmony of a smile is not solely determined by the shade, shape and arrangement of teeth, but also by the appealing and healthy appearance of the surrounding gingival tissues [Healthy gingival color is generally described as coral pink [Gingival hyperpigmentation is defined as increased intensity of gingival color through excessive melanin deposition by the melanocytes found within the basal and supra-basal cell layers of the gingival epithelium [A wide range of depigmentation techniques have been proposed with the surgical approaches being the most widely employed such as conventional scalpel surgery, bur abrasion, electrosurgery, cryosurgery, radiosurgery & more recently, the application of lasers of different types & wavelengths [Laser-tissue interaction is dependent on the laser light’s affinity for specific chromophores found within the tissue [Efficient coagulation, short treatment line, accelerated healing, and excellent esthetic outcomes are laser’s known advantages. However, the expensive and sophisticated equipment limits its use, and significantly raises the cost of treatment [Vitamin C, also known as Ascorbic acid, has been introduced as a promising therapeutic agent for reducing melanin hyperpigmentation due to its ability to suppress the activity of tyrosinase, the rate-limiting enzyme in melanin biosynthesis [In the field of dermatology, vitamin C has gained significant popularity and has been widely employed as a safe depigmenting agent. It has shown promising results in the treatment of various dermatological problems associated with hyperpigmentation [However, a recent systematic review indicated that studies investigating the application of vitamin C for gingival depigmentation are scarce, with the majority being experimental studies [The aim behind introducing vitamin C mesotherapy in clinical practice was to develop a novel approach that enables targeted and localized delivery of the therapeutic agent, vitamin C, to the site of concern, maximizing its efficacy and ensuring a more potent and focused effect. On the financial aspect, vitamin C mesotherapy stands out as a cost-effective treatment modality, allowing successful drug delivery using inexpensive equipment, and requiring short learning curve for the general practitioner [To the best of our knowledge, no clinical trial has exclusively compared the clinical effect of vitamin C mesotherapy with laser ablation therapy for gingival depigmentation. Therefore, the aim of this study was to compare the effectiveness of vitamin C mesotherapy with diode laser ablation therapy for the management of physiologic gingival hyperpigmentation in terms of clinical outcome, pain perception and patients’ satisfaction.