Assessment of heat provocation tests on the human gingiva: the effect of periodontal disease and smoking.

Periodontal inflammation is associated with morphological changes in the blood vessels which may influence the regulation of gingival blood flow (GBF). Our aim was to adapt the heat provocation test to the human gingiva to assess vascular reactivity in periodontal inflammation. METHOD: GBF was recorded by Laser Doppler Flowmetry before and after heat provocation in healthy volunteers (n = 50). Heat was generated either by warm saline or a halogen lamp. The latter method was also utilized for a heat test in non-smoking and smoking patients with periodontal inflammation. The circulatory parameters were correlated to the inflammatory marker, i.e. gingival crevicular fluid (GCF) production measured by Periotron. RESULTS: Local application of heat caused a rapid, significant and transient increase in GBF regardless of the method used. The increase in the speed and not in the concentration of moving blood cells was responsible for increased GBF. Higher GCF values were correlated with increased peak flow, flux pulse amplitude and faster restoration of GBF after the test in non-smokers, but not in smokers. CONCLUSIONS: The heat test could be a valuable tool to check the vascular reactivity of gingival vessels. Moderate periodontal inflammation may facilitate gingival vascular responsiveness which can be suppressed by smoking

Microcirculation changes in gingival tissue after ultrasonic tooth preparation in beagle dog

Abstract: Ultrasonic wave technology is widely used during dental treatments. We previously demonstrated that this method protects the gingival tissue. However, the physiological change on the gingival microvasculature caused by this method remains unclear. Objective: The aim of this study was to investigate the relationship between the morphological and physiological effects on gingival microcirculation when preparing teeth, using the conventional dental turbine or ultrasonic method. Methodology: The lower premolar teeth of beagle dogs were prepared along the gingival margin by using a dental turbine or ultrasonic wave instrument. Gingival vasculature changes were investigated using scanning electron microscopy for corrosion resin casts. Gingival blood flow at the preparation site was determined simultaneously by laser Doppler flowmetry. These assessments were performed immediately (Day 0), at 7 days and 30 days after tooth preparation. Results: At day 0, in the turbine group, blood vessels were destroyed and some resin leaked. Furthermore, gingival blood flow at the site was significantly increased. In contrast, the ultrasonic group demonstrated nearly normal vasculature and gingival blood flow similar to the non-prepared group for 30 days after preparation. No significant alterations occurred in gingival circulation 30 days after either preparation; however, the turbine group revealed obvious morphological changes. Conclusions: Based on multiple approach analyses, this study demonstrated that ultrasonic waves are useful for microvascular protection in tooth preparation. Compared with a dental turbine, ultrasonic wave instruments caused minimal damage to gingival microcirculation. Tooth preparation using ultrasonic wave instruments could be valuable for protecting periodontal tissue

Laser Doppler Flowmetry Evaluation of the Microcirculation in Dentistry

This chapter presents the most important features of laser Doppler (LD) techniques: LD flowmetry (LDF) and LD imaging (LDI), together with examples of their clinical applications in dentistry. LDF gives a constant estimation of blood flow at a specified point, whereas LDI gives a ‘snapshot’ of perfusion at a given point. These methods are non-invasive laser-based techniques for monitoring gingival and pulpal blood flow and could be used as a diagnostic tool. In paediatric dentistry and odontology, LDF proved to be an atraumatic real-time method used for determining the tooth vitality by monitoring the pulp microcirculation in traumatized teeth, fractured teeth and teeth undergoing different conservative treatments (e.g. bleaching, dental preparation for prosthetic restorations, etc.). In periodontology, recent studies showed the ability of LDF to evaluate the health of gingival tissue in different types of periodontal diseases. By using LDF, it is also possible to evaluate the outcome after different periodontal treatments. The laser Doppler line scanning can be used for recording the gingival healing process after a surgical procedure in the anterior area of the oral cavity

Periodontal Alteration of the Microcirculation and Hypercholesterolemia: A Possible Correlation?

OBJECTIVE: We evaluated the morphological and parametric characteristics of the periodontal microcirculation in patients diagnosed as having hypercholesterolemia and high levels of low-density lipoprotein (LDL). METHODS: Forty patients were recruited, 20 of whom were affected by hypercholesterolemia and 20 of whom were considered healthy. A videocapillaroscopic examination was carried out on the periodontal mucosa in the proximity of the frenulum (II, V sextant). RESULTS: The difference between the parameters of the hypercholesterolemia group and the control group was evaluated with the Mann-Whitney U-test for non-parametric ordinal data; the level of significance being P < 0.05. The videocapillaroscopy documented extremely significant differences between the two groups, regarding the following parameters: total diameter of the loop (P = 0.0017), diameter of the afferent loops (P = 0.0004), diameter of the efferent loops (P = 0.00008) and periodontal density (P = 0.0001). CONCLUSIONS: The capillaroscopic examination revealed a morphological alteration of the periodontal microcirculation in patients with hypercholesterolemia, which is an expression of peripheral vascular phlogosis

Factors Affecting Gingival Recession in the Esthetic Zone: A Human Cadaver Study

The purpose of this study was to assess the correlation of gingival recession to the following parameters in fresh cadavers: gingival thickness, buccal bone loss, buccal bone thickness, shape of bony dehiscence defect, and age. A secondary aim was to evaluate predictors for gingival recession. Sixteen fresh cadavers were used in this study. Gingival recession, facial gingival thickness, alveolar bone loss, and buccal bone thickness were measured at teeth #6-#11 and #22-#27. Sites with a dehiscence (D) or fenestration (F) were presented, and resultant bony defect shape was noted. The correlation of gingival recession to gingival thickness, buccal bone loss, buccal bone thickness, shape of dehiscence defect and age was evaluated using Spearman’s rho correlation coefficient. The strongest predictors for gingival recession were identified through a multiple regression analysis performed on candidate predictors. Gingival recession was found to be correlated to age and bone loss (rho=0.53, p\u3c0.01; rho = 0.57, p\u3c0.01, respectively). A statistically significant difference was found in the correlation between bone loss and gingival recession when comparing D/F sites and non-D/F sites (rho = -0.095, p = 0.667; rho = 0.646, p\u3c0.001, respectively). After correlating potential predictors with gingival recession, we found that the magnitude of correlations was different in males and females. Multiple linear regression analysis found that the strongest predictors for gingival recession in both males and females were underlying bone loss, bone thickness 3 mm apical to the bony crest, and age. Within gender groups, the predictive value for bone loss and age were found to be statistically significant (p\u3c0.01). Within the limitations of this study, we conclude that gingival recession is correlated to bone loss and age. Bone loss, bone thickness and age were the strongest predictors for gingival recession. The magnitude of effect of bone thickness 3mm apical to the bony crest was much greater in males than in females. Clinical studies of larger scale are needed to apply these findings to our clinical practice

Therapeutic Dentistry for the 4th year students

УЧЕБНО-МЕТОДИЧЕСКИЕ ПОСОБИЯСТОМАТОЛОГИЯ ЛЕЧЕБНО-ВОССТАНОВИТЕЛЬНАЯСТОМАТОЛОГИЯПЕРИОДОНТА БОЛЕЗНИСТОМАТОЛОГИЯ ТЕРАПЕВТИЧЕСКАЯИНОСТРАННЫЕ СТУДЕНТЫTHERAPEUTIC DENTISTRYПособие рассматривает один из важнейших разделов терапевтической стоматологии - периодонтологию. Изложены основные аспекты этиологии и патогенеза заболеваний периодонта, их клиническая картина. Представлена классификация заболеваний периодонта, основные и дополнительные методы диагностики, профилактики и лечения заболеваний периодонта. Предназначено для студентов 4 курса стоматологического факультета, обучающихся на английском языке