Mechanism of Periodontal Destruction in Gingival Microcirculation by Cigarette Smoking

早期使用热扩散技术对尼古丁影响的研究和最近使用激光多普勒流量计（LDF）对吸烟影响的研究表明，牙龈血流量（GBF）会减少。另一项关于沟液流动和沟性GBF的研究表明吸烟后GBF增加。到目前为止，关于吸烟对GBF急性效应的研究尚无定论。在本研究中，我们使用光纤间距分别为0.3 mm （LDF-0.3）和0.7 mm （LDF-0.7）的LDF测量吸烟后的GBF。在研究之前，我们证实了LDF-0.3和LDF-0.7与LDF-0.3的差值（LDF-d）分别代表浅层和深层的GBFs。9名每天吸烟15-30支的男性吸烟者自愿参加，并被要求在实验前至少6小时不吸烟。用树脂支架将探针固定在上颌第二前磨牙边缘龈上。休息5分钟后，受试者先抽未点燃的香烟5分钟，然后抽完香烟，最后休息40分钟。吸烟后收缩压、心率显著升高（p<0.05）。吸烟后LDF-0.3和LDF-d变化无统计学意义。然而，6名受试者吸烟后ldl -0.3立即下降，6名受试者吸烟导致ldl -d相对于假吸烟增加。在4名受试者中发现吸烟后LDF读数的变化。这些结果表明，吸烟后，GBF呈表层降低，深层增加的趋势。

Earlier studies on the effects of nicotine using a heat diffusion technique and a recent study on the effect of smoking using a laser Doppler flowmeter (LDF) demonstrated a decrease in gingival blood flow (GBF). Another studies on crevicular fluid flow and sulcus GBF indicated increased GBF after smoking. So far, results from the studies on acute effect of smoking on GBF are inconclusive. In this study, we measured GBF following smoking using LDF with different optic-fiber separations of 0.3 mm (LDF-0.3) and 0.7 (LDF-0.7). Prior to the study, we confirmed that the LDF-0.3 and difference between LDF-0.7 and LDF-0.3 (LDF-d) represented GBFs in superficial fraction and deeper fraction, respectively. Nine male smokers consuming 15-30 daily volunteered and were asked not to smoke at least 6 h before the experiment. The probe was fixed upon marginal gingiva of the second premolar in maxilla with a resin stent. After resting for 5 min, subjects sham smoked an unlighted cigarette for 5 min, then smoked the cigarette, and finally rested for 40 min. Systolic blood pressure and heart rate increased significantly after smoking (p<0.05). Changes in LDF-0.3 and LDF-d after smoking were not statistically significant. However, 6 subjects showed a decrease in LDF-0.3 immediately after smoking while smoking in 6 subjects caused a relative increase in LDF-d over sham smoking. Both the changes in the LDF readings after smoking were found in 4 subjects. These results in indicate that GBF tends to decrease in superfcial layr and increase in deeper layr after smoking.