Gingivectomy–Gingivoplasty for Oral Physiological Melanosis Depigmentation: A Case Report Involving Human Papillomavirus

TL;DR

This case report describes a surgical treatment for gum pigmentation, which improved the patient's appearance and revealed an underlying HPV infection.

Contribution

The paper presents a case where gingivectomy and gingivoplasty were used to treat oral melanosis and uncovered an HPV infection.

Findings

Surgical depigmentation of the gingiva achieved acceptable aesthetic and functional outcomes.

Histological analysis confirmed melanotic macula and suggested HPV infection.

HPV presence necessitates long-term patient follow-up.

Abstract

Gingiva hyperpigmentation resulting from physiological melanosis causes aesthetic discomfort and is usually perceived as a disease by patients because healthy attached gingiva is typically characterized by coral pink coloring with stippling and scalloped contours. When physiological melanosis compromises the aesthetics of smiling, it may induce insecurity in patients, who usually seek out alternatives for reducing or eliminating hyperpigmentation. We present a case report of a surgical procedure combining gingivectomy with gingivoplasty for the management of physiological melanosis. The surgical procedure was performed on a 40-year-old female patient with bilateral pigmentation in both arches. The results of the histological analysis confirm the diagnoses of melanotic macula, with papillary hyperplasia and cytopathic changes being suggestive of HPV infection, which was verified using an immunohistochemistry analysis based on the detection of a major capsid protein of HPV. Acceptable functional and aesthetic results were obtained for the patient without major discomfort during the postoperative period. In cases when HPV infection is present, long-term follow-up becomes necessary.

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