Downloaded 31 times
More Related Content
Similar to GINGIVAL DEPIGMENTATION.pptx
GINGIVAL DEPIGMENTATION.pptx
- 1. GINGIVAL DEPIGMENTATION DR PRIYANKA N ISTYEAR MDS DEPARTMENT OF PERIODONTOLOGY
- 2. INTRODUCTION EPIDEMIOLOGY PHYSIOLOGY OF ORALPIGMENTATION BIOCHEMICAL EVENTS IN PIGMENTATION ETIOLOGY CLASSIFICATIONS DISTRIBUTION AND INDEX FOR PIGMENTATION TYPES OF PIGMENTATION – PHYSIOLOGICAL PIGMENTATION - PATHOLOGICAL PIGMENTATION TREATMENT PROCEDURES REPIGMENTATION RECENT MODALITIES USED FOR GINGIVAL DEPIGMENTATION CONCLUSION REFERENCES
- 4. (Çiçek Y. etal, The Normal and Pathological Pigmentation of Oral Mucous Membrane: A Review. 2003) • Oral pigmentation occurs in all races of man though there range varies from one race to another. • There were no significant differences in oral pigmentation between males and females. • The intensity and distribution of racial pigmentation of the oral mucosa is variable, not only between races, but also between different individuals of the same race and within different areas of the same mouth. • Physiologic pigmentation is probably genetically determined, but as Dummett suggested, the degree of pigmentation is partially related to mechanical, chemical, and physical stimulation. • In darker skinned people oral pigmentation increases, but there is no difference in the number of melanocytes between fair-skinned and dark- skinned individuals
- 5. • The variationis related to differences in the activity of melanocytes. • Physiological pigmentation of the oral mucosa (mostly gingiva), is clinically manifested as multifocal or diffuse melanin pigmentation with variable amounts in different ethnic groups worldwide and it occurs in all races. • In Caucasians, most melanocytes have striated granules that are incompletely melanized and vary in size from 0.1 to 0.3 mm. But, the amount is insufficient to cause pigmentation (less than 10% demonstrate pigmentation). • A high amount of melanin granules is found in individuals of African and East Asian ethinicity.15 In dark-skinned and black individuals, an increased melanin production has long been known to be the result of genetically determined hyperactivity of melanocytes. • Melanocytes of dark skinned and black individuals are uniformly highly reactive, whereas in light skinned individuals, melanocytes are highly variable in reactivity
- 8. Round cells withpale staining cytoplasm. Lack desmosomes and tonofilaments but possess long dendritic processes. Prescence pf melanosomes. Replicate throughout their life although at a much slower rate.
- 17. Melanin synthesis canbe controlled by three major determinants : - GENES - UV RADIATIONS - HORMONES Melanocyte Stimulating Hormone(MSH) Adreno-Corticotrophic Hormone(ACTH) Androgens
- 55. Patient’s Skin Color ExtentOf Gingival Pigmentation Lip Line Upper Lip Curvature Esthetic Concern Expectation From The Treatment
- 69. Pigmented areasare touched lightly with No. 135 ball-shaped electrodes or tapping the area with the No. 134 L-shaped electrodes using fully rectified cut mode (power setting at 11) for thick, hard gingiva and partially rectified coagulation mode (power setting at 7) for gingiva soft in consistency and near the mucogingival junction. Tiny electrodes (2 mm ACE electrode) are employed in narrow interdental papillary regions. Mahesh et al. observed that depigmented areas treated with RS showed minimal recurrence compared to conventional (slicing) treatment after 90-day follow-up. Based on Oringer's exploding cell theory,he electrically generated thermal energy influences the molecular disintegration of melanin cells that are present on the basal and suprabasal cell layer of operated gingival sites. It was proposed that the LH of RS had some influence on retarding the development and migration of melanocytes, making RS more efficient in surgical depigmentation over conventional procedures.
- 85. CONCLUSION: The results ofthis study highlight the effectiveness of dental lasers, particularly the diode laser for GD. It shows very promising results in comparison to Er:YAG laser, when postoperative pain, bleeding, and pigmentation recurrence are considered. Nonetheless, Er:YAG laser provides a better tissue healing cascade. Also, we confirm that laser ablation can be performed without the use of anesthesia provided the laser parameters are well controlled
- 86. It is atreatment method used to destroy the overlying gingival epithelium using a chemical peeling agent. A variety of chemical agents are available such as phenols, salicylic acid, glycolic acid,and trichloroacetic acid. The most commonly used are phenols and alcohols. In a study by Hirschfield in 1951, pigmented gingiva was burnt out by destroying tissue down to and slightly below the basal layer of mucous membranes using amixture of 90% phenol and 95% alcohol. However, repigmentation and relapse occurred in all cases shortly after the application of either agent. As phenols may induce cardiac arrhythmias, cardiac monitoring is necessary. The inability to control the depth of penetration and amount of destruction are the main drawbacks of this method. Thereby, these methods are no longer in use and are unacceptable to the clinicians as well as patients.
- 114. • Demand fordepigmentation therapy is mostly seen in patients with the excessive gingival display. • Gingival biotype, clinician’s expertise, patient preferences, and recurrence rate, greatly determine the selection of a technique. • Although a wide range of techniques have been employed, cryosurgery followed by lasers has been reported to be superior techniques with better esthetic results and low rate of recurrence. • Relapse or repigmentation is a critical concern and depends on the technique employed and follow-up period. • Majority of the available literature is comprised case reports. • Hence, authors recommend the conduct of randomized controlled longitudinal studies to identify the efficiency and effectiveness of available techniques.
- 115. Clinical Periodontology– Carranza , 10th edition Burket’s Oral Medicine – 11th Editon Cawsons Essentials of Oral Pathology and Oral Medicine – 7th Edition Verma S, Gohil M, Rathwa V. Gingival depigmentation. Indian J Clin Pract 2013;23:801e3. Dummett CO, Barrens G. Pigmentation of oral tissues: a review of literature. J Periodontol 1967;38:360e78 Kumar S, Bhat GS, Bhat KM. Development in techniques for gingival depigmentation an update. Indian J Dent 2012;3(4):213e21. Dummett, Clifton O.: Normal and abnormal pigmentations of the oral mucosae. Dermat. Dig., 5:41-9, Jan., 1966 Dummett, C. O.: A classification of oral pigmentations.Mil. Med., 127:837, Oct., 1962. Hirschfeld I, Hirschfeld L. Oral pigmentation and method of removing it. Oral Surg Oral Med Oral Path 1951;4:1012. Bergamaschi O, Kon S, Doine AI, Ruben MP. Melanin repigmentation after gingivectomy: A 5-year clinical and transmission electron microscopic study in humans. Int J Periodontics Restorative Dent 1993;13:85-92.
- 116. Patil KP,Joshi V, Waghmode V, Kanakdande V. Gingival depigmentation: A split mouth comparative study between scalpel and cryosurgery. Contemp Clin Dent 2015;6:S97-S101. Dhafer S. Alasmari-An insight into gingival depigmentation techniques: The pros and cons:International Journal of Health Sciences:Vol. 12, Issue 5 (September - October 2018) Raaman AR, Pratebha B, Jananni M, Saravanakumar R. Comparison of efficacy of depigmentation of gingiva in terms of ImageJ intensity values and surface area of repigmentation using scalpel and diode laser. Int J Oral Health Sci 2016;6:59-64. Diana Mostafa and Shaden M. Alotaibi:A Successful Esthetic Approach of Gingival Depigmentation Using Microneedling Technique and Ascorbic Acid (Vitamin C) Hindawi Case Reports in Dentistry,Volume 2022, Article ID 3655543 Mahajan G, Kaur H, Jain S, Kaur N, Sehgal NK, Gautam A. To compare the gingival melanin repigmentation after diode laser application and surgical removal. J Indian Soc Periodontol 2017;21:112-8 Mandal S, Bose S, Choudhuri P, et al. Esthetic correction of gingival pigmentation using different techniquescase reports. J. Evolution Med. Dent. Sci. 2020;9(13):1102-1105, Çiçek Y. The Normal and Pathological Pigmentation of Oral Mucous Membrane: A Review. J Contemp Dent Pract 2003 August