Gingivitis and periodontitis as antagonistic modulators of gingival perfusion.
BACKGROUND
We explore the possible association between the extent of gingivitis or periodontitis and an index of gingival microvascular perfusion response to compression of alveolar mucosa, called the gingival perfusion index (GIPI).


METHODS
A cross-sectional analytical study was done in a sample of 60 adults, including healthy and non-insulin-dependent diabetic subjects of either gender, with teeth in the anteromandibular sextant with or without gingivitis and with or without periodontitis at the lower-left lateral incisor (LLLI). A sample was selected by convenience non-probability sampling. Gingival perfusion was evaluated at labial LLLI attached gingiva. Two perfusion recordings were done 5 minutes apart, each one consisting of a 40-second control phase, a 22-second compression phase, and a 40-second postcompression phase. LLLI alveolar mucosa was compressed with a wood-mounted cotton swab until reaching about one-fifth of the control perfusion value. GIPI was used as response dependent variable. The gingival index and probing depth were used as measures of the extent of gingivitis and periodontitis, respectively.


RESULTS
By analysis of covariance and multiple regression analysis, it was found that only the probing depth (negatively) and gingival index (positively) predicted GIPI (R(2) adjusted = 0.5194, P <0.0001).


CONCLUSIONS
The data strongly suggest that, at least in the studied sample, gingivitis and periodontitis operate as antagonistic modulators of gingival perfusion. The major practical implication of our findings is that an increase or decrease in this index (GIPI) at a given attached gingiva site could indicate, respectively, the clinical predominance of gingivitis or periodontitis in such a site.
Rodríguez-Martínez
Manuel
M
Department of Physiology and Pharmacology, School of Medicine, Autonomous University of San Luis Potosí, San Luis Potosí, Mexico, USA. rodrigum@uasip.mx
Patiño-Marín
Nuria
N
Loyola-Rodríguez
Juan Pablo
JP
Brito-Orta
Ma Dolores
MD
D000328:Adult; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology; D005260:Female; D005544:Forecasting; D005881:Gingiva / Q000098:blood supply*; D005891:Gingivitis / Q000503:physiopathology*; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D009061:Mouth Mucosa / Q000098:blood supply; D009765:Obesity / Q000503:physiopathology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000503:physiopathology; D010518:Periodontitis / Q000503:physiopathology*; D011312:Pressure