Gingival blood flow changes following periodontal access flap surgery using laser Doppler flowmetry.

AIM To investigate the pattern of gingival blood flow changes following periodontal access flap surgery by laser Doppler flowmetry (LDF). MATERIAL AND METHODS Fourteen patients with chronic periodontitis presenting upper anterior sites with pocket depth >or=5 mm after initial treatment were included in the study. Periodontal access flap surgery was performed on the experimental areas and LDF recordings were taken at baseline, following anaesthesia, immediately postoperatively and on days 1, 2, 3, 4, 7, 15, 30 and 60 of healing, at nine predetermined sites per flap. RESULTS Significant ischaemia was observed at all flap sites following anaesthesia and immediately postoperatively. At the alveolar mucosal sites, a peak increase of the gingival blood flow was observed on postoperative day 1 (p<0.001), which persisted until day 7 (p=0.012) and resolved by day 15. The mucosal sites close to the flap periphery presented higher blood perfusion compared with the sites located centrally in the flap. The microcirculatory perfusion of the buccal and palatal papillae was maximum on postoperative day 7 (p=0.013 and <0.001, respectively) and returned to baseline by day 15. CONCLUSION Topographically distinct areas of the periodontal access flap consistently present different patterns of microvascular blood flow alterations during the wound-healing period.

[1]  R. Hirsch,et al.  The effects of local anesthetic containing adrenaline on gingival blood flow in smokers and non-smokers. , 1997, Journal of clinical periodontology.

[2]  D. Hendricks,et al.  Cutaneous Blood-Flow Patterns in Free Flaps Determined by Laser Doppler Flowmetry , 1996, Journal of reconstructive microsurgery.

[3]  Nikolaos Donos,et al.  Evaluation of gingival blood flow by the use of laser Doppler flowmetry following periodontal surgery. A pilot study. , 2005, Journal of periodontal research.

[4]  R. Esclamado,et al.  Ischemia/reperfusion injury in microvascular surgery , 2000, Head & neck.

[5]  M. Torabinejad,et al.  Wound healing after mucoperiosteal surgery in the cat. , 1996, Journal of endodontics.

[6]  J C Yuen,et al.  Monitoring Free Flaps Using the Laser Doppler Flowmeter: Five‐Year Experience , 2000, Plastic and reconstructive surgery.

[7]  P. Grace,et al.  Ischemia-reperfusion injury , 1994 .

[8]  G. A. Holloway,et al.  Gingival blood flow measured with a laser Doppler flowmeter. , 1986, Journal of periodontal research.

[9]  R. Caffesse,et al.  Vascular changes following mucoperiosteal flap surgery: a fluorescein angiography study in dogs. , 1995, Journal of periodontology.

[10]  P. Brodin,et al.  Hyperaemic response to cigarette smoking in healthy gingiva. , 2003, Journal of clinical periodontology.

[11]  Pascal Ambrosini,et al.  A laser Doppler study of gingival blood flow variations following periosteal stimulation. , 2002, Journal of clinical periodontology.

[12]  C. Nasjleti,et al.  Vascular response to modified Widman flap surgery in monkeys. , 1981, Journal of periodontology.

[13]  Yoshiyuki Hatakeyama,et al.  Microvascular response in the periosteum following mucoperiosteal flap surgery in dogs: 3-dimensional observation of an angiogenic process. , 2005, Journal of periodontology.

[14]  Mark L. Johnson,et al.  Skin blood flow response in the rat model of wound healing: expression of vasoactive factors. , 2002, The Journal of surgical research.

[15]  T. Kono,et al.  Microvascular response in the periosteum following mucoperiosteal flap surgery in dogs: angiogenesis and bone resorption and formation. , 2005, Journal of periodontology.

[16]  R. Caffesse,et al.  Revascularization following a combined gingival flap-split thickness flap procedure in monkeys. , 1984, Journal of periodontology.

[17]  H. Imai,et al.  Periosteal microvasculature in the dog alveolar process. , 1989, Journal of periodontology.

[18]  M Ide,et al.  Laser Doppler flowmeter measurement of relative gingival and forehead skin blood flow in light and heavy smokers during and after smoking. , 2000, Journal of clinical periodontology.

[19]  O. Kirkland The Suppurative Periodontal Pus Pocket; Its Treatment by the Modified Flap Operation* , 1931 .

[20]  J Serup,et al.  Guidelines for visualization of cutaneous blood flow by laser Doppler perfusion imaging , 2002, Contact dermatitis.

[21]  R. Bonner,et al.  The microvascular composition of the healing wound compared at skin sites with nutritive versus arteriovenous perfusion. , 1998, The Journal of surgical research.

[22]  H Svensson,et al.  Laser Doppler flowmetry and laser photometry for monitoring free flaps. , 1985, Scandinavian journal of plastic and reconstructive surgery.

[23]  D. Ramsay,et al.  Human gingival and pulpal blood flow during healing after Le Fort I osteotomy. , 2001, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.