Retzepi M, Tonetti M, Donos N
Periodontology Unit, Eastman Dental Institute, University College London, London, UK.
J Clin Periodontol. 2007 May;34(5):437-43. doi: 10.1111/j.1600-051X.2007.01062.x.
To investigate the pattern of gingival blood flow changes following periodontal access flap surgery by laser Doppler flowmetry (LDF).
Fourteen patients with chronic periodontitis presenting upper anterior sites with pocket depth >or=5 mm after initial treatment were included in the study. Periodontal access flap surgery was performed on the experimental areas and LDF recordings were taken at baseline, following anaesthesia, immediately postoperatively and on days 1, 2, 3, 4, 7, 15, 30 and 60 of healing, at nine predetermined sites per flap.
Significant ischaemia was observed at all flap sites following anaesthesia and immediately postoperatively. At the alveolar mucosal sites, a peak increase of the gingival blood flow was observed on postoperative day 1 (p<0.001), which persisted until day 7 (p=0.012) and resolved by day 15. The mucosal sites close to the flap periphery presented higher blood perfusion compared with the sites located centrally in the flap. The microcirculatory perfusion of the buccal and palatal papillae was maximum on postoperative day 7 (p=0.013 and <0.001, respectively) and returned to baseline by day 15.
Topographically distinct areas of the periodontal access flap consistently present different patterns of microvascular blood flow alterations during the wound-healing period.
通过激光多普勒血流仪(LDF)研究牙周翻瓣手术后牙龈血流变化规律。
本研究纳入14例慢性牙周炎患者,这些患者在初始治疗后上前牙部位牙周袋深度≥5mm。在实验区域进行牙周翻瓣手术,并在基线、麻醉后、术后即刻以及愈合的第1、2、3、4、7、15、30和60天,于每个瓣的9个预定部位进行LDF记录。
麻醉后及术后即刻,所有瓣部位均观察到明显缺血。在牙槽黏膜部位,术后第1天牙龈血流出现峰值增加(p<0.001),持续至第7天(p=0.012),并在第15天恢复。靠近瓣边缘的黏膜部位比瓣中央部位的血流灌注更高。颊侧和腭侧乳头的微循环灌注在术后第7天达到最大值(分别为p=0.013和p<0.001),并在第15天恢复至基线水平。
在伤口愈合期间,牙周翻瓣不同部位的微血管血流变化模式始终存在差异。