Evaluation of Laser Speckle Contrast Imaging for the Assessment of Oral Mucosal Blood Flow following Periodontal Plastic Surgery: An Exploratory Study

Abstract

The laser speckle contrast imaging (LSCI) is proved to be a reliable tool in flap monitoring in general surgery; however, it has not been evaluated in oral surgery yet. We applied the LSCI to compare the effect of a xenogeneic collagen matrix (Geistlich Mucograft®) to connective tissue grafts (CTG) on the microcirculation of the modified coronally advanced tunnel technique (MCAT) for gingival recession coverage. Gingival microcirculation and wound fluid were measured before and after surgery for six months at twenty-seven treated teeth. In males, the flap microcirculation was restored within 3 days for both grafts followed by a hyperemic response. During the first 8 days the blood flow was higher at xenogeneic graft comparing to the CTG. In females, the ischemic period lasted for 7–12 days depending on the graft and no hyperemic response was observed. Females had more intense and prolonged wound fluid production. The LSCI method is suitable to capture the microcirculatory effect of the surgical intervention in human oral mucosa. The application of xenogeneic collagen matrices as a CTG substitute does not seem to restrain the recovery of graft bed circulation. Gender may have an effect on postoperative circulation and inflammation.

Blood flow kinetics of a xenogeneic collagen matrix following a vestibuloplasty procedure in the human gingiva—An explorative study

“…This apico‐coronal direction was also confirmed in a series of case studies by Mormann (Mormann & Ciancio, ; Mormann, Meier, & Firestone, ), who found that marginal gingival perfusion is sensitive to the horizontal incision. This observation is in agreement with another cohort study in which, following tunnel preparation, more severe and longer ischemia was observed in the marginal area of the flap compared to its apical and proximal areas (Molnar et al, ). On the other hand, clinical observations revealed that the marginal gingiva could survive after horizontal incision and it could be revascularized by rapidly developing anastomosis from the periodontal plexus (Cutright, ; Kennedy, ).…”

“…Prolonged ischemia at the apical side was counterbalanced by increased permeability of the vessels—indicated by higher wound fluid production—which facilitates the diffusion of nutritive compounds. The negative correlation between blood flow and wound fluid production has been observed previously in humans after periodontal plastic surgical procedures (Molnar et al, ) and in mice after skin grafting (Shaterian et al, ).…”

“…The measurement area covered the whole surgical field. Our method of oral mucosal blood flow measurement by LSCI was described in detail in previous studies (Molnar et al, , ). Based on these studies, the inter‐day reproducibility of gingival LSCI measurements can be significantly improved with intra‐session repetitions.…”

“…The recent introduction of laser speckle contrast imaging (LSCI) into the field of oral surgery (Molnar et al, ) allows us to describe the spatial and temporal dimensions of vascularization. LSCI is a non‐invasive, two‐dimensional method, which is suitable for studying postoperative microcirculation continuously in time in a human subject (Molnar, Fazekas, Lohinai, Toth, & Vag, ; Molnar et al, ). With a combination of LSCI and wound fluid measurements, we could estimate the proportion of blood supply and diffusion in various regions of the graft.…”

Evidence of spreading vasodilation in the human gingiva evoked by nitric oxide

“…The laser speckle contrast imager (LSCI) is a more recent advancement in microvascular imaging, which proved to be useful in measuring the microcirculation of the human gingiva with high spatial and temporal resolution simultaneously . Taking the opportunity provided by the high spatial resolution, a new method was designed to study the remote effects of various drugs when applied to a small restricted area on the human gingiva.…”