Relationship of hemoglobin levels and distribution and severity of gingival melanin pigmentation: An exploratory cross-sectional study.

Abstract

Background: Recurrence of gingival pigmentation following depigmentation procedures is common, raising the question of the influence of an underlying cause, if any. Melanin, a non-hemoglobin-derived brown pigment, is the most common endogenous pigment contributing to gingival pigmentation. Hemoglobin derivatives are among the other prime pigments that contribute to gingival color. This exploratory cross-sectional study evaluated the influence of hemoglobin levels on the distribution and severity of gingival melanin pigmentation in periodontitis, gingivitis, and healthy periodontium.

Methods: Twenty subjects with periodontitis (group 1), gingivitis (group 2), and healthy periodontium (group 3) were recruited in this observational study, totaling 60 subjects. The hemoglobin levels in g/dL and Hedin Melanin Index (HMI-1977) scores were recorded for all subjects, and relevant statistical tests were applied (P<0.05).

Results: A negative correlation was observed between the hemoglobin levels and the HMI scores for the whole sample and each group. This correlation was statistically significant for the whole sample and for the gingivitis group in which the correlation was moderate.

Conclusion: The inverse and significant relation between the hemoglobin levels and distribution and severity of melanin pigmentation observed for the whole sample and the gingivitis group requires further research and validation to identify and manage the confounding factors in the treatment of gingival pigmentation.