A Narrative Review on Etiology, Pathogenesis and Therapeutic Strategies in Management of Gingival Pigmentation

Abstract

A beautiful smile defines the facial aesthetics and has a positive psychological impact on the individual. It is governed by the harmonious balance between the pink and white esthetics. The color of the gingiva is physiologically attributed by the melanin pigmentation. The degree of pigmentation depends on various factors including the ethnicity. Gingival depigmentation is an esthetic procedure that reduces the intensity of the melanin pigmentation using various surgical and non-surgical techniques. This narrative review will discuss the etiopathogenesis of gingival pigmentation and various gingival depigmentation techniques, critically analyzing its indication, advantages and disadvantages. Numerous databases, including PubMed, Google Scholar, and Google Search, were reviewed. The search method employed combined phrases like “Smile esthetics,” “Gingival pigmentation,” “Gingival depigmentation,” “gingival peeling,” “Laser assisted gingival depigmentation,” and “oral mesotherapy.” This search results gathered and analyzed 36 distinct academic publications. According to the study’s findings, gingival pigmentation can be either a physiological condition caused due to melanin pigmentation or can be due to underlying systemic disease condition. Various surgical, chemical, non-surgical and minimally invasive techniques have been scientifically tested and proved to reduce the intensity of pigmentation. The selection of the appropriate gingival depigmentation technique depends on holistically considering the individual’s skin tone, extent, severity, gingival architecture, phenotype and biotype. Depigmentation is performed only if it’s of esthetic concern to the subject. These procedures are highly technique sensitive and depend on the clinician’s skill to perform the appropriate technique which is cost effective and cause minimal discomfort to the individuals.