Human gingival and pulpal blood flow during healing after Le Fort I osteotomy

Purpose: The occurrence of a hypervascular period during healing after orthognathic surgery has not been investigated rigorously in human pulpal and gingival tissues. This study used laser Doppler flowmetry to investigate the effects of Le Fort I osteotomy on maxillary pulpal and gingival blood flow between the first and third week after surgery. Patients and Methods: Pulpal blood flow was recorded in maxillary incisors, and gingival blood flow was assessed from a site slightly apical to the interdental papilla of the maxillary central incisors in 10 patients who were undergoing a Le Fort I osteotomy, 10 patients who were undergoing a mandibular osteotomy, and 10 nonsurgical control subjects who were not undergoing orthodontic treatment. Blood flow measurements were made before surgery and at intervals between 7 and 10 days, 14 and 17 days, and 21 and 24 days after surgery. The nonsurgical control subjects were tested at similar intervals. Results: Baseline gingival and pulpal blood flow values did not differ significantly for the 3 groups. In addition, gingival and pulpal blood flow did not change in the nonsurgical control group. Analysis of the postsurgical change from baseline blood flow values indicated a significant increase in pulpal blood flow in the maxillary surgery patients relative to the patients treated with mandibular surgery. However, no significant group difference was found for gingival blood flow. Conclusions: This study provides evidence that pulpal blood flow is increased between the first and third week after Le Fort I osteotomy, but it did not find a significant change in gingival blood flow. (C) 2001 American Association of Oral and Maxillofacial Surgeons.