The decline in circulatory function with aging may be alleviated by a combination of gingival massage (physical stimulation) and mechanical cleaning. Several studies have reported the systemic effect of physical stimulation on various parts of the body, including its therapeutic effect on pain in the neck and shoulders that becomes evident with age, and improvement in blood circulation. In contrast, few studies have reported on the changes in gingival microcirculation induced by gingival massage, while no previous study has evaluated the effect of gingival microcirculation on age-related changes in the hemodynamics of the oral cavity. This study aimed to investigate how gingival massage affects age-related changes in gingival microcirculation. Male Wistar rats (7-week, 6-month and 1-year old) were prepared for a gingival massage group and a control group. Mechanical stimulation was applied on the maxillary molar gingiva for 5 seconds twice a week for 4 weeks. Subsequently, gingival reactive hyperemia was measured using a laser Doppler flowmeter. In addition, morphological analyses were also performed by hematoxylin and eosin and Indian ink staining and a vascular resin cast model. Base Flow, maximum response (Peak), and time required for the maximum response to halve (T 1/2) were reduced in 1-year-old rats compared with the other age groups. In the mechanical stimulated group, T 1/2 was increased in 7-week, 6-month, and 1-year-old rats, and total blood flow (Mass) was increased in 6-month and 1-year-old rats. In addition, clear blood vessel networks and loop-like revascularization were only observed in the mechanical stimulated group. Changes in age-related decline in gingival microcirculatory function and vascular construction were reported in this study, and the results suggested that gingival massage activates both the functional and morphological aspects of gingival microcirculation and may be effective for maintaining oral health.

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In a student course of gross anatomy dissection at Kanagawa Dental University in 2011, we encountered anomalous case of the right subclavian artery arising from the aortic arch as the last branch in an 84-year-old Japanese male cadaver. The anomalous artery ran obliquely upward, passed behind the esophagus and trachea, and ultimately ran toward right scalene gap. The area of distribution of the anomalous artery was normal. We report a case of retroesophageal right subclavian artery, and discuss its development, or relation with the thoracic duct, and its clinical importance. Despite this type of variation being relatively rare, reports on such a case have been accumulating. Owing to the recent development of CT and MRI, the number of clinical reports on this anomaly has been increasing.