Gingival blood circulation after experimental wounds in man

Abstract

Capillary blood circulation following experimental wounding was observed by fluorescein angiography. Contralateral punch wounds 1.5 mm in diameter were made in healthy mandibular labial attached gingiva of 31 volunteers. Areas of ischemia were clearly visible angiographically 6 hours after wounding and were significantly greater in area (P less than 0.05) and wider (P less than 0.01) for wounds in the long axis of mandibular incisors (N = 14) than those on the vertical midline of the gingival papillae (N = 17). The ischemic changes occurred exclusively cranial to the experimental wounds. By the third day the epithelium adjacent to the wound margin in the central part of the ischemic area had necrotized, thus extending the wound coronally. By the seventh day the axial wounds were significantly (P less than 0.001) larger than the papillary wounds. The data strongly suggest that the blood supply of mandibular labial attached gingiva is preferentially oriented in an apico-coronal direction and that the capacity for collateral circulation is dependent upon local differences in vascular structure. The findings are applicable to flap design in periodontal surgery.

Root Coverage in Miller Classes I and II associated with Subepithelial Connective Tissue Graft: A comparative Clinical Trial of Two Techniques

“…28 In the surgery with the modifi ed envelope technique, 11 there is 84% of root coverage in this study by this author, but in other studies, Tözüm and Dini 29 showed 95% and Tözüm et al 25 showed 96.4% of root coverage, but in this study, we obtained 89.5% of root coverage. The authors cited earlier claim that the use of this technique preserves the interdental papillae, minimizing the possibility of scarring, providing a better blood supply, and may accelerate the initial healing, 30 and therefore, the results of our study are similar to the results demonstrated in the literature. Both techniques have shown to be highly predictable for the proposed procedure ( Figs 5 and 6 ); there was a signifi cant reduction for the clinical attachment level at 90 days for both groups, but the control group had an additional gain at 180 days ( Table 2 ), probably one of the associated factors may be the lower tension and positioning of fl ap proposed in the test group.…”

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

“…The apical direction of spreading vasodilation reaffirms the priority of the plexus of the alveolar mucosa in blood supply to the keratinized gingiva in physiological conditions and during regular flap elevation or wounding . It also concurs with the ascending feature of flow‐mediated vasodilation.…”

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

“…In a challenging situation induced by short‐time horizontal compression of the gingival vessels, the compensatory blood comes from the alveolar mucosa (Fazekas et al, ). 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, ).…”