A novel procedure for evaluating gingival perfusion status using laser-Doppler flowmetry

To systematize a procedure that allows one to characterize the perfusion response pattern of attached gingiva to the topical and transitory compression of alveolar mucose, using laser-Doppler flowmetry.

A cross-sectional study was carried out, in 20 healthy adult subjects of either sex, with teeth in antero-mandibular sextant but without periodontitis at the lower left lateral incisor (LLLI). Sample was selected by convenience non-probability sampling. Gingival perfusion was evaluated at labial LLLI attached gingiva using a specially designed gingival tray. Two perfusion recordings were carried out 5 min. apart, each one consisting of a 40 s control phase, a 22 s compression phase and a 40 s post-compression phase. During compression phase, LLLI alveolar mucose was compressed with a wood-mounted cotton swab until the perfusion decreased to about 1/5 of its control perfusion value.

Integrated primary basal flow (IPBF) during control phase was of 14,210+/-1075 perfusion units (PU), whereas integrated flow during compression phase was of 1651+/-202 PU (p<0.05). After compression was released, integrated total secondary real flow was 13,322+/-1513 PU (p<0.05) which represented a 91.3+/-3.8% of IPBF. Gingival compression propitiated an induced flow debt (IFD) of 6478+/-781 PU, which increased in 980+/-482 PU after compression was released, representing 18% of the IFD (Debt index).

A hypoaemic response in reaction to topical and transitory LLLI alveolar mucose compression was observed. Debt index and the ITSRF% are reproducible indices of microvascular perfusion response whose validation under pathological circumstances remains to be evaluated.