Gingival blood flow in periodontitis patients before and after periodontal surgery assessed in smokers and non-smokers

Background: The aim of this study was to evaluate the gingival blood flow of smokers and non-smokers with periodontal disease before and after surgical periodontal treatment. Methods: Nine smokers and six non-smokers with at least two periodontal lesions were included in the study. Laser Doppler flowmetry was used to measure blood flow in two gingival sites and two skin sites. Two intrabony defects were treated surgically at the same time; enamel matrix derivative was applied at random to one of the sites, whereas the other site received a placebo gel. We measured resting gingival blood flow (GBF) and responses to cold pressor test (CPT) and to smoking and made continuous measurements of blood pressure (BP). Resting GBF levels of 26 young healthy subjects were used as a reference value. Results: Resting GBF was significantly lower for the periodontitis patients compared to the reference subjects, regardless of smoking habits. GBF and gingival vascular conductance (VC) decreased significantly pre- and postoperatively in response to smoking. CPT evoked significant decreases in VC in smokers and non-smokers. Skin blood flow decreased significantly in response to CPT, more so in the non-smokers. BP was significantly higher in the non-smokers. Conclusions: Resting GBF of periodontitis patients was not lower in smokers than in non-smokers, but it was significantly lower than in the younger reference subjects. In contrast to our earlier findings in healthy subjects, smoking one cigarette may cause a decrease in GBF and VC in periodontitis patients. These observations suggested the existence of a dysfunction in the gingival vasculature in smokers and non-smokers with periodontitis.