The purpose of this study was to determine the changes that occur in the gingival microcirculation during the development of experimental gingivitis in humans. There have been no studies published to date combining videomicroscopy and laser Doppler flowmetry to study vascular dynamics in experimental gingivitis. Alterations occurring in the microcirculation of the marginal gingiva in 10 (18-30-year-old), healthy male humans when they suspended oral hygiene procedures in a proscribed area for 12-16 days were monitored. A partial mouth, experimental gingivitis model was employed. Gingival health was evaluated before and after the experimental period by assessing gingival and plaque indices and gingival crevicular fluid volume. Gingival vascular monitoring included measurement of red blood cell velocity in individual gingival microvessels via videomicroscopy and measurement of regional gingival blood flow using laser doppler flowmetry. The number of vessels visible in a given microscopic field in a given subject and the number of vessels exhibiting flow were also determined from the videotapes. Systemic cardiovascular and respiratory parameters were monitored to ensure that gingival vascular changes were not secondary to systemic changes. Gingivitis developed in all subjects; significant increases (Student t-test, p < 0.05) were seen in plaque index, gingival index, bleeding on probing and crevicular fluid volume. No change in superficial capillary blood velocity and a significant decrease in gingival regional blood flow were seen with gingivitis. A significant increase in the number of vessels visible in microscopic fields and a decrease in the % of vessels exhibiting flow were observed. Gingival microcirculation exhibited a dramatic, dynamic change in response to the development and progression of gingivitis.
The validity of current theories concerning the function of the area postrema ultimately rests on the nature of its microcirculation. Therefore a detailed study of the vasculature of the postremal region was undertaken in the rat.The findings indicate a singular arteriolar supply from branches of the posterior inferior cerebellar arteries. These vessels are caudal, intracranial branches of the vertebral arteries. Networks of enlarged capillaries are prominent features of sections taken through the area postrema. These enlarged capillary channels are re-entrant. At the borders of the structure they are joined by short interconnecting vessels to capillaries of smaller caliber typical of the medullary tissue. The bed is considered to be a portal system because two distinctive, serially connected capillary beds are interposed between artery and vein. No arteriovenous shunts or thoroughfare channels are observed in the rat, contrary to reports of this type of vessel in other species.This microcirculatory pattern would seem to be adequate to current theories of postremal function, which attribute neurosecretory or chemosensory functions to this region.
There have been no published reports characterizing gingival vascular function in humans of different ages. In this study, we compared gingival vascular dynamics in 60 healthy male humans ranging in age from 18-75 years (young, 18-25 years (Y); middle, 35-45 years (M); old, 65-75 years (O), 20 subjects/group). Both videomicroscopy of individual microvessels and laser doppler flowmetry were employed to assess marginal gingival circulation. Systemic cardiopulmonary parameters were monitored as controls. The number of gingival vessels visible in a microscopic field was higher and the number of microvessels exhibiting active flow was lower in M and O compared to Y. There were no differences among age groups in laser doppler flow values (tissue blood flow) or in red blood cell velocity in individual vessels. Although not statistically significant with age there was a trend towards decreasing blood flow velocity in both the laser doppler and videomicroscopic measurements. Blood pressure increased slightly with age. Peripheral oxygen saturation was lower in O compared to Y and M. No differences were seen in heart rate, respiratory rate or end-tidal carbon dioxide concentration. The changes in blood pressure and oxygen saturation were expected. The differences in numbers of visible vessels and the number of vessels with active blood flow may reflect the way the gingival microcirculation adapts with age to changing nutritional needs or to microbial and/or mechanical challenge.
The effects of local application of capsaicin on the vascular conductance of the oral structures (upper gingiva, lower gingiva, tongue, right and left submandibular glands) were studied with and without pretreatment with NG-nitro-L-arginine methyl ester (L-NAME), a potent inhibitor of nitric oxide formation in rats. Alterations in tissue blood flow were measured by laser-Doppler-flowmetry; systemic blood pressure was monitored continuously during the experiments. Local application of increasing concentrations of capsaicin (1.0; 3.33; 10.0; 33.3 mM; in a volume of 5 microliters) resulted in a dose-dependent increase in the vascular conductance of all tissues investigated. There was a significant correlation between the values obtained for vascular conductance in the right and the left submandibular glands. Bolus intravenous injection of L-NAME (10 mg kg-1) elevated the mean systemic blood pressure significantly, by about 20%, with a rapid onset. This increase persisted until the end of the experiment. The augmentation of vascular conductance elicited by 10.0 mM capsaicin, locally administered, was significantly diminished in animals pretreated with L-NAME in all tissues tested. The results indicate that nitric oxide formation plays a significant role in the enhancement of vascular conductance produced in rat oral structures by local capsaicin administration.
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