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Systematic Review of Treatment Modalities for Gingival Depigmentation: A Random-Effects Poisson Regression Analysis

Authors

  • Yi Hung Lin DDS,

    Attending Doctor
    1. Division of Periodontics, Department of Dentistry, Changhua Christian Hospital, Changhua, Taiwan
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  • Yu Kang Tu DDS, MS, PhD,

    Professor
    1. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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  • Chun Tai Lu DDS, MS, PhD,

    Attending Doctor
    1. Division of Periodontics, Department of Dentistry, Changhua Christian Hospital, Changhua, Taiwan
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  • Wen Chen Chung DDS,

    Attending Doctor, Superintendent
    1. Periodontal Clinics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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  • Chiung Fang Huang DDS, MS,

    Director
    1. Division of Family Dentistry, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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  • Mao Suan Huang DDS, MS,

    Director
    1. Division of Oral and Maxillofacial Surgery, Department of Dentistry, Shuang Ho Hospital, Taipei, Taiwan
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  • Hsein Kun Lu DDS, MS

    Superintendent, Professor, Corresponding author
    1. Periodontal Clinics, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
    2. Division of Periodontics, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
    • Reprint requests: Hsein Kun Lu, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110-31, Taiwan; Tel.: 886-2-27361661 ext. 511; Fax: 886-2-27362295; email: jackson@tmu.edu.tw

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Abstract

Objective

Repigmentation variably occurs with different treatment methods in patients with gingival pigmentation. A systemic review was conducted of various treatment modalities for eliminating melanin pigmentation of the gingiva, comprising bur abrasion, scalpel surgery, cryosurgery, electrosurgery, gingival grafts, and laser techniques, to compare the recurrence rates (Rrs) of these treatment procedures.

Material and Methods

Electronic databases, including PubMed, Web of Science, Google, and Medline were comprehensively searched, and manual searches were conducted for studies published from January 1951 to June 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A Poisson regression was used to analyze the outcome of depigmentation using the various treatment methods.

Results

The systematic review was based on case reports mainly. In total, 61 eligible publications met the defined criteria. The various therapeutic procedures showed variable clinical results with a wide range of Rrs. A random-effects Poisson regression showed that cryosurgery (Rr = 0.32%), electrosurgery (Rr = 0.74%), and laser depigmentation (Rr = 1.16%) yielded superior result, whereas bur abrasion yielded the highest Rr (8.89%).

Conclusions

Within the limit of the sampling level, the present evidence-based results show that cryosurgery exhibits the optimal predictability for depigmentation of the gingiva among all procedures examined, followed by electrosurgery and laser techniques.

Clinical Significance

It is possible to treat melanin pigmentation of the gingiva with various methods and prevent repigmentation. Among those treatment modalities, cryosurgery, electrosurgery, and laser surgery appear to be the best choices for treating gingival pigmentation.

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