Mohamed El-Mofty1,2, Sarah Elkot3, Amira Ghoneim4, Dalia Yossri1, Ola Mohammed Ezzatt5. 1. Department of Oral Medicine, Periodontology Oral Diagnosis and Radiology, Faculty of Dentistry, Ain-Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt. 2. Department of Oral Medicine, Periodontology, Faculty of Dentistry, Nahda University, Beni Suef, Egypt. 3. Department of Oral Medicine, Periodontology, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt. 4. Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt. 5. Department of Oral Medicine, Periodontology Oral Diagnosis and Radiology, Faculty of Dentistry, Ain-Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt. dr.ola@dent.asu.edu.eg.
Abstract
OBJECTIVE: Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation. MATERIALS AND METHODS: Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman's tests, respectively. RESULTS: The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797). CONCLUSIONS: Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation. CLINICAL RELEVANCE: Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.
OBJECTIVE: Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation. MATERIALS AND METHODS: Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman's tests, respectively. RESULTS: The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797). CONCLUSIONS: Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation. CLINICAL RELEVANCE: Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.
Authors: Yi Hung Lin; Yu Kang Tu; Chun Tai Lu; Wen Chen Chung; Chiung Fang Huang; Mao Suan Huang; Hsein Kun Lu Journal: J Esthet Restor Dent Date: 2014-01-12 Impact factor: 2.843
Authors: Jack G Caton; Gary Armitage; Tord Berglundh; Iain L C Chapple; Søren Jepsen; Kenneth S Kornman; Brian L Mealey; Panos N Papapanou; Mariano Sanz; Maurizio S Tonetti Journal: J Clin Periodontol Date: 2018-06 Impact factor: 8.728