Comparative evaluation of the efficacy of diode laser and cryosurgery (Using 1,1,1,2 tetrafluroethane) for the treatment of gingival pigmentation

Introduction: Cosmetic expectations have increased with time and pigmentation of gingiva is a negative factor in an otherwise acceptable “smile window”. Amongst the various treatment modalities for depigmentation like scalpel technique, cryosurgery, laser, abrasion etc, there seems to be a need to compare efficacy of cryosurgery with TFE and Diode laser. Objective: The objective was to compare the efficacy of cryosurgery with 1,1,1,2 tetrafluroethane and Diode Laser for the treatment of gingival pigmentation. Materials and Methods: A randomized controlled split mouth study was conducted for 10 patients with gingival pigmentation, wherein one quadrant was treated with the TFE cooled swab( Group A) and the other quadrant was treated using diode laser (980nm at 1W) (Group B). Pre and post treatment photographs, VAS pain scores, were evaluated by the clinician at 4 days, 1 week, 1month and also number of analgesics required to be taken by the patient following treatment with both the techniques. Results: Clinically significant results were seen in both the groups. Mild erythema was seen immediately after the application of cryogen following which a whitish slough could be separated from the underlying connective tissue at fourth day. In group B, a white fibrin slough was seen 24hrs after the procedure. The healing was uneventful and complete epithelialization takes place in 3-4 weeks in both the groups. Though, the patient acceptance was good for both the procedures, mild pain and discomfort was experienced by the patient in group B. Conclusion: Depigmentation of gingival melanin hyperpigmentation by cryosurgery using TFE and diode laser were found to be an effective procedures, however the patient compliance and acceptance was greater in Tetrafluoroethane cryosurgery when compared to the Diode laser.