Scalpel Surgical Technique

In this technique, the pigmented gingival epithelium along with a layer of the underlying connective tissue is surgically removed by splitting the epithelium with blade. Care should be taken not to leave any pigmented remnants over the denuded area.

The scalpel method is one of the most economic techniques and also does not require extensive armamentarium [6]. It is highly recommended in consideration of the equipment constraints that may not be frequently available in clinics. Moreover, it is known that the healing period for scalpel wounds is faster than other techniques.

However, scalpel surgery causes bleeding during and after the procedure and it is necessary to cover the surgical site with periodontal dressing for 7–10 days. Though the initial results of depigmentation procedure are highly encouraging, regimentation is a possibility. This process may be attributed to the fact that active melanocytes from the adjacent pigmented tissues migrate to the treated areas.

Bur Abrasion Method

In this technique a medium grit football shaped diamond bur is used at high speeds to denude the epithelium. The procedure requires 45 min to1hour for completion.

It is relatively simple, safe, non-aggressive method and easy to perform. Above all, it causes less discomfort and is esthetically acceptable to the patients [33]. Also, this technique does not require any sophisticated equipment and is hence; economical

On the other hand, bur abrasion method was found to be difficult in controlling the depth of de-epithelialization. Moreover, bleeding and post-operative pain are anticipated.