Capillaroscopic evaluation of smoking and non-smoking patients’ gingival margin

Yıl 2019, , 105 - 110, 16.06.2019

Bahar Füsun Oduncuoğlu , Deniz Göçhan

https://doi.org/10.22312/sdusbed.521171

Öz

Objective: Gingival
videocapillaroscopy is a non-invasive method to observe the changes in the
gingival microvasculature. Smoking, which may cause vascular changes in
gingiva, is a risk factor for periodontal diseases. This study aimed to observe
the gingival capillary characteristics of healthy, gingivitis and chronic
periodontitis patients and the effect of smoking status on microcirculation.

Material-Methods: One-hundred twenty-nine patients participated in the study. Smoking and
non-smoking patients were categorized in three groups based on the periodontal
status as follows; group S (n=23), non-smoking patients with clinically healthy
gingiva; group SS (n=20), smoking patients with clinically healthy gingiva;
group G (n=25), non-smoking patients with gingivitis; group GS (n=20), smoking
patients with gingivitis; group P (n=20), non-smoking patients with chronic
periodontitis and group PS (n=21), smoking patients with chronic periodontitis.
Periodontal clinical parameters were recorded. Gingival videocapillaroscopy was
used to investigate the characteristics of microcirculation with x200
magnification. Obtained images were analyzed for the capillary number and area
by a software program.

Results: Number of capillaries were significantly lower in S, SS, SG and SP groups
compared to G and P groups (p<0,003). Vascular area calculations showed
significant differences between the groups and were S-SS <PS-GS <P-G,
respectively (p <0.003).

Conclusion: It was observed
that the number of smokers capillaries did not increase in the presence of
periodontal disease and the capillary area of smoking patients with gingivitis
and periodontitis was lower than the non-smoker gingivitis and periodontitis
groups. Increased periodontal destruction caused by smoking may be due to
microvascular effects.

Anahtar Kelimeler

capillaroscopy, periodontal diseases, smoking

Sigara İçen ve İçmeyen Hastaların Dişeti Marjininin Kapilleroskopi ile Değerlendirilmesi

Öz

Amaç: Gingival videokapilleroskopi, dişetinin mikrovasküler
yapısındaki değişimlerin gözlenmesine olanak sağlayan invaziv olmayan bir
yöntemdir. Dişeti dokusunda, damarsal değişimlere de neden olabilen sigara kullanımı
periodontal hastalıklar için bir risk faktörüdür. Bu çalışmada; klinik olarak
sağlıklı, gingivitisli ve kronik periodontitisli hastaların dişeti marjinindeki
mikrodolaşıma ait değişimlerin değerlendirilmesi ve sigara kullanımının
etkisinin belirlenmesi amaçlanmıştır.

Materyal-Metot: Çalışmaya 129 birey katıldı. Sigara kullanan ve kullanmayan hastalar
periodontal durumlarına göre; sigara kullanmayan ve klinik olarak sağlıklı
dişetine sahip bireyler, grup S (n=23); sigara içen ve klinik olarak sağlıklı
dişetine sahip bireyler, grup SS (n=20); sigara kullanmayan gingivitisli
hastalar, grup G (n=25), sigara içen gingivitisli hastalar, grup GS (n=20),
sigara içmeyen kronik periodontitisli hastalar, grup P (n=20) ve sigara içen
kronik periodontitisli hastalar, grup PS (n=21) olarak gruplandırıldı.
Periodontal klinik parametreler kaydedildi. Gingival videokapillaroskopi
yöntemi ile x200 büyütmede görüntüler elde edildi. Elde edilen görüntüler kapiller
sayısı ve alanı açısından bir bilgisayar programı yardımıyla analiz edildi.

Bulgular: S, SS, GS ve PS gruplarında kapiller sayısı, G ve P gruplarına göre
anlamlı olarak düşük bulundu (p<0,003). Damar alanı hesaplamalarında gruplar
arasında anlamlı farklılık izlendi ve sırasıyla S-SS<PS-GS<P-G şeklinde
olduğu belirlendi (p<0,003).

Sonuç: Sigara
içen bireylerde kapiller sayısının periodontal hastalık varlığında artmadığı,
sigara içmeyen gingivitis ve periodontitisli gruplardan düşük olduğu gözlendi. Sigaraya
bağlı artmış periodontal yıkım, sigara içen bireylerdeki mikrovasküler
etkilenimlerden kaynaklanıyor olabilir.  

Anahtar Kelimeler

sigara içme, kapilleroskopi, periodontal hastalıklar

Kaynakça

• 1. Kindlova M. The blood supply of the marginal periodontium in macacus rhesus Arch Oral Biol 1965; 10: 869–74.
• 2. Egelberg J. The blood vessels of the dento-gingival junction J Periodont Res 1966; 1: 163–79.
• 3. Hansson BO, Lindhe J, Branemark PI. Microvascular topography and function in clinically healthy and chronically inflamed dentogingival tissues – a vital microscopic study in dogs. Periodontics 1968; 6: 264–71.
• 4. Nuki K, Hock J. The organization of the gingival vasculature. J Periodont Res 1974; 9: 305–13.
• 5. Haffajee AD, Socransky SS. Relationship of cigarette smoking to attachment level profiles. J Clin Periodontol 2001; 28: 283–295.
• 6. Villar CC, Martorelli de Lima AF. Smoking influences on the thickness of marginal gingival epithelium. Pesqui Odontol Bras 2003; 17: 41–45.
• 7. Benowitz NL, Porchet H, Sheiner L, Jacob P. Nicotine absorption and cardiovascular effects with smokeless tobacco use: Comparison with cigarette and nicotine gum. Clinical Pharmacology and Experimental Therapeutics 1998; 221: 368–372.
• 8. Pindborg JJ. Tobacco and gingivitis I Statistical examination of the significance of tobacco in the development of ulceromembranous gingivitis and the formation of calculus. J Dent Res 1947; 26: 261–265.
• 9. Nakamura T, Ono K, Honda E, Yokota M, Inenaga K. Central nicotinic stimulation reduces vascular conductance in the gingiva in anesthetized rats. J Periodont Res 20015; 40: 67–72.
• 10. Morozumi T, Kubota T, Sato T, Okuda K, Yoshie H. Smoking cessation increases gingival blood flow and gingival crevicular fluid. J Clin Periodontol 2004; 31: 267–272.
• 11. Lindeboom JA, Mathura KR, Harkisoen S, van den Akker HP, Ince C. Effect of smoking on the gingival capillary density: assessment of gingival capillary density with orthogonal polarization spectral imaging. J Clin Periodontol 2005; 32: 1208–1212.
• 12. Scardina GA, Roggieri A, Messina P. Oral microcirculation observed in vivo by videocapillaroscopy: A review. J Oral Sci 2009; 51: 1–10.
• 13. Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand 1964; 22: 121-135.
• 14. Löe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand 1963; 21: 533-551.
• 15. Danielsen B, Manji F, Nagelkerke N, Feherskov O, Baelum V. Effect of cigarette smoking on the transition dynamics in experimental gingivitis. J Clin Periodontol 1990; 17: 159-164.
• 16. Bergström J. Oral hygiene compliance and gingivitis expression in cigarette smokers. Scand J Dent Res 1990 ; 98: 497-503.
• 17. Persson L, Bergström J. Smoking and vascular density of healthy marginal gingiva. Eur J Oral Sci 1998; 106: 953-957.
• 18. Bergström J, Preber H. The influence of cigarette smoking on the development of experimental gingivitis. J Periodontal Res 1986; 21: 668-676.
• 19. Bergström J, Persson L, Preber H. Influence of cigarette smoking on vascular reaction during experimental gingivitis. Scand J Dent Res 1988; 96: 34–39.
• 20. Baab DA, Öberg PA. The effect of cigarette smoking on gingival blood flow in humans. J Clin Periodontol 1987; 14: 418 – 424.
• 21. Meekin TN, Wilson RF, Scott DA, Ide M, Palmer RM. Laser Doppler flowmeter measurement of relative gingival and forehead skin blood flow in light and heavy smokers during and after smoking. J Clin Periodontol 2000; 27: 236–242.
• 22. Shuler RL. Effect of cigarette smoking on the circulation of the oral mucosa. J Dent Res 1968; 47: 910-915.
• 23. Boutault F, Cadenet H, Hibert PJ. Evaluation of gingival microcirculation by a laser-Doppler flowmeter. J Craniomaxillofac Surg 1989; 17: 105-109.
• 24. Scheja A, Akesson A, Niewrowicz I, Wallin L, Wildt M, Wolheim FA. Computer based quantitative analysis of capillary abnormalities in systemic sclerosis and its relation to plasma concentrations of von Willebrand factor. Ann Rheum Dis 1996; 155: 52–56.
• 25. Gasser P, Berger W. Naifold videomicroscopy and local cold test in type I diabetics. Angiology 1992;43: 395–400.