Gingival depigmentation strategies: a narrative review of laser and scalpel approaches

Gingival melanosis (GM), a benign pigmentation of the gums, is a common aesthetic concern, especially among individuals with darker skin tones. Although harmless, it often prompts patients to seek treatment for cosmetic enhancement. This narrative review compares the efficacy of two primary treatment modalities, diode laser (DL) therapy and traditional surgical scalpel (SS) techniques, in managing physiological gingival pigmentation. By analyzing clinical data from recent studies, this review evaluates key parameters such as intraoperative bleeding, postoperative pain, wound healing, and repigmentation intensity. DL therapy demonstrates notable advantages, including immediate coagulation, reduced bleeding, minimal discomfort, and faster initial healing. While SS techniques remain practical and widely accessible, they are associated with more significant postoperative pain and slower early tissue recovery. Despite differences in the procedural experience, both methods achieve comparable long-term results in depigmentation and repigmentation control. Treatment choices should be tailored to individual patient needs, tissue characteristics, and aesthetic expectations. Although the DL presents several clinical benefits, more standardized and large-scale studies are necessary to confirm its superiority. This review provides practical guidance for clinicians to optimize outcomes in gingival depigmentation procedures.