Dental and Oral Health

Aesthetic awareness has increased over the past several years and dentistry has developed numerous ways of providing esthetic solutions. Gingival hyperpigmentation is an esthetic concern in an otherwise acceptable smile window. Gingival depigmentation is a periodontal plastic surgical procedure in which gingival hyperpigmentation is removed/reduced by various techniques. The procedure involves surgical removal of gingival epithelium along with a layer of underlying connective tissue. Over the years, a plethora of techniques have been developed and practiced for the same. Most of these treatment modules have shown low predictability in terms of re-pigmentation at follow-up. Cryosurgery is a branch of therapeutics that makes use of local freezing for the controlled destruction or removal of living tissues. Though it is extensively used in dermatological practice for skin diseases, there is paucity of its use in dentistry with few studies. Thus, the current presentation lays emphasis on the predictability of cryosurgery for gingival depigmentation, and highlights on a case report showing excellent results maintained at 30 months follow up. Cryosurgery using nitrous oxide and gas expansion cryoprobe cooled to -70°C was used for the depigmentation. The depigmentation was performed from maxillary right cuspid to maxillary left cuspid in a single appointment. Post-surgical instructions and medications were given. The patient reported no adverse effects and no repigmentation of the treated areas for a period of 30 months. To the best of our knowledge, documented evidence of cryosurgery

for gingival depigmentation with such long follow up is limited. Cryosurgery is an easy procedure with lack of bleeding and scar formation. The aesthetic outcome may be maintained for 30 months as shown in the present case. Cryosurgery can be considered a desirable treatment option for gingival depigmentation.