Clinical Efficacy of Topical Ascorbic Acid 2-Glucoside in Enhancing Outcomes of Laser Gingival Depigmentation: A Randomized Controlled Trial

Background Melanin accumulation in the oral epithelium causes gingival hyperpigmentation, which is a common aesthetic problem. Precision, low invasiveness, and favorable recovery make diode laser depigmentation (LD) the ideal method. Yet, recurrence of pigmentation is still a concern. The antioxidant and melanin inhibitor ascorbic acid 2-glucoside (AS-G) may improve results and postpone repigmentation. The effectiveness of topical AS-G following laser gingival depigmentation (LD + AS-G) was assessed in this study. Materials and methods A randomized controlled trial was conducted on 20 participants with physiologic gingival hyperpigmentation. Gingival depigmentation was performed in both LD + AS-G (test group) and LD (control group). Evaluations of clinical parameters, such as Dummett Oral Pigmentation Index (DOPI), Plaque Index (PI), and bleeding on probing, were performed at baseline, followed by assessments at one, three, six, and nine months. The Visual Analogue Scale (VAS) (pain and discomfort) was recorded on the seventh day, and VAS (satisfaction) was measured at six and nine months. Results To summarize, there was a significant reduction in PI within both groups over time, changes were observed in the modified Sulcus Bleeding Index (mSBI), intergroup differences were noted in DOPI scores at the nine-month follow-up, and differences were found in patient satisfaction scores at six and nine months. Intragroup analysis showed a statistically significant reduction in PI in both test and control groups at three, six, and nine months (p < 0.05). No significant changes were observed in the mSBI values in the test group, whereas the control group demonstrated a significant reduction only at nine months (p < 0.05). Intergroup comparison revealed no statistically significant differences in PI and mSBI scores at most follow-up intervals; however, a statistically significant difference in PI was observed at the nine-month follow-up (p = 0.022). DOPI scores demonstrated a statistically significant difference between the groups at nine months (p = 0.004), indicating higher recurrence of pigmentation in the control group. Patient satisfaction scores were comparable at six months but were significantly higher in the test group at nine months (p < 0.001). Conclusions Within the limitations of this randomized controlled trial, topical application of AS-G demonstrated beneficial effects in improving clinical outcomes following laser gingival depigmentation. The adjunctive use of this antioxidant appeared to enhance gingival healing and may contribute to improved patient-reported outcomes. These findings suggest that topical AS-G may serve as a useful adjunct in depigmentation procedures. Nevertheless, further studies with larger sample sizes and longer follow-up periods are recommended to validate these findings and establish long-term clinical benefits.