How Effective Is Vitamin C for Gingival Depigmentation? A Scoping Review

OBJECTIVES: Excessive gingival pigmentation can be treated by surgically removing the pigmented gingival tissue with a scalpel, bur, LASER, electrocautery, cryotherapy, chemical peeling, or masking with free gingival grafts. Recently, vitamin C (ascorbic acid), in gel, powder, or liquid has been used alone or as an adjunct to micro-needling or scalpel for gingival depigmentation. This paper aims to critically appraise current evidence on the role of vitamin C in gingival depigmentation. MATERIAL AND METHODS: The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-analysis for Scoping Review (PRISMA-Scoping Review). Studies using "Vitamin C" in any form, via any application method, frequency, duration, and dosage for gingival depigmentation and compared were included. RESULTS: Out of 119, 103 articles were excluded and 16 articles were taken up for full text screening. Of 16, 12 articles were included in the review. The results showed that vitamin C has been used along with scalpel depigmentation or as a stand-alone therapy (as mesotherapy or topical application). Vitamin C effectively reduced gingival pigmentation, however with no statistical difference between the scalpel and vitamin C application was noted. No studies have compared the efficacy of vitamin C to cryotherapy. Microneedling of gingiva followed by vitamin C application was also done. The recurrence rate of pigmentation following vitamin C mesotherapy application was 32.59% after 3 months compared to 32.87% with the scalpel. Vitamin C mesotherapy also revealed a significant reduction in VAS scores for itching and pain and better patient acceptance than scalpel depigmentation. CONCLUSION: Vitamin C application with microneedle or mesotherapy is a promising atraumatic alternative to a scalpel for gingival depigmentation.