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Hyperpigmentation; MelaninNCT04680806

Laser-Assisted Gingival Depigmentation

A study testing Er,Cr:YSGG laser 2780 nm and Diode laser 940 nm in people with Hyperpigmentation; Melanin and Laser-Induced Hyperpigmentation, run by Academy of Laser Dentistry - Gulf Laser Chapter at 1 site in Qatar.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This randomized clinical trial evaluated the recurrence rates of physiological gingival pigments during 24 months follow-up and the patient perceptions after the ablative depigmentation using two laser wavelengths; Diode 940 nm and Er,Cr:YSGG 2780 nm. Read more about this study

Who is it for?
Ages 20 years and olderHealthy volunteers can take part
What is being tested?
Er,Cr:YSGG laser 2780 nm and Diode laser 940 nm
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 siteQatar
Study dates
5 Apr 2015to 20 Oct 2019
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 20 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • All patient exhibiting physiologic pigmentation of score2 or more according to Oral pigmentation index (DOPI)

Who cannot join

  • Pathologic hyperpigmentation
  • Participants with a systemic condition that could affect tissue healing (e. g., autoimmune diseases)
  • Pregnancy and lactation
  • History of smoking
  • Previous mucogingival surgery at the region to be treated
  • No contraindication for the laser treatment.

Trial locations and contacts

1 site in 1 country.

Qatar1 site
  • Dr. Tamim Dental Polyclinic

    Doha, 13876

Other trials in Qatar

About this study

Official title: Gingival Depigmentation With Er,Cr:YSGG and Diode Laser: Randomized Clinical Trial to Evaluate the Repigmentation and Patient Perceptions

This randomized clinical trial evaluated the recurrence rates of physiological gingival pigments during 24 months follow-up and the patient perceptions after the ablative depigmentation using two laser wavelengths; Diode 940 nm and Er,Cr:YSGG 2780 nm.

Read the detailed description

This study aim to compare the clinical outcomes, the rate of repigmentation, and the patient perceptions after laser-assisted gingival depigmentation with diode 940 nm and Erbium, chromium-doped yttrium, scandium, gallium and garnet (Er,Cr:YSGG) 2780 nm. Two pigmentation index were used to compare between the treatment outcomes of using Diode laser or Er,Cr:YSGG.

The depigmentation procedure essentially involves ablation of epithelial layer of buccal gingiva containing melanin pigmentation.

Sixty healthy patients (22 males and 38 females, aged 21 to 43 years) who presented with a chief complaint of having dark-brown to black gingival hyperpigmentation between April 2015 and September 2018. Participants were randomly divided into 2 groups (30 patients each). Randomization was carried out using randomization table; by a computer-generated randomization list (SPSS v23.0) with allocation ratio 1:1.

All of the patients were selected according to the study inclusion and exclusion criteria.

Data collection was done by a dental specialist who was blinded about the provided treatment. Data collections included the clinical examination at baseline and follow up appointments. To achieve blinding, three calibrated external experts, blinded to the provided treatment classified the degree of gingival pigments and gingival topography according oral pigmentation index (DOPI) and melanin pigmentation index.

The periodontal surgery was performed by a periodontist specialised in laser dentistry. The periodontist did not interfere with the treatment option.

Descriptive statistics and statistical analysis was done by an external expert using SPSS Statistics software(SPSS v23.0) . Nonparametric tests, Kruskal-Wallis test was used to compare between the two groups according the time intervals.

The patients who did not show in all the study follow up's appointments were dropped from the data analysis.

Patients were asked to evaluate the procedure by using a self-administered questionnaire. The patients were recalled after 1 week, 1 month, 12 months and 24 months.

Being tested
Er,Cr:YSGG laser 2780 nm, Diode laser 940 nm
Keywords
Depigmentation, Gingival Hyperpigmentation, Diode laser, Er,Cr:YSGG laser, Repigmentation
Medical subject headings
Hyperpigmentation, Vitiligo

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Er,Cr:YSGG laser 2780 nmDevice

    The depigmentation procedure essentially involves laser ablation of epithelial layer of buccal gingiva containing melanin pigmentation.

  • Diode laser 940 nmDevice

    The depigmentation procedure essentially involves laser ablation of epithelial layer of buccal gingiva containing melanin pigmentation.

Study groups in NCT04680806
Study groupRoleWhat they receive
Er,Cr:YSGG laser 2780 nmExperimentalGroup A was treated by an Er,Cr:YSGG laser 2780 nm cylindrical tip (tip 600 μm, 45 millijoule /pulse, average power 2.25 W, frequency 50 Hz, pulse duration 60 µs, energy density 43 J/cm2, water 50%, and air 40%). The procedure was performed completely without anesthesia with the laser tip at angulation ~30° and distance of ~1 mm from the gingival tissue. The laser tip was advancing in scanning movement from in the cervical-apical direction in all pigmented areas. The following settings was used to achieve hemostasis in case of the bleeding was present (tip 600 μm, 30 millijoule /pulse, average power 1.5 W, frequency 50 Hz, pulse duration 700 µs, energy density 28.7 J/cm2, water 10%, and air 20%).
Receives: Device: Er,Cr:YSGG laser 2780 nm
Diode laser 940 nmExperimentalGroup B was treated with diode 940 nm Laser. The procedure was performed with a pencil-sized handpiece containing a 400 µm lasing fiber (400 μm initiated tip, average power 0.8 watts, Pulsed mode, Duty cycle 20%, Pulse duration 10 μs, energy density 636.9 J/cm2 per second, no water or air). Infiltration anesthesia was injected for B group . The laser tip was placed in angle ~30° with the gingival surface. Short light paint brush strokes were used in the cervical-apical direction in all pigmented areas.
Receives: Device: Diode laser 940 nm

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Oral pigmentation index (DOPI)

    • Score 1: No clinical pigmentation (pink-colored gingiva)
    • Score 2: Mild clinical pigmentation (mild light brown color)
    • Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
    • Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

    Measured: Baseline

  2. Oral pigmentation index (DOPI)

    • Score 1: No clinical pigmentation (pink-colored gingiva)
    • Score 2: Mild clinical pigmentation (mild light brown color)
    • Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
    • Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

    Measured: 1 month post-operative

  3. Oral pigmentation index (DOPI)

    • Score 1: No clinical pigmentation (pink-colored gingiva)
    • Score 2: Mild clinical pigmentation (mild light brown color)
    • Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
    • Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

    Measured: 1 year follow-up

  4. Oral pigmentation index (DOPI)

    • Score 1: No clinical pigmentation (pink-colored gingiva)
    • Score 2: Mild clinical pigmentation (mild light brown color)
    • Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
    • Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

    Measured: 2 years follow-up

  5. Melanin pigmentation index:

    • Score 0: No pigmentation
    • Score 1: Solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units
    • Score 2: Formation of continuous ribbon extending from neighboring solitary units

    Measured: Baseline

  6. Melanin pigmentation index:

    • Score 0: No pigmentation
    • Score 1: Solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units
    • Score 2: Formation of continuous ribbon extending from neighboring solitary units

    Measured: 1 month post-operative

  7. Melanin pigmentation index:

    • Score 0: No pigmentation
    • Score 1: Solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units
    • Score 2: Formation of continuous ribbon extending from neighboring solitary units

    Measured: 1 year follow-up

  8. Melanin pigmentation index:

    • Score 0: No pigmentation
    • Score 1: Solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units
    • Score 2: Formation of continuous ribbon extending from neighboring solitary units

    Measured: 2 years follow-up

  9. Gingival Appearance

    • Score 1:Pink vital appearance for the gingiva
    • Score 2: Pale Non-vital appearance for gingiva

    Measured: 1 month

Secondary outcomes (4)
  1. Oral Hygiene Index

    The Oral Hygiene Index is composed of the combined Debris Index and Calculus index, each of these index is in turn based on 12 numerical determinations representing the amount of debris or calculus found on the buccal and lingual surfaces of each of three segments of each dental arch.

    Criteria for classifying debris 0 No debris or stain present

    1. Soft debris covering not more than one third of the tooth surface, or presence of extrinsic stains without other debris regardless of surface area covered
    2. Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface.
    3. Soft debris covering more than two thirds of the exposed tooth surface.

    Measured: Baseline

  2. Oral Hygiene Index

    The Oral Hygiene Index is composed of the combined Debris Index and Calculus index, each of these index is in turn based on 12 numerical determinations representing the amount of debris or calculus found on the buccal and lingual surfaces of each of three segments of each dental arch.

    Criteria for classifying debris 0 No debris or stain present

    1. Soft debris covering not more than one third of the tooth surface, or presence of extrinsic stains without other debris regardless of surface area covered
    2. Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface.
    3. Soft debris covering more than two thirds of the exposed tooth surface.

    Measured: 1 month post-operative

  3. Gingival Index

    The Gingival Index (Löe and Silness, 1963) was created for the assessment of the gingival condition and records qualitative changes in the gingiva. It scores the marginal and interproximal tissues separately on the basis of 0 to 3. The criteria are:

    0= Normal gingiva;

    1= Mild inflammation - slight change in color and slight edema but no bleeding on probing; 2= Moderate inflammation - redness, edema and glazing, bleeding on probing; 3= Severe inflammation - marked redness and edema, ulceration with tendency to spontaneous bleeding.

    Measured: Baseline

  4. Gingival Index

    The Gingival Index (Löe and Silness, 1963) was created for the assessment of the gingival condition and records qualitative changes in the gingiva. It scores the marginal and interproximal tissues separately on the basis of 0 to 3. The criteria are:

    0= Normal gingiva;

    1= Mild inflammation - slight change in color and slight edema but no bleeding on probing; 2= Moderate inflammation - redness, edema and glazing, bleeding on probing; 3= Severe inflammation - marked redness and edema, ulceration with tendency to spontaneous bleeding.

    Measured: 1 month post-operative

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Dec 2020
  2. Study start5 Apr 2015
  3. Primary completion30 Sep 2018
  4. Study completion20 Oct 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Participants were randomly allocated to the two treatment groups: -Group A was treated by an Er,Cr:YSGG laser 2780 nm. -Group B: was treated with diode 940 nm Laser.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04680806
Sponsor's protocol ID
GulfLaserChapter
Status last verified
Dec 2020
First submitted
15 Dec 2020
Last updated
23 Dec 2020
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No: there is no plan to make individual participant data (IPD) available

Publications

  • Simsek Kaya G, Yapici Yavuz G, Sumbullu MA, Dayi E. A comparison of diode laser and Er:YAG lasers in the treatment of gingival melanin pigmentation. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Mar;113(3):293-9. doi: 10.1016/j.tripleo.2011.03.005. Epub 2011 Jun 12.

    PubMed 22676819
  • Nammour S, El Mobadder M, Namour M, Namour A, Rompen E, Maalouf E, Brugnera Junior A, Brugnera AP, Vescovi P, Zeinoun T. A Randomized Comparative Clinical Study to Evaluate the Longevity of Esthetic Results of Gingival Melanin Depigmentation Treatment Using Different Laser Wavelengths (Diode, CO2, and Er:YAG). Photobiomodul Photomed Laser Surg. 2020 Mar;38(3):167-173. doi: 10.1089/photob.2019.4672. Epub 2020 Jan 17.

    PubMed 31951510
  • Hegde R, Padhye A, Sumanth S, Jain AS, Thukral N. Comparison of surgical stripping; erbium-doped:yttrium, aluminum, and garnet laser; and carbon dioxide laser techniques for gingival depigmentation: a clinical and histologic study. J Periodontol. 2013 Jun;84(6):738-48. doi: 10.1902/jop.2012.120094. Epub 2012 Sep 24.

    PubMed 23003920

Questions about this trial

What is this clinical trial studying?

A study testing Er,Cr:YSGG laser 2780 nm and Diode laser 940 nm in people with Hyperpigmentation; Melanin and Laser-Induced Hyperpigmentation, run by Academy of Laser Dentistry - Gulf Laser Chapter at 1 site in Qatar.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 23 Dec 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Qatar. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Oral pigmentation index (DOPI) (time frame: Baseline). The study lists 9 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04680806, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Dec 2020.

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