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Vitamin C mesotherapy versus topical application for gingival hyperpigmentation: a clinical and histopathological study

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A Correction to this article was published on 02 August 2021

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Abstract

Objective

Vitamin C/Ascorbic acid inhibits tyrosinase enzyme causing melanin biosynthesis suppression. This study aimed to compare the efficacy of intra-mucosal injection (mesotherapy) with topical gel as non-surgical methods for managing gingival hyperpigmentation.

Materials and methods

Twenty healthy non-smokers with mild to severe hyperpigmented gingiva were randomly assigned for Mesotherapy (G1); intra-mucosal injection of ascorbic acid (1/week/3 weeks); or Gel (G2), topical ascorbic acid gel (1/day/3 months). Pigmentation index (DOPI), patient satisfaction, as well as histological analysis for Fontana-Masson-stained specimens were performed at baseline and after 6 months. Comparison between groups and changes by time were analyzed using Mann-Whitney and Friedman’s tests, respectively.

Results

The median DOPI significantly decreased after 1 month in G1 (P value < 0.001, r = 0.9) compared with non-significant change in G2. No pain experienced during or after treatment in both groups. G1 patients showed significantly higher satisfaction with treatment than G2. Mean area fraction of melanin forming cells was significantly reduced in both groups after 6 months, but the effect size was higher in G1 (r = 0.886) than in G2 (r = 0.797).

Conclusions

Vitamin C mesotherapy showed better and early effect than topical gel, and both techniques were not painful and esthetically satisfying in managing gingival hyperpigmentation.

Clinical relevance

Gingival melanin pigmentation causes esthetic concerns for significant number of patients. Investigating non-surgical depigmentation techniques to decrease postoperative complications and patient discomfort, pain and long healing period associated with surgical methods would be clinically significant.

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Data availability

Data available on request from the authors.

Change history

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Acknowledgement

The authors want to acknowledge resources and staff in Oral Pathology Laboratory, in Faculty of Dentistry, Ain Shams University, Cairo, Egypt.

Part of this work was presented during 2nd International conference of Faculty of Dentistry ASU (20-22 October- 2016) under the title “Gingival depigmentation should we modulate or irradicate melanocytes”

Author information

Authors and Affiliations

  1. Department of Oral Medicine, Periodontology Oral Diagnosis and Radiology, Faculty of Dentistry, Ain-Shams University, 20 Organization of African Union St., Cairo, 1156, Egypt

    Mohamed El-Mofty, Dalia Yossri & Ola Mohammed Ezzatt

  2. Department of Oral Medicine, Periodontology, Faculty of Dentistry, Nahda University, Beni Suef, Egypt

    Mohamed El-Mofty

  3. Department of Oral Medicine, Periodontology, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt

    Sarah Elkot

  4. Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt

    Amira Ghoneim

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Contributions

Conceptualization: [Mohamed El-Mofty]; Methodology: [Ola Ezzatt]; Formal analysis and investigation: [Sarah Elkot], [Dalia Yossri], [Amira Ghoneim]; Writing - original draft preparation: [Ola Ezzatt], [Sarah Elkot]; Writing - review and editing: [Mohamed El-Mofty], Supervision: [Mohamed El-Mofty].

Corresponding author

Correspondence to Ola Mohammed Ezzatt.

Ethics declarations

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the research ethical committee in faculty of dentistry Ain Shams University and was approved under the number (FDASU-REC D041602) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The trial was registered at https://clinicaltrials.gov/ under the number (NCT03252418).

Conflict of interest

The authors declare that they have no conflict of interest and do not have any financial interest in the companies whose materials are included in this article.

Informed consent

All needed information about the study were given to the patients and informed consent term was obtained from every individual participant included in the study.

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The original version of this article was revised: The authors made the description more clinically applicable and refined the description to eliminate any conflict to the practitioners during practicing the technique. The information in reference 32 was also modified to coincide with the reference citation.

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El-Mofty, M., Elkot, S., Ghoneim, A. et al. Vitamin C mesotherapy versus topical application for gingival hyperpigmentation: a clinical and histopathological study. Clin Oral Invest 25, 6881–6889 (2021). https://doi.org/10.1007/s00784-021-03978-6

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  • DOI: https://doi.org/10.1007/s00784-021-03978-6

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