IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 20, Issue 7 Ser.6 (July. 2021), PP 28-34 www.iosrjournals.org DOI: 10.9790/0853-2007062834 www.iosrjournal.org 28 | Page Gingival Melanin Depigmentation by Diode Laser 980 nm with Minimal Power Parameters Sarah Arafat 1 , Mariam Mohsen 2 , Heba A. Shawky 3 , Ali Saafan 4 1 (Oral and maxillofacial Surgery Department, Faculty of Dentistry/ Misr University for Science and Technology, Egypt) 2 (Oral and maxillofacial Surgery Department, Faculty of Dentistry/ Misr University for Science and Technology, Egypt) 3 (Periodontics, Preventive Dental Sciences Department, Princess Nourah bint Abdulrahman University, KSA) 4 (Medical Applications of Laser Department, National Institute of Laser Enhanced Sciences, Cairo University, Egypt) Abstract: Background: Laser gingival depigmentation is the easiest and least painful treatment option and does not require periodontal dressing. In most studies, gingival depigmentation by diode laser was performed using power parameters higher than 1 Watt; which is commonly associated with post-operative pain. Materials and Methods: In this retrospective descriptive study, 10 patients, 4 males and 6 females, with age range from 16 to 29 years, having moderate to severe melanin physiologic pigmentation of gingiva were treated by diode laser 980 nm, with lowered power parameters to reduce post-operative pain and to allow faster healing of the gingiva. Post-operative assessment included procedure time, pain, clinical response, and patient satisfaction Results: The mean procedure time was 26 minutes. Six patients reported no post-operative pain, and 4 patients reported slight pain on the first day only. Two patients only required a second session of Laser depigmentation. Eight patients were very satisfied and 2 patients were satisfied, with the painless procedure and esthetic results. After 12 months, there was no recurrence. Conclusion: Lowered power Diode Laser 980 nm is a painless effective treatment for gingival melanin depigmentation. Key Word: Gingiva, depigmentation, Diode 980 nm, power, parameters --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 28-06-2021 Date of Acceptance: 12-07-2021 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Gingival tissue plays an important part of dento-facial esthetics along with face, lip, and teeth. A beautiful smile mainly depends on the appearance of teeth and gingiva. The shape, level, and color of gingival play an essential role in smile harmony. 1 Melanin pigmentation of gingiva causes esthetic problems, social embarrassment, and it may have psychological problems; especially when the pigmentations are visible during speech and smiling. This impact is more obvious in patients with “gummy smile” or excessive gingival display while smiling (high lip line). The color of gingiva is determined by number and size of blood vessels, thickness of epithelium and its keratinization degree, and melanin pigments present in epithelium. Melanin, which plays a main role for pigmentation of gingiva, is a brown pigment, produced by Melanocytes, located in the basal and suprabasal layers of gingival epithelium. 2 Gingival hyperpigmentation can be defined as a darker gingival color beyond what is normally expected. This hyperpigmentation can be seen in all the races, but it is more common in black individuals. 3 Gingival hyperpigmentation results from physiologic melanin pigments, or other environmental risk factors; such as, tobacco smoking, ultraviolet radiation, drug induced (anti-malarial agents & tricyclic anti-depressant agents), occupational exposure to heavy metals contribute to the gingival hyperpigmentation. Ethnicity and age also can influence the color of gingiva, and there is no gender predilection. Treatment modalities for depigmentation of gingiva different have been reported like chemical agents (alcohols\ phenols\ ascorbic acid), scalpel surgical scraping, partial thickness flap, bur abrasion, electrosurgery, cryosurgery, and laser. 4 The first and most popular technique used is the scalpel surgical removal of melanin pigmentation of gingiva. However, periodontal dressing is mandatory for at least a week; in addition, repigmentation of melanin pigment after surgical procedure has been reported in a high percentage. 5 Electrosurgery is always associated with more pain and clinically delayed healing when compared to scalpel surgery. 6