Treatment of gingival hyperpigmentation with rotary abrasive, scalpel, and laser techniques: A case series.

Melanin pigmentation often occurs in the gingiva as a result of an abnormal deposition of melanin, due to which the gums may appear black, but the principles, techniques, and management of the problems associated with gingival melanin pigmentation are still not fully established. Depigmentation procedures such as scalpel surgery, gingivectomy with free gingival autografting, electrosurgery, cryosurgery, chemical agents such as 90% phenol and 95% alcohol, abrasion with diamond bur, Nd: YAG laser, semiconductor diode laser, and CO2 laser have been employed for removal of melanin hyper pigmentation. The following case series describes three different surgical depigmentation techniques: scalpel surgery, abrasion with rotary abrasive, and a diode laser. Better results of depigmentation were achieved with diode laser than conventional scalpel and with rotary abrasion with respect to esthetics. The results point out that lasers are an effective and a safe means to removal of hyperpigmentation from the gingiva. Healing was uneventful and no repigmentation occurred.

Osteoimmunology - Unleashing the concepts.

Osteoimmunology is an emerging field of research dedicated to the relationship between the immune processes and the bone metabolism of various inflammatory bone diseases. The regulatory mechanisms governing the osteoclast and osteoblast are critical for understanding the health and disease of the skeletal system. These interactions are either by cell to cell contact or by the secretion of immune regulatory mediators like cytokines and chemokines by immune cells that are governed by the RANKL (TRANCE)-RANK- OPG axis. TRANCE-RANK signaling has served as a cornerstone of osteoimmunology research. There is increased recognition of the importance of the inflammatory and immune responses in the pathogenesis of periodontal disease. Thus, this field has provided a framework for studying the mechanisms underlying periodontal destruction. As bone homeostasis is mainly regulated by both the immune and endocrine systems, there emerged osteoimmunoendocrinology where adipokines take the lead. This review focuses on the underlying concepts of osteoimmunology, its relation to Periodontics.