Gingival depigmentation with Er: YAG and Nd: YAG lasers: report of two cases

Pigmentation in the gingiva may cause aesthetic problems. In addition to medical therapy and conventional surgery, laser techniques have been used to treat this condition for many years. However, until now, there have been no reports of the application of an erbium: yttrium-aluminum-garnet (Er: YAG) laser combined with a neodymium: yttrium-aluminum-garnet (Nd: YAG) laser in gingival depigmentation. The aim of this study was to propose a minimally invasive surgical approach employing low-level laser therapy (LLLT) with Er: YAG and Nd: YAG lasers for gingival discoloration. Two clinical cases of "black anterior gingiva" were surgically treated with a sequential combination of Er: YAG and Nd: YAG lasers. In the treatment process, an Er: YAG laser was first used for depigmentation, and an Nd: YAG laser was then used for pain and inflammation control and potential infection prevention. The patients experienced no bleeding, reported a low level of discomfort during and immediately after intervention, and showed complete disappearance of pigmentation at the 1 y follow-up. The present cases showed that laser therapy combining Er: YAG with Nd: YAG is effective in depigmentation procedures and can reduce the duration of treatment and postoperative discomfort.