Comparison of two different laser techniques in the removal of gingival pigmentation

INTERVENTION: The study is designed to compare the effectiveness of both the ablative technique (surgical technique) of diode 980 nm and carbon dioxide laser (10600 nm), and the non‐ablative technique (selective photo thermolysis) of diode 450 nm in the removal of physiologic gingival pigmentation using several indices. Patients will be randomly allocated to one of the three groups. All patients will receive initial treatment (scaling and root planing) and after 1 week they will undergo laser treatment with one of the three lasers. The laser treatment will take one session. The enrolled patients will be followed up after 10 days to assess the healing, and after 1, 3, 6 and 9 months to assess the recurrence of the gingival pigments. Random allocation software was used to generate the randomisation sequence. CONDITION: Physiologic gingival melanin pigmentation ; Oral Health PRIMARY OUTCOME: Gingival pigmentation recurrence measured using Dummet et al index for gingival pigmentation color and Takashi index for gingival pigmentation extension after 1, 3, 6, and 9 months SECONDARY OUTCOME: ; 1. Bleeding assessed using a bleeding inde X(0 to 3) directly after surgery; 2. Healing assessed using a healing inde X10 days and 1 month postoperatively; 3. Procedure duration recorded in minutes for each jaw (this is the laser surgery duration which will be recorded after local anesthesia for each jaw separately), during the clinical procedure; 4. Procedure difficulty assessed by the researcher directly after the procedure (laser surgery); 5. Gingival appearance assessed using a gingival appearance score at 1, 3, 6, and 9 months postoperatively; 6. Pain, edema, and discomfort evaluated using a self‐modified McGill questionnaire immediately after the procedure, 1 day, and 10 days postoperatively; 7. Patient satisfaction assessed using questionnaire at the end of follow‐up sessions; INCLUSION CRITERIA: 1. Patients exhibiting physiologic gingival melanin pigmentation of score 2 or more according to Dummet et al. 2. Aged 18‐45 years