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This method involves the use of a rotary bur, like the kind used to prepare cavities, for the removal of the of the top layer of the gums. The time taken to complete the depigmentation via this method is probably the least and it is also pretty forgiving to the doctor.
Bleeding is still a disadvantage with this method as is the excessive amount of trauma when compared to a scalpel. Doctors should take care to use a large sized bur otherwise the smaller sized bur will cause uneven pitting to occur on the surface of the gums and not abrade it as intended.
Cryosurgery for the purposes of removal of the pigmented layer of gingival was extremely popular before it was replaced by better methods on a large scale. It will be hard to find practitioners that practice this method because of its associated and well-documented disadvantages.
The method involved the use of liquid nitrogen to freeze the top layer of the gingival that would then over the course of a week necrose and fall off. It was frequently necessary to perform this procedure in two sittings, with the second one to remove any areas that may have been left behind.
The procedure was effective and painless but there was no way control the depth of penetration of the cold. Thus, patients would frequently develop recession or damage to the underlying bone as collateral damage.
The advent of lasers has made this technique mostly irrelevant.
This is by far the best method that can be used for the removal of pigmentation from the gingival and make it lighter in appearance. There is no blood during the procedure, the wound that is left behind is sterile and thus does not need a periodontal dressing, and it is extremely easy for the doctor to perform the procedure using this method.
The only problem is that the laser has a fixed depth of penetration depending upon the kind of laser it is and the intensity at which it is being used. This makes it difficult to alter the depth in areas of the gingival that may not be as thick.
Patients are quite satisfied since they find it quite comfortable to go through the procedure without any noise, blood, pain or a bulky dressing afterward.
The cost of getting the procedure done using a laser is considerably higher than with other methods while the result may not be that different.
The color of the gingiva varies from person to person, similar to how the color of the skin varies. It is possible to make the gingival lighter for some time, however, it is bound to return to its original color in the long run.
No one can predict the exact time frame in which this return to the original pigmentation levels will happen or guarantee that any one method is going to work better than all others. The final decision as to what procedure is to be followed should be made on the advice of your doctor based on a clinical examination and previous experience.