Microcirculation and micromorphology of healthy and inflamed gingivae

Inflammation changes the microcirculatory and micromorphological dynamics of human gingiva. Laser Doppler flowmetry (LDF) and a replica technique for scanning electron microscopy (SEM) were used to examine the facial soft tissues of six maxillary anterior teeth, before and after treatment, in 12 patients exhibiting clinically healthy tissues and in 12 others with moderate gingivitis. All patients received oral hygiene instructions and scaling. The gingiva in the gingivitis group became healthy within 3 months after treatment. LDF results were recorded at the free gingivae, interdental gingivae, attached gingivae, and alveolar mucosae of the six maxillary anterior teeth. The gingival blood flows in the gingivitis group before treatment were significantly different from those in the healthy gingiva group. Flows were restored to the same level as the healthy gingiva, with no significant difference, at P > 0.01, 3 months after treatment. However, there were significant differences among sites during the same period. In addition, blood flow was reduced to a normal level after the inflammation subsided. Initially, the gingival morphology of the inflamed sites exhibited irregular free gingival margins, in contrast to that of healthy gingivae, which were characterized by rounded margins closely adapted to the tooth. One month post-treatment, the gingivae exhibited a wrinkled appearance, but they had reverted to normal micromorphology by 3 months post-treatment. The replica impression technique can be used to record gingival micromorphology both before and after reduction of inflammation.