Ketabi M, Hirsch R S
Department of Dentistry, University of Adelaide, Australia.
J Clin Periodontol. 1997 Dec;24(12):888-92. doi: 10.1111/j.1600-051x.1997.tb01207.x.
Recent evidence suggests that fundamental differences exist in the development of gingival and periodontal diseases in smokers versus non-smokers. In part, these differences may be attributable to smoking-induced differences in the vascular dynamics of the periodontium. This study monitored gingival blood flow when challenged by a local anesthetic-containing adrenaline in 20 smokers and 20 non-smokers using laser Doppler flowmetry (LDF). The dosage of local anesthetic used (0.5 ml lignocaine hydrochloride 2% with adrenaline 1:80,000) was calculated after establishing a dose-response curve (DRC) for 3 subjects (2 non-smokers and 1 smoker). Plain lignocaine and normal saline were used as controls. The injection of lignocaine-containing adrenaline had little effect on LDF signals when different doses were injected at frequent short intervals, indicating that tolerance to adrenaline had rapidly developed in the receptors of gingival blood vessels. Injection of local anesthetics containing adrenaline consistently resulted in a marked and significant drop (average: 46%, sd;13.5) in the LDF output signals from gingiva; smokers and non-smokers responded similarly. The significant finding of this study was that the recovery of LDF signals to baseline took considerably longer in smokers than in non-smokers. This provides further evidence that gingival blood vessels in smokers with healthy gingival conditions respond differently to those of non-smokers.
近期证据表明，吸烟者与非吸烟者在牙龈疾病和牙周疾病的发展方面存在根本差异。部分差异可能归因于吸烟引起的牙周血管动力学差异。本研究使用激光多普勒血流仪（LDF）监测了20名吸烟者和20名非吸烟者在使用含肾上腺素的局部麻醉剂刺激时的牙龈血流情况。在为3名受试者（2名非吸烟者和1名吸烟者）建立剂量反应曲线（DRC）后，计算出所用局部麻醉剂的剂量（0.5毫升2%盐酸利多卡因加1:80,000肾上腺素）。使用普通利多卡因和生理盐水作为对照。当频繁短时间间隔注射不同剂量的含肾上腺素利多卡因时，对LDF信号影响不大，这表明牙龈血管受体对肾上腺素迅速产生了耐受性。注射含肾上腺素的局部麻醉剂始终导致牙龈LDF输出信号显著下降（平均：46%，标准差；13.5）；吸烟者和非吸烟者反应相似。本研究的重要发现是，吸烟者的LDF信号恢复到基线所需的时间比非吸烟者长得多。这进一步证明，牙龈健康状况良好的吸烟者的牙龈血管与非吸烟者的牙龈血管反应不同。
