Premium
Systematic Review of Treatment Modalities for Gingival Depigmentation: A Random‐Effects P oisson Regression Analysis
Author(s) -
Lin Yi Hung,
Tu Yu Kang,
Lu Chun Tai,
Chung Wen Chen,
Huang Chiung Fang,
Huang Mao Suan,
Lu Hsein Kun
Publication year - 2014
Publication title -
journal of esthetic and restorative dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.919
H-Index - 60
eISSN - 1708-8240
pISSN - 1496-4155
DOI - 10.1111/jerd.12087
Subject(s) - depigmentation , electrosurgery , cryosurgery , medicine , dermatology , abrasion (mechanical) , surgery , dentistry , mechanical engineering , engineering
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 ( R rs) of these treatment procedures. Material and Methods Electronic databases, including P ub M ed, W eb of S cience, G oogle, and M edline were comprehensively searched, and manual searches were conducted for studies published from J anuary 1951 to J une 2013. After applying inclusion and exclusion criteria, the final list of articles was reviewed in depth to achieve the objectives of this review. A P oisson 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 R rs. A random‐effects P oisson regression showed that cryosurgery ( R r = 0.32%), electrosurgery ( R r = 0.74%), and laser depigmentation ( R r = 1.16%) yielded superior result, whereas bur abrasion yielded the highest R r (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.