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

Gánti, Bernadett; Molnár, Eszter; Fazekas, Réka; Mikecs, Barbara; Lohinai, Zsolt; Mikó, S.; Vág, János

doi:10.1111/jre.12650

Cited by 10 publications

(9 citation statements)

References 59 publications

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“…The sample size was determined by experience from the previous study with very similar set-up [ 34 ]. Data are presented in the text and the figures as mean ± standard error.…”

Section: Discussionmentioning

confidence: 99%

“…GBF changes were continuously recorded for further 14 min by LSCI (PeriCam PSI HR System, Perimed AB, Stockholm, Sweden) with a 2 × 3 cm measurement area, 0.06 mm/pixel resolution and 2 images/sec. The gingival thickness was measured by PIROP ultrasonic biometer (Echo-Son, Puławy, Poland) [ 34 , 35 ] at the test and control sides according to the location of the 5–5 ROIs in group A, and at the midway1 and apical regions in group B.…”

Section: Methodsmentioning

confidence: 99%

“…The laser speckle contrast imager (LSCI) has been proved to be capable of capturing spatial variations in flap microcirculation without compromising temporal resolution with high reliability [ 28 – 33 ]. Recently, the nitric oxide donor-induced spreading vasodilation was also demonstrated by LSCI in human gingiva [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

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Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

et al. 2020

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Background It has been demonstrated in non-oral tissues that the locally evoked vasoconstriction could elicit remote vasoconstriction. This study aimed to investigate the spreading vasoconstrictor effects of epinephrine in the gingiva. Methods Gingival blood flow (GBF) was measured by laser speckle contrast imager in 21 healthy volunteers. In group A, two wells were fabricated from orthodontic elastic ligature and placed 2 mm apically to the free gingival margin at the mid buccal line of 12 (test side) and 21 (control side) teeth. The GBF was measured in the wells and tightly apical, coronal, distal and mesial to the wells. In group B, the wells were made on the buccal surface of the same teeth, including the gingival sulcus. Four regions were selected for measurement from the gingival margin reaching the mucogingival line (coronal, midway1, midway2 and apical). After the baseline recording, 3 µg epinephrine was applied into the test, and physiological saline into the control well. The GBF was recorded for 14 min. The gingival thickness was measured with a PIROP Ultrasonic Biometer. Results In group A, the GBF did not increase or decrease after the application of epinephrine. In group B, the GBF significantly decreased in all regions of the test side and remained low for the observation period. The vasoconstriction appeared with delays in more apical regions (at min 1 in the coronal and the midway1, at min 2 in the midway2, at min 4 in the apical region). Similarly, the amount of the decrease at 14 min was the largest close to sulcus (− 53 ± 2.9%), followed by the midway1 (− 51 ± 2.8%) and midway2 (− 42 ± 4.2%) and was the lowest in the apical region (− 32 ± 5.8%). No correlation was found between GBF and gingival thickness. Conclusion Epinephrine could evoke intense vasoconstriction propagating to the mucogingival junction, indicating the presence of spreading vasoconstriction in the human gingiva. The attached gingiva is impermeable to epinephrine, unlike the gingival sulcus. This trial was registered in ClinicalTrials.gov titled as Evidence of Spreading Vasoconstriction in Human Gingiva with the reference number of NCT04131283 on 16 October 2019. https://clinicaltrials.gov/show/NCT04131283

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“…The sample size was determined by experience from the previous study with very similar set-up [ 34 ]. Data are presented in the text and the figures as mean ± standard error.…”

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

et al. 2020

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“…The vasodilation should ascend (i.e., spread) to the proximal feed artery and arterioles to ensure the blood supply of the distal microcirculatory network [ 1 ]. Recently, spreading vasodilation and vasoconstriction evoked by nitric oxide or epinephrine was observed in human gingiva [ 2 , 3 ], which could have an impact on flap survival and the spatial progression of periodontitis. However, some evidence suggests that microcirculation of the human gingiva might be affected by sex.…”

Section: Introductionmentioning

confidence: 99%

Sex-related differences in endothelium-dependent vasodilation of human gingiva

2022

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Background Sex hormones influence circulation, periodontitis, and wound healing. The aim of the study was to compare the endothelium-dependent and independent vasodilation in human gingiva in men and women. Methods Gingival blood flow was evaluated in twelve male and twelve female subjects with healthy gingiva and no systemic conditions after acetylcholine or nitric oxide donor (NitroPOHL). Agonists were administered into the gingival sulcus at the right secondary incisor (test site). Regional gingival blood flow (GBF) was imaged by Laser Speckle Contrast Imager from the marginal gingiva to the mucogingival junction in four consecutive regions (coronal, midway1, midway2 and apical). Blood flow was expressed in Laser Speckle Perfusion Unit (LSPU). The absolute maximal blood flow change (Dmax), the area under the blood flow curve (AUC), and the time to peak (TTP) were calculated. Results Males had higher baseline GBF than females (257 ± 18.2 vs. 225 ± 18.8 LSPU, p < 0.001). Acetylcholine and NitroPOHL significantly increased the GBF in all test regions. The Dmax after the acetylcholine was reduced apically compared to the coronal (90 ± 13 LSPU vs. 117 ± 7 LSPU, p < 0.01), but it was similar after NitroPOHL (78 ± 9 LSPU vs. 86 ± 6 LSPU, p = 0.398) in both sexes. The Dmax and AUC were higher, and the TTP was smaller in men in most regions after acetylcholine but not after NitroPOHL. Conclusion In the human gingiva, the endothelium-independent vasodilation propagates without attenuation in the line of the vascular supply in both sexes. At the same time, the endothelium-dependent ascending vasodilation attenuates similarly in men and women. However, men had more pronounced endothelium-dependent vasodilation than women. Therefore, it might contribute to the increased severity of periodontal disease in men. Trial registration The study was registered with ClinicalTrials.gov on 09.06.2021 (NCT04918563).

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“…On the other hand, clinical observations revealed that the marginal gingiva could survive after horizontal incision and it could be revascularized by rapidly developing anastomosis from the periodontal plexus (Cutright, ; Kennedy, ). A recent observation showed that local vasodilation evoked on the keratinized gingiva spreads apically (Ganti et al, ) opening the supply vessels. This phenomenon could also have an important role in flap survival.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Objectives The aim of the present study was to investigate temporal and spatial blood flow patterns following vestibuloplasty procedures using a collagen matrix (CM) to get an insight into the timing and direction of neovascularization in the CM. Methods Five patients were treated using a modified apically repositioned flap combined with a CM. Intraoral photographs and blood flow measurements by laser speckle contrast imaging were taken for 12 months. Thirty regions of interest in the graft and the surrounding mucosa were evaluated. The clinical parameters were assessed after 6 and 12 months. VEGF expression was analyzed in the wound fluid on days 2 and 4. Results At 6 months, the mean width of keratinized gingiva increased, but the thickness was unchanged. Scar formation was observed in all cases. Perfusion in the graft began to increase at the lateral and coronal edges and then spread concentrically toward the center. The apical side showed a significant delay in perfusion, the highest VEGF expression, and wound fluid production as well as the most abundant scar formation. Conclusions Neovascularization occurs mainly from the lateral and coronal edges, which may limit the extent of the surgical area. Abundant scar formation may be explained by increased VEGF expression induced by prolonged ischemia in this area.

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

Cited by 10 publications

References 59 publications

Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

Epinephrine penetrates through gingival sulcus unlike keratinized gingiva and evokes remote vasoconstriction in human

Sex-related differences in endothelium-dependent vasodilation of human gingiva

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

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