Efficacy of Superoxidised solution and Povidone iodine solution with periodontal dressing in gingival depigmentation A split mouth randomized controlled trial

Gingival pigmentation is presented as a diffuse deep purplish discolouration or as irregularly shaped brown or black patches, striae or strands. Melanin, carotene, reduced haemoglobin and oxy-haemoglobin are the prime pigments contributing to the normal colour of the gingiva . Excessive deposition of melanin located in the basal and suprabasal cell layers of the epithelium will result in gingival hyperpigmentation(Dummett,1979). Gingival hyperpigmentation is an aesthetic concern. It can be physiological or pathological. Physiological hyperpigmentation is genetic and does not pose any health concerns, whereas pathological hyperpigmentation is a health concern and can occur due to variety of reasons like endocrine disorders, ingestion of heavy metals, Kaposi’s sarcoma, smoking, etc . Gingival depigmentation can be defined as a periodontal plastic surgical procedure whereby the gingival hyperpigmentation is removed or reduced by various techniques .A variety of depigmentation techniques have been described in the literature which can be classified as surgical and non surgical or chemical methods. Surgical methods mainly include bur abrasion, scalpel surgery, electrocautery, laser ablation, cryosurgery, radiosurgery, gingivectomy. Nonsurgical methods mainly refer to chemical cauterization using alcohols, phenols, ascorbic acid . A scalpel technique is one of the first techniques employed for gingival melanin depigmentation that involves surgical removal of gingival epithelium along with a layer of underlying connective tissue, thus allowing the denuded connective tissue to heal by secondary intention . It is traditional approach which is simple, easy to perform, cost effective, with minimum discomfort and aesthetically acceptable to patient. Superoxidised solution and Povidone Iodine solution represent two distinct interventions for gingival depigmentation, each with its unique characteristics and purported advantages. It is crucial to understand the comparative effectiveness of Superoxidised solution alongside Povidone iodine solution, a more traditional approach, to provide practitioners with a comprehensive understanding of available options. Superoxidised solution , a relatively novel method, is gaining attention for its ease of application and potential efficacy.The importance of Superoxidised solution lies in its potential to offer a less invasive and more patient friendly adjunct for gingival depigmentation. The spray form allows for precise application, potentially reducing discomfort during the procedure, as it is superoxidised solution which is colourless solution, has an anti inflammatory effect , it has bactericidal, fungicidal, sporicidal properties ,reduces patient discomfort, helps in early healing of the wounds . Understanding its efficacy compared to Povidone iodine solution is pivotal for practitioners seeking to incorporate innovative and patient-centric methods into their cosmetic dentistry practices. On the other hand, Povidone Iodine solution has been a longstanding choice for depigmentation, known for its effectiveness, which acts as a disinfectant , used as an oxidizing agent ,has an antimicrobial action. However, the comparative assessment with Superoxidised solution is essential to validate its continued relevance and identify potential areas for improvement .This study is essential as it aims to fill the existing gap in the literature by directly comparing the two treatments in a controlled manner, employing a split-mouth technique. Such a design enhances the internal validity of the study, minimizing the impact of confounding variables. The comparison of Superoxidised solution and Povidone iodine solution is specifically chosen to provide practitioners with evidence-based insights when deciding on the most suitable method for gingival depigmentation, as well as patient comfort and postoperative outcomes. While various methods exist for depigmentation, there is a scarcity of comprehensive comparative studies addressing the effectiveness and postoperative aspects of Superoxidised solution and Povidone iodine solution. Henceforth this study aims to evaluate and compare the effectiveness of Superoxidised solution and Povidone iodine solution with periodontal dressing in gingival depigmentation using a split -mouth technique.