歯肉メラニン色素沈着症に対する歯科用（Er:YAG, CO2）レーザーの着色除去効果
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概要
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Gingival hyperpigmentation can cause esthetic problems and embarrassment. Although melanin pigmentation of the oral tissues does not present a medical problem, patients complain they feel "ugly". Therefore, various methods of depigmentation including surgery and laser irradiation have been reported.Many methods of removing gingival hyperpigmentation have been reported, but there are few reports evaluating the effect of each method. Therefore, in this study we evaluated and compared the effects of Er:YAG and CO2 laser treatment with surgical abrasion for gingival depigmentation.Depigmentation treatment was performed for one patient who complained of dark-brown gingival hyperpigmentation and who provided informed consent for this clinical comparative study. This patient was a smoker. The area of hyperpigmentation was divided into 4 parts and each area of the gingiva was treated differently as follows—Er:YAG laser: maxillary, left side, central incisor–cuspid, CO2 laser: mandibular, right side, central incisor–cuspid, abrasion surgery with carborundum points: maxillary, right side, central incisor–cuspid, and untreated control area: mandibular, left side, central incisor–cuspid. Laser irradiation was performed according to the manufacturer's recommendations for the treatment of hyperpigmentation. After treatment, depigmentation effects were evaluated using Image J (ver1.43, NIH, Bethesda, MD) for all methods.The results achieved were considered satisfactory by both the patient and the operator. Er:YAG laser treatment was performed 10 times until the patient was satisfied; however, the patient felt slight pain during the procedure. CO2 laser treatment was also performed 10 times to achieve a satisfactory outcome, but the CO2 laser did not cause any intraoperative pain. Abrasion surgery using a carborundum point was the most effective with regard to the degree of depigmentation, but it entailed a lot of pain after the procedure. The effect of depigmentation was highest with the abrasion surgery using a carborundum point, when evaluated by image analysis.Both Er:YAG and CO2 laser treatments achieved a satisfactory effect, with both methods producing almost equal results in terms of the degree of depigmentation.CO2 laser treatment provided an adequate depigmentation effect without pain, and there was no difference in the degree of depigmentation between Er:YAG laser and CO2 laser treatment.
- 日本レーザー歯学会の論文