الفهرس 
Introduction and Review of literatureOnly 14 pages are availabe for public view
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Abstract
Gingival hyperpigmentation is excessive melanin deposition in the basal and supra basal layers of the epithelium. Gingival hyperpigmentation is not a disease, but many patients have esthetic concerns regarding their “black gums”.
Many techniques have been used in gingival depigmentation either surgical or non-surgical. The surgical techniques include surgical stripping, bur abrasion, cryosurgery, electrosurgery, lasers, or masking the pigmented gingiva using autografts or allografts. The non- surgical techniques include acids, phenols and alcohols that are used in gingival peeling and subsequent gingival depigmentation. Despite the numerous techniques there’s no consensus on which technique is the most suitable.
Ceramic soft tissue trimming burs is a recent technique in gingival depigmentation. It was primarily launched to be used in gingivectomy. They have the advantage of good hemostasis due to the frictional heat produced during rotation resulting in a less invasive and bloodless operation.
Surgical stripping is one of the first techniques used for gingival depigmentation and remains the gold standard owing to its efficacy, simplicity, affordability. Despite its disadvantages which include bloody field of surgery and lack of control of depth of de- epithelization.
In this study, eight patients complaining from gingival hyperpigmentation in both arches were randomized in a split mouth fashion where each patient gingival depigmentation by ceramic soft tissue trimmer in one arch (Test group) and No. 15 surgical blade in the opposing arch (Control group). So, each patient served as his own control to avoid inter-subject variables that could induce bias regarding the estimated effect, re-pigmentation rate and pain perception.
The parameters that were assessed in our study were: clinical outcomes of the procedure using two pigmentation indices (DOPI & MI) for better accuracy, pain perception and patient satisfaction as primary outcome measures. Operation time and wound healing scores were assessed as secondary outcomes. The patients were followed up for 3 months to assess the stability of the results using the same two pigmentation indices.
The results of this study showed no statistically significant difference in all the measured outcomes. However, the control group had better initial clinical outcomes, while the test group having less visible re-pigmentation, pain Scores, treatment time, along with more patient satisfaction.
We conclude that, Ceramic soft tissue trimming bur and scalpel had comparable results. Thus, Ceramic soft tissue trimming bur abrasion is a viable technique for gingival depigmentation due to its efficacy, simplicity, and bloodless nature.