Group A was treated by an Er,Cr:YSGG laser 2780 nm cylindrical tip (tip 600 μm, 45 millijoule /pulse, average power 2.25 W, frequency 50 Hz, pulse duration 60 µs, energy density 43 J/cm2, water 50%, and air 40%). The procedure was performed completely without anesthesia with the laser tip at angulation ~30° and distance of ~1 mm from the gingival tissue. The laser tip was advancing in scanning movement from in the cervical-apical direction in all pigmented areas. The following settings was used to achieve hemostasis in case of the bleeding was present (tip 600 μm, 30 millijoule /pulse, average power 1.5 W, frequency 50 Hz, pulse duration 700 µs, energy density 28.7 J/cm2, water 10%, and air 20%).

Group B was treated with diode 940 nm Laser. The procedure was performed with a pencil-sized handpiece containing a 400 µm lasing fiber (400 μm initiated tip, average power 0.8 watts, Pulsed mode, Duty cycle 20%, Pulse duration 10 μs, energy density 636.9 J/cm2 per second, no water or air). Infiltration anesthesia was injected for B group . The laser tip was placed in angle ~30° with the gingival surface. Short light paint brush strokes were used in the cervical-apical direction in all pigmented areas.

The depigmentation procedure essentially involves laser ablation of epithelial layer of buccal gingiva containing melanin pigmentation.

• Score 1: No clinical pigmentation (pink-colored gingiva)
• Score 2: Mild clinical pigmentation (mild light brown color)
• Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
• Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

• Score 1: No clinical pigmentation (pink-colored gingiva)
• Score 2: Mild clinical pigmentation (mild light brown color)
• Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
• Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

• Score 1: No clinical pigmentation (pink-colored gingiva)
• Score 2: Mild clinical pigmentation (mild light brown color)
• Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
• Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

• Score 1: No clinical pigmentation (pink-colored gingiva)
• Score 2: Mild clinical pigmentation (mild light brown color)
• Score 3: Moderate clinical pigmentation (medium brown or mixed pink and brown color)
• Score 4: Heavy clinical pigmentation (deep brown or bluish black color)

• Score 0: No pigmentation
• Score 1: Solitary unit(s) of pigmentation in papillary gingiva without extension between neighboring solitary units
• Score 2: Formation of continuous ribbon extending from neighboring solitary units

The Oral Hygiene Index is composed of the combined Debris Index and Calculus index, each of these index is in turn based on 12 numerical determinations representing the amount of debris or calculus found on the buccal and lingual surfaces of each of three segments of each dental arch.

Criteria for classifying debris 0 No debris or stain present

1. Soft debris covering not more than one third of the tooth surface, or presence of extrinsic stains without other debris regardless of surface area covered
2. Soft debris covering more than one third, but not more than two thirds, of the exposed tooth surface.
3. Soft debris covering more than two thirds of the exposed tooth surface.