Gingival blood flow before, during, and after clenching, measured by laser Doppler blood flowmeter: A pilot study

Abstract

This study aimed to investigate the effects of the strong occlusal force on the hemodynamics of gingival microcirculation. Eleven adult volunteers with healthy periodontium and normal occlusion participated in this study. Using a noncontact laser Doppler flowmeter placed at the attached gingiva and the interdental papilla of the maxillary first premolar, changes in gingival blood flow (GBF) were examined during and after clenching. When the strong occlusal pressure was applied on the maxillary first premolar by clenching, GBF in the attached gingiva on the buccal side decreased significantly compared with the resting GBF, with medians of 2.3mL/min/100g and 5.4mL/min/100g, respectively (P<0.05). After the release of the maximum clenching, GBF recovered immediately and transiently increased to a median of 2.4mL/min/100g, showing a significant difference to the resting GBF (P<0.05). In contrast, in the interdental papilla, no significant change in GBF was found by clenching. Ischemia of the buccal attached gingiva associated with strong clenching may be due to compression of the vascular network of the periodontal membrane. Through reactive hyperemia resulting from the release of clenching, it is possible not only that blood flow will be restored to the tissue but that the tissue itself may be damaged by the reperfusion. During active orthodontic treatment, it is suggested that occlusal management to prevent occlusal trauma is important to avoid detrimental effects on periodontal tissues.