Rodriguez Amanda, Kripfgans Oliver, Aellos Fabiana, Velasquez Diego, Baltazar Alejandra, Chan Hsun-Liang
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.
Department of Periodontics, College of Dentistry, University of Illinois Chicago, Chicago, IL, United States.
Front Dent Med. 2025 May 22;6:1587821. doi: 10.3389/fdmed.2025.1587821. eCollection 2025.
Understanding the available methods to study blood flow in the oral cavity can enhance knowledge of research methodology on periodontal circulation related to disease initiation and progression as well as wound healing. This study aims to systematically review non-invasive techniques that allow for the assessment of oral tissue perfusion in clinical and pre-clinical studies.
A complete electronic literature search in 5 databases (NLM PubMed, Embase, EBSCOhost CINAHL, EBSCOhost Dentistry and Oral Sciences Source, and Wiley Cochrane Central Register of Controlled Trials) was conducted by two reviewers. The search terms included gingival blood flow, tissue perfusion, imaging perfusion, soft tissue perfusion, diagnostic, vascularization, soft tissue, and microvascularization. The focused question is: What are the available non-invasive and quantitative imaging techniques used to evaluate oral and periodontal tissue perfusion?
A total of 79 articles were included for qualitative analysis. Various methods were identified, including Laser Doppler Flowmetry (LDF), Laser Speckle Contrast Imaging (LSCI), Spectral Imaging Methods (such as Diffuse Reflectance Spectroscopy), Ultrasound (US), Intravital Video Microscopy, and Oral Videocapillaroscopy. LDF is the most applied to estimate blood flow in a small focal area for the study of periodontal diseases and oral wound healing, among other indications. LSCI, providing surrogate superficial blood flow values in a 2-dimensional, larger field-of-view, has been used for similar reasons. The use of cross-sectional ultrasound is on a rise to record blood velocity and blood volume using color flow and color power modes, respectively. Comparisons of the available technologies revealed their strengths and limitations related to their spatial resolution, sensitivity, reliability, accuracy, invasiveness, dependence of (image) data in the field of view relative to probe positioning and angulation, and safety. The ideal features of such a device pertinent to probe geometry, data acquisition, recording, and infection control needs were also discussed.
A few imaging technologies have been identified in the literature to study blood flow in the oral cavity. These methods could potentially augment our ability to diagnose oral diseases and monitor wound healing objectively and timely. In combination, these could potentially enhance treatment outcomes significantly.
了解研究口腔血流的现有方法，可增进对与疾病发生、发展以及伤口愈合相关的牙周循环研究方法的认识。本研究旨在系统回顾在临床和临床前研究中用于评估口腔组织灌注的非侵入性技术。
两名研究者在5个数据库（美国国立医学图书馆的PubMed、Embase、EBSCOhost的CINAHL、EBSCOhost的牙科学与口腔科学资源库以及Wiley Cochrane对照试验中央注册库）中进行了全面的电子文献检索。检索词包括牙龈血流、组织灌注、成像灌注、软组织灌注、诊断、血管形成、软组织和微血管形成。重点问题是：用于评估口腔和牙周组织灌注的现有非侵入性定量成像技术有哪些？
共纳入79篇文章进行定性分析。确定了多种方法，包括激光多普勒血流仪（LDF）、激光散斑对比成像（LSCI）、光谱成像方法（如漫反射光谱法）、超声（US）、活体视频显微镜检查和口腔视频毛细血管镜检查。LDF最常用于估计小焦点区域的血流，以研究牙周疾病和口腔伤口愈合等情况。LSCI在二维、更大视野中提供替代的浅表血流值，其使用原因与此类似。横断面超声的使用呈上升趋势，分别使用彩色血流和彩色能量模式记录血流速度和血容量。对现有技术的比较揭示了它们在空间分辨率、灵敏度、可靠性、准确性、侵入性、视野中（图像）数据相对于探头定位和角度的依赖性以及安全性方面的优势和局限性。还讨论了与探头几何形状、数据采集、记录和感染控制需求相关的此类设备的理想特性。
文献中已确定了一些用于研究口腔血流的成像技术。这些方法可能会增强我们客观、及时诊断口腔疾病和监测伤口愈合的能力。综合起来，这些方法可能会显著提高治疗效果。
