Objective: To compare the 6-month clinical efficacy of Er:YAG
laser and standard scalpel technique in treating gingival hyperpigmentation.
Method and Materials: Patients requesting
treatment for moderate to severe gingival hyperpigmentation
in the maxilla were enrolled in this split-mouth study. The contralateral
maxillary sides were randomly assigned to receive
either Er:YAG laser (continuous wavelength of 2,940 nm) with a
noncontact tip or the standard scalpel technique. Dummett
oral pigmentation index (DOPI) and Hedin melanin index (HMI)
were compared at the baseline and at 1 and 2 weeks, and 1, 3,
and 6 months following the treatment. Bleeding Index, total
treatment time, patient preference, pain perception at the first
3 days, wound healing, and level of satisfaction were also compared.
Mann-Whitney test, Kruskal-Wallis test, and chi-square
test were used to test the significance between variables. A P
value of less than or equal to .05 was considered statistically
significant. Results: Of the 22 patients enrolled, 20 completed
this study. After assessing DOPI and HMI at 1 and 2 weeks, and at 1-, 3-, and 6-month follow-up appointments, both Er:YAG
laser and scalpel were significantly effective in treating gingival
hyperpigmentation when compared to baseline (P < .001) but
with no statistically significant difference between the two
treatment methods (P > .05). More patients preferred the scalpel
technique as it was associated with slightly shorter treatment
time and less postoperative pain when compared to
Er:YAG laser, but with no statistical significance (P > .05).
Er:YAG laser sites showed minimal bleeding and more rapid
wound healing (P < .001). Conclusion: Both Er:YAG laser and
scalpel technique achieved similar outcomes regarding the
efficacy of gingival depigmentation, postoperative pain perception,
and the time required for the treatment. Laser therapy
requires more advanced technology and is associated with
higher financial costs. Therefore, the scalpel technique is still considered
the gold standard treatment for gingival depigmentation.