New Publication in Lasers in Medical Science
Laser-Assisted Gingival Melanin Depigmentation Using Diode 450 nm; Ablative vs. Non-Ablative Techniques: Randomized Clinical Trial
Walid Altayeb, PhD
Kenneth Luk,PhD
Josep Arnabat, PhD
Ahmed Abdullah PhD
Raneem Darkazali MSc
Omar Hamadah, PhD
Laser Gingival Depigmentation: Which Technique Is Right for You?
Discover the difference between ablative and non-ablative laser treatments for gum pigmentation
Two Philosophies: How Each Technique Works
Ablative: The Removal Approach
Uses photothermal ablation to physically vaporize and surgically remove the pigmented gingival epithelium layer containing melanin-producing cells.
Goal: Immediate, total depigmentation in a single session
Non-Ablative: The Targeted Approach
Uses selective photothermolysis where 450 nm wavelength is highly absorbed by melanin, heating and disrupting pigment cells without removing overlying tissue.
Goal: Reduce pigmentation with minimal discomfort and faster healing
Procedural Differences: Anesthesia & Application
Ablative
  • Local anesthesia required
  • Contact procedure with laser tip touching tissue at 30° angle
  • No water or air cooling used
  • Complete when pigmented epithelial layer is removed
Non-Ablative
  • No anesthesia needed
  • Non-contact procedure performed from 5mm away
  • Water irrigation and air spray cooling
  • Applied until pigmented area turns gray
Time Investment: A Significant Difference
10.2
Ablative Minutes
Average duration ± 1.7 minutes. Significantly longer procedure time.
6.7
Non-Ablative Minutes
Average duration ± 1.5 minutes. Notably shorter treatment time.
1
Ablative Session
Depigmentation completed in a single session.
2+
Non-Ablative Sessions
May require additional sessions for optimal results.
Patient Experience: Comfort & Recovery
Patient-reported outcomes during and immediately after the procedure revealed clear differences in comfort and recovery between the two methods.
55%
Ablative Anxiety
Patients reported higher anxiety levels
10%
Non-Ablative Anxiety
Significantly lower anxiety reported
65%
Exceeded Expectations
Found non-ablative less challenging than anticipated
Post-Operative Pain & Swelling
Ablative Technique
Majority of patients reported mild to moderate post-operative pain. Significantly more gingival swelling during the first week of recovery.
Non-Ablative Technique
Patients experienced almost no post-operative pain. Minimal swelling with rapid healing and superior patient comfort.
The non-ablative approach offers a dramatically more comfortable recovery experience, making it ideal for patients with lower pain tolerance or busy schedules.
Long-Term Results: Efficacy & Re-pigmentation
1
1 Month: Initial Efficacy
Ablative: 65% achieved uniform pink gingival appearance
Non-Ablative: 35% achieved uniform pink appearance
Difference not statistically significant (p=0.06)
2
12 Months: Re-pigmentation Rates
Ablative: 20% experienced pigment returning
Non-Ablative: 30% experienced pigment returning
Ablative showed lower long-term recurrence
3
Patient Satisfaction
Initial satisfaction similar for both treatments
One-month satisfaction significantly higher for ablative due to more complete, uniform initial results
Both Techniques Are Effective
Choosing the Right Technique for You
Choose Ablative If:
  • You prioritize complete pigment removal in one session
  • You're willing to accept greater post-operative discomfort
  • You want immediate, uniform results
  • You prefer fewer treatment sessions
Choose Non-Ablative If:
  • You seek a more comfortable experience
  • You want minimal discomfort and rapid healing
  • You're amenable to multiple sessions
  • You have lower pain tolerance
The appropriate technique should be selected based on your individual priorities, tolerance for discomfort, and treatment goals.
Laser Gingival Depigmentation:
Which Technique Is Right for You?
Walid Altayeb
DDS, MSc, PhD

Walid Altayeb (@walidaltayeb)