Operative procedures
hyperpigmentation, strokes
DEPIGMENTATION, INFILTRATION, HYPERPIGMENTATION, STROKES
Eligible participants were randomly allocated into test group (G1. Mesotherapy) and control group (G2. Diode laser). All interventions were performed by the same operator (S.E.), thereby minimizing any potential variations in operator skills.In both groups, infiltration anesthesia was administered at the target area using a local anesthetic agent; Alexandricaine 1:100000 (1.7 ml Articaine hydrochloride with 1:100000 Adrenaline, Alexandria Co. for Pharmaceuticals & Chemical Industries, Alexandria, Egypt). Group 1 [Vitamin C intra-mucosal injection (G1. Mesotherapy)] received intra-mucosal field injections of 1–1.5 ml Cevarol (L-Ascorbic acid 1000 mg/5 ml, Memphis Pharmaceuticals & Chemical Industries, Cairo, Egypt) using insulin syringe (30 Gauge 1 cc 0.33 mm × 8 mm 5/16″ needle) [The intra-mucosal injection procedure involved inserting the needle just beneath the surface of the gingival epithelium, aligning it parallel to the junction between the epithelium & connective tissue. While ensuring that the bevel of the needle faced upward, an injection volume of 0.1 ml was administered at each point until the tissues blanched. This process was repeated across the entire pigmented area, while maintaining a distance of 2 to 3 mm between injection sites (Fig. Illustration of Vitamin C intramucosal injection (Mesotherapy technique)Each patient underwent four treatment sessions, with a one-week interval between each session. Follow-up evaluations were conducted during each visit, and gingival depigmentation was assessed at 1 month, 2 months, and 3 months following the completion of the treatment procedure. Group 2 [Diode laser ablation (G2. Diode Laser)] was managed using 980 nm Diode laser (MEDENCY Primo Dental Laser, Italy). A comprehensive overview of the laser parameters can be found in (Table Laser parametersTo prevent overheating of the tissues, the tip was moved using small brush strokes in a back and forth motion. Throughout the procedure, the fiber tip was regularly cleaned using gauze soaked in saline solution. To ensure the preservation of the delicate gingival margin and interdental papilla, and to minimize the risk of gingival recession, the elimination of gingival hyperpigmentation was performed with a 1 mm distance maintained from the free gingiva. Epithelial remnants were cleared using gauze soaked in normal saline, serving to enhance visualization and to provide a cooling effect on the tissues. The ablation process was concluded when a whitish pink color was attained throughout the treated area.