The state of microcirculation in patients with periodontal diseases and disorders of the occlusal relationships of the dentition

Abstract

Background. The study of microcirculation disorders, as one of the key factors in the pathogenesis of periodontal diseases, is relevant in clinical dentistry. Premature contacts, acting as provoking factors for occlusal disorders, cause overload of individual teeth and aggravate the severity of inflammatory periodontal pathology. Objective registration of capillary blood flow and associated changes in the microvessels of the arteriolar and venular units in patients with periodontopathies and occlusal dis-orders will allow us to assess the degree and nature of tissue blood flow disorders in the gum tissue.Goal. Increasing the efficiency of diagnosing microcirculatory disorders in periodontal tissues in patients with chronic generalized mild periodontitis and disorders of the occlusal relationships of the dentition.Materials and methods. Using laser Doppler flowmetry (LDF), the state of mi-crocirculation in the periodontium was studied in 78 people aged 21–35 years with intact dentition and physiological occlusion, of which 33 people (group 1) had clinically healthy periodontium and the absence of occlusal disorders (group 1), with generalized chronic pulmonary periodontitis degree and premature occlusal contacts – 45 people (group 2). The microcirculation index (M), standard deviation (σ), and coefficient of variation (КV) were assessed. To obtain objective diagnostic data, amplitude-frequency analysis of the harmonic rhythms of LDF-grams was used with spectral decomposition into harmonic components of physiological oscillations of tissue blood flow (wavelet analysis).Results. In patients of group 2, in comparison with patients of group 1, a decrease in the level of periodontal blood perfusion, a reduction in the fluctuation of erythro-cyte flow and vasomotor activity of microvessels is determined, while a decrease in “active” and an increase in «passive» modulation of tissue blood flow contributes to an increase in the volume of circulating blood at arteriovenular anastomoses when the intensity of blood flow through the vessels of the capillary bed decreases.Conclusions. Patients of group 1 were diagnosed with a normoemic type of LDF-gram, which provides a relatively high degree of intensity of tissue blood flow, balance of regulatory mechanisms, and optimal trophism of periodontal tissues. In patients of group 2 with a spastic type of LDF-gram, characterized by a reduced level of perfusion, flux, vasomotor activity of microvessels, indicators of tissue blood flow and trophic function are significantly reduced.