Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

Vág, János; Gánti, Bernadett; Mikecs, Barbara; Szabó, Enikő; Molnár, Bálint; Lohinai, Zsolt

doi:10.1186/s12903-020-01296-z

Cited by 6 publications

(4 citation statements)

References 55 publications

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“…Better blood flow recovery may facilitate wound healing in males. In previous investigations [ 5 , 51 , 52 ], blood flow changes induced either by nitric oxide, epinephrine, or surgery were not correlated with the gingival thickness measured by the ultrasonic instrument. Therefore, gender differences cannot be explained by biotype.…”

Section: Discussionmentioning

confidence: 86%

Revisiting the vascularity of the keratinized gingiva in the maxillary esthetic zone

et al. 2021

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Background The active arterial-to-arterial collaterals are a significant factor in the prevention of ischemia and extensive tissue necrosis in the case of arterial blockage of various tissues. The present study investigates the mucogingival vasculature in the maxillary esthetic zone mucosa in human cadavers and functionally evaluates the area, which is supplied by the terminal arterioles, on the individual level. Methods In the human cadaver study, macroscopic arterial analyses of the anterior maxillary vestibule in 7 specimens were scrutinized by latex milk injection. The tracks of the mucosal branches in relation to the mucogingival junction were investigated. In the functional study, individual gingival blood flow (GBF) changes were measured by laser speckle contrast imaging (LSCI) in 31 young subjects with healthy gingiva before and during 30-s compressions. This was conducted with a ball-shaped condenser. The data was analyzed by the linear mixed model. Results The vertically aligned branches of the superior labial artery (SLA) divided into small, slightly deviating sub-branches near the mucogingival junction. These arteries created collateral plexuses and supplied the attached gingiva. The compression of these branches resulted in ischemia coronally with significant individual variation. The ischemia was either apico-mesial, apico-distal, or straight apical to the compression. A significant correlation was found between the ischemic area and the magnitude of the decrease in GBF (r = 0.81, p < 0.001). In males, 77% of the subjects, and 50% of the female subjects had an ischemic response in either region. The horizontal extension of the ischemic area ranged between 0.26 mm and 8.76 mm. Males had significantly higher baseline GBF and larger ischemia than females. At the base of the papilla, significant restoration of GBF was observed during compression in males, but not in females. Conclusion The arcade anastomoses formed by the small arteries in the keratinized gingiva of the upper esthetic zone explain the consequences of vertical incisions. The considerable individual variations in ischemic responses might be the reason for unexpected surgical outcomes in some cases. Furthermore, there is increasing evidence that men have different vascular reactivity and/or regulation of collateral circulation than women, which may affect wound healing.

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Section: Discussionmentioning

confidence: 86%

Revisiting the vascularity of the keratinized gingiva in the maxillary esthetic zone

et al. 2021

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“…Physiologically, the Water Temperature (WT) 20 o C method with the addition of 0.25 and 0.50 l/s Water Speeds causes local arteriolar and venular vasoconstriction. This vasoconstriction is caused by reflex action of smooth muscle arising from stimulation of the autonomic nervous system and the release of epinephrine and norepinephrine [17]. However, if the cold continues to be given for 15 to 30 minutes there will be a vasodilation phase that occurs intermittently for 4 to 6 minutes.…”

Section: Multivariate Test Resultsmentioning

confidence: 99%

Effect of Circulated Flow of Hydrotherapy on Reduction of Lactic Acid Levels in the Body after Physical Exercise

Setiawan¹,

Hartono²,

Wahjuni³

et al. 2023

saj

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The purpose of this study was to analyze the effect of circulating hydrotherapy on reducing lactic acid levels in the body. This study used a 2 x 2 factorial experimental design. Subjects were taken in this study by means of purposive sampling and then the subjects were divided into 4 groups. A total of 24 adult males aged 18-21 years participated in this study. Exclusion criteria in this study were having a history of lung disease and heart disease. Subjects took blood to measure lactic acid levels (Pre-test). Furthermore, the subject carried out the running-based Anaerobic Sprint Test (RAST) activity. Then the subject rested for 2 minutes. Each subject was given an intervention based on their respective groups for 10 minutes. Furthermore, the subject took blood to measure lactic acid levels (post-test). The statistical test used is the two-way Anova in the SPSS application. The results of this study indicate that there are differences in the effect of water temperature of 20 o C, with a water speed of 0.25 and 0.50 liters/second on the decrease in lactic acid levels. There is a significant difference in the effect of water at 37 o C, with a water speed of 0.25 and 0.50 liters/second to reduce lactic acid levels. There is an interaction between water temperature (20 o C, 37 o C) with a water speed of 0.25 and 0.50 liters/second on changes in lactic acid levels. It can be concluded that Circulated Flow of Hydrotherapy with the development of modified Water Temperature (WT), and Water Speed (WS) can both be used to improve recovery by lowering blood lactic acid levels in the body after physical activity.

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“…This is in line with similar studies on the effects of epinephrine in humans. Vag et al 25 studied gingival blood flow with LSCI in human healthy volunteers and found a 50 % decrease after the administration of 2.24 μg epinephrine. Ghali et al 21 and O’Malley et al studied the effect of epinephrine in the head and neck, where perfusion was found to decrease to approximately 56% (10 μg/ml) and 25–50% (5–10 μg/ml) 22 of the initial value.…”

Section: Discussionmentioning

confidence: 99%

Hyperspectral and Laser Speckle Contrast Imaging for Monitoring the Effect of Epinephrine in Local Anesthetics in Oculoplastic Surgery

Bunke

Merdasa

Stridh

et al. 2022

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: Epinephrine is used in local anesthetics to induce vasoconstriction and thus reduce bleeding and prolong the anesthetic effect. Finding the optimal delay between the administration of the anesthetic and skin incision to ensure vasoconstriction and minimize bleeding is important and has recently become the subject of debate. This is the first study to assess blood perfusion and oxygen saturation (sO 2 ) simultaneously in response to a local anesthetic containing epinephrine in human oculoplastic surgery. Methods: A local anesthetic consisting of lidocaine and epinephrine (20 mg/ml + 12.5 μg/ml) was injected in the eyelids of 9 subjects undergoing blepharoplasty. The perfusion and sO 2 of the eyelids were monitored using laser speckle contrast imaging and hyperspectral imaging, respectively. Results: Laser speckle contrast imaging monitoring showed a decrease in perfusion over time centrally at the site of injection. Half-maximum effect was reached after 34 seconds, and full effect after 115 seconds, determined by exponential fitting. The drop in perfusion decreased gradually further away from the injection site and hypoperfusion was less prominent 4 mm from the injection site, with a spatially dependent half-maximum effect of 231 seconds. Hyperspectral imaging showed only a slight decrease in sO 2 of 11 % at the injection site. Conclusions: The optimal time delay for skin incision in oculoplastic surgery is approximately 2 minutes after the injection of lidocaine with epinephrine. Longer delay does not lead to a further decrease in perfusion. As sO 2 was only slightly reduced after injection, the results indicate that the use of epinephrine is safe in the periocular region.

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Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

Cited by 6 publications

References 55 publications

Revisiting the vascularity of the keratinized gingiva in the maxillary esthetic zone

Revisiting the vascularity of the keratinized gingiva in the maxillary esthetic zone

Effect of Circulated Flow of Hydrotherapy on Reduction of Lactic Acid Levels in the Body after Physical Exercise

Hyperspectral and Laser Speckle Contrast Imaging for Monitoring the Effect of Epinephrine in Local Anesthetics in Oculoplastic Surgery

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