Comparative evaluation of efficacy of injectable vitamin C and glutathione in the treatment of physiological gingival melanin hyperpigmentation– A randomized clinical trial

Abstract

Title: Comparative Evaluation of Efficacy of Injectable Vitamin C and Glutathione in the Treatment of Physiological Gingival Melanin Hyperpigmentation – A Randomized Clinical Trial. Objectives: The present study aimed to comparatively evaluate the efficacy of injectable Vitamin C and Glutathione in the treatment of physiological gingival melanin hyperpigmentation. Secondary objectives included assessment of changes in gingival biotype and evaluation of pain and discomfort associated with both treatment modalities. Materials and Methods: Forty selected sites in 20 subjects with physiological gingival melanin hyperpigmentation were randomly divided into two groups namely Site A and Site B. In a double blinded study scaling and root planing was performed in all the selected subjects. Prior to the procedure baseline parameters were recorded namely DOPI Index, Gingival Biotype, VAS score. The area was anaesthetized by topical local anesthetic agent. After achieving adequate anesthesia, about 0.2ml of Vitamin C (500mg/ml) was administered at Site A and about 0.2ml of Glutathione (600mg/ml) was administered at Site B; using an insulin syringe. The procedure was repeated at weekly interval for a period of 4 weeks. The gingival tissue biotype was assessed by transgingival method using an endodontic reamer no: 20 with a rubber stopper measured using digital vernier caliper. Subjects were recalled at 1 week, 1month and 3 months for follow up and parameters were recorded. Results: Both injectable Vitamin C and Glutathione demonstrated a statistically significant reduction in gingival melanin pigmentation scores from baseline to follow-up periods. Intergroup comparison revealed that Vitamin C showed comparable or slightly superior depigmenting efficacy compared to Glutathione. Gingival biotype remained unchanged in both groups. Pain and discomfort scores were minimal in both treatment modalities, with no statistically significant difference between groups. Conclusion: Injectable Vitamin C and Glutathione are effective, minimally invasive non-surgical modalities for the management of physiological gingival melanin hyperpigmentation. Vitamin C showed slightly better clinical outcomes, though both agents were well tolerated by patients. These therapies can be considered promising alternatives to conventional surgical depigmentation procedures