Validity and Reliability of Polarized vs Non-Polarized Digital Images for Measuring Gingival Melanin Pigmentation.

Aim: This study aimed to compare the validity and reliability of polarized and non-polarized intraoral photography for the measurement of gingival melanin pigmentation. Materials and Methods: A case series study was conducted on ten patients scheduled for gingival depigmentation. A total of 976 polarized and non-polarized image samples were collected, capturing two rows above the gingival margin, for analysis. These images were taken both before and one year after the depigmentation procedure. Three independent evaluators assessed the photographs (an orthodontist, a general dentist, and a layperson). The Dummett Oral Pigmentation Index (DOPI) and Gingival Melanosis Record (GMR) indices were used to measure the level of gingival pigmentation. Results: The study found no significant differences between polarized and non-polarized images taken before and after depigmentation. Both methods of imaging received similar scores from the evaluators. The orthodontist identified more pigmented slides than the layperson and the general dentist. Conclusion: Both polarized and non-polarized photographic methods may be used for assessing gingival pigmentation. However, further research is warranted to confirm this finding and examine additional factors.

Utilización de láser diodo en tejidos blandos: reporte de 3 casos / Use of diode laser in soft tissue: report of 3 cases

Existen diversas condiciones anatómicas o alteraciones mucogingivales que pueden afectar tanto el normal funcionamiento como la estética gingival de piezas dentarias e implantes dentales. Si bien los tratamientos de estas condiciones se han realizado tradicionalmente con bisturí, el desarrollo tecnológico ha permitido que actualmente se pueden realizar con láser. Existen diferentes tipos de láser, siendo el diodo uno de los más utilizados debido a su menor tamaño, portabilidad, fácil configuración y menor costo. El láser ha adquirido mayor popularidad en cirugías de tejido blando dado sus múltiples beneficios: menor tiempo operatorio, control del sangrado y de la hemostasia, reducción de la cantidad de anestesia, posibilidad de no requerir suturas y minimización del dolor e inflamación postquirúrgica. El propósito de este trabajo es presentar la resolución de tres casos clínicos a los cuales se les realizaron los procedimientos de frenectomía labial, remoción de melanosis gingival y resección de fibroma irritativo mediante el uso de láser diodo. Para desarrollar todos los procedimientos se utilizó un equipo de láser diodo de 940 nm (Biolase®, USA) con una potencia que varió entre 2 y 2.5 W en modo continuo utilizando una pieza quirúrgica con una punta de 300 µm (E 3-4), la que fue activada antes de empezar. Posterior a la cirugía se bioestimuló para disminuir el dolor y edema postoperatorio utilizando la punta de dolor a 4 W por 30 segundos a una distancia de 1 cm directo en la zona intervenida a todos los casos. La conclusión arroja que en todos los casos, el láser de diodo permitió un resultado exitoso. El procedimiento fue seguro, la técnica fue sencilla y de tiempo clínico reducido. El postoperatorio ocurrió con ausencia de dolor o molestias, generando una mayor satisfacción del paciente. Cabe señalar que la técnica depende de la habilidad del profesional que la realiza.

There are various anatomical conditions or mucogingival alterations that can affect the normal functioning and the gingival aesthetics of teeth and dental implants. Although the treatments of these conditions have been traditionally performed with a scalpel, technological development has allowed that they can be now performed with lasers. There are different types of lasers, being the diode one of the most used due to its smaller size, portability, easy configuration, and lower cost. The laser has become more popular in soft tissue surgeries due to its multiple benefits: shorter operating time, control of bleeding and hemostasis, reduction in the amount of anesthesia, possibility of not requiring sutures, and minimization of post-surgical pain and inflammation. The purpose of this work is to present the resolution of three clinical cases which underwent labial frenectomy procedures, removal of gingival melanosis and resection of irritative fibroma using diode laser. To develop all the procedures, a 940 nm diode laser equipment (Biolase®, USA) was used with a power that varied between 2 and 2.5 W in continuous mode, using a 300 µm tip (E 3-4), which was activated before starting. After surgery, biostimulation was carried out to reduce postoperative pain and edema using the pain tip at 4 W for 30 seconds at a distance of 1 cm directly in the operated area in all cases. In all cases, the diode laser allowed a successful result. The procedure was safe, the technique was simple, and the clinical time was short. The postoperative period occurred with the absence of pain or discomfort, generating greater patient satisfaction. It should be noted that the technique depends on the skill of the professional who performs it.

Gingival Pigmentation Affected by Smoking among Different Age Groups: A Quantitative Analysis of Gingival Pigmentation Using Clinical Oral Photographs.

The presence of any age-related differences in gingival pigmentation associated with smoking, particularly in a young population, remains to be fully investigated. The purpose of this study was to determine the age-related differences in smoking gingival pigmentation. Gingival pigmentation was analyzed using the gingival melanosis record (GMR) and Hedin's classification with frontal oral photographs taken at 16 dental offices in Japan. Participants were categorized into 10-year age groups, and their baseline photographs were compared. In addition, to evaluate the effect of smoking cessation on gingival pigmentation, subjects were divided into a former smoker group (stopped smoking) and current smoker group. A total of 259 patients 19 to 79 years of age were analyzed. People in their 30s showed the most widespread gingival pigmentation. In addition, subjects in their 20s showed a weak effect of smoking cessation on gingival pigmentation. These findings suggested that the gingival pigmentation induced by smoking was more remarkable in young people than in middle-aged people. This information may be useful for anti-smoking education, especially among young populations with a high affinity for smoking.

Measurement of Reduced Gingival Melanosis after Smoking Cessation: A Novel Analysis of Gingival Pigmentation Using Clinical Oral Photographs.

BACKGROUND: Due to moisture and the anatomical complexity of the oral mucosa, it is difficult to measure the extent of gingival melanosis in an optical manner. Therefore, we developed a new quantitative method using clinical oral photographs and compared the extent of gingival melanosis before and after smoking cessation. METHODS: A new analysis method, which we named the gingival melanosis record (GMR), is a quantitative analysis method using clinical oral photographs. We obtained 659 clinical photographs from 263 patients from 16 general dental offices in Japan. Standardized measuring sites were automatically spotted on the screen, and the presence of gingival melanosis was determined at the measuring sites. We assessed the validity of the GMR with the previously reported Hedin's classification using Spearman's rank correlation and intraclass correlation coefficients. RESULTS: The GMR showed a significant association with Hedin's classification (p < 0.01, correlation coefficient = 0.94). The GMR also showed excellent reproducibility of the substantial repeated agreement intraclass correlation coefficients (ICC) (1,1) and ICC (2,1), p > 0.61). The longitudinal loss of gingival melanosis was confirmed by a change in the GMR among patients who successfully achieved smoking cessation for a mean of 4.5 years. CONCLUSION: The GMR is an effective method to assess gingival melanosis. The loss of gingival melanosis after smoking cessation can be objectively confirmed with the use of the GMR.