Gingival Esthetics by Depigmentation

In dentistry, esthetics has a special place. Although gingival melanin pigmentation does not present a medical problem, clinicians are often faced with a challenge of achieving gingival esthetics. Melanin pigmentation of the gingiva occurs in all races. Melanin, a brown pigment, is the most common cause of endogenous pigmentation of gingiva and is the most predominant pigmentation of mucosa. Gingival hyper-pigmentation is seen as a genetic trait in some populations and is more appropriately termed physiologic or racial gingival pigmentation. This problem is aggravated in patients with a “gummy smile” or excessive gingival display while smiling. Gingival depigmentation is a periodontal plastic surgical procedure whereby the gingival hyper-pigmentation is removed or reduced by various techniques. The first and foremost indication for depigmentation is patient demand for improved esthetics. Various depigmentation techniques have been employed, with similar results. Selection of a technique should be based on clinical experience and the individual's preferences. Removal of gingival melanin pigmentation should be performed cautiously and the adjacent teeth should be protected, since inappropriate application may cause gingival recession, damage to underlying periosteum and bone, delayed wound healing, as well as loss of enamel.