Morphofunctional assessment of periodontal tissues using optical and laser diagnostic methods in patients with plaque-induced gingivitis

Relevance. Plaque-induced gingivitis in young adults is often asymptomatic and is accompanied by early clinical, microcirculatory, and metabolic changes in periodontal tissues. Therefore, noninvasive optical and laser diagnostic methods that enable objective assessment of microcirculation and tissue metabolism are particularly relevant.

Objective. To evaluate the diagnostic utility of optical and laser methods for assessing the microcirculatory and metabolic status of periodontal tissues in patients with plaque-induced gingivitis.

Materials and methods. The study included 24 participants with no clinical signs of periodontal disease and 17 patients with plaque-induced gingivitis, all aged 20–25 years. Oral hygiene and gingival inflammation were assessed using the Simplified Oral Hygiene Index (OHI-S), Approximal Plaque Index (API), and papillary–marginal–attached (PMA) index. Microcirculatory parameters were evaluated by laser Doppler flowmetry, the capillary bed was assessed by oral capillaroscopy and tissue metabolism parameters and the porphyrin index were evaluated by fluorescence spectroscopy.

Results. In patients with plaque-induced gingivitis, the OHI-S score was 2.26 ± 0.10 vs 0.81 ± 0.10 in the control group (p = 0.001), the API was 49.9 ± 2.0% vs 30.1 ± 2.9% (p = 0.01), and the PMA index was 41.4 ± 2.2% vs 22.2 ± 1.4% (p = 0.001). Laser Doppler flowmetry showed reduced perfusion in both the marginal gingiva (14.94 ± 2.60 vs 23.04 ± 0.89 perfusion units; p = 0.007) and the interdental papilla (13.52 ± 2.10 vs 17.39 ± 0.40 perfusion units; p = 0.001). Oral capillaroscopy revealed increases of 52% and 43% in the diameters of the arterial and venous capillary segments, respectively (p = 0.001). Nicotine-midadenine dinucleotide fluorescence intensity was 84% higher in the marginal gingiva (p = 0.007) and 81% higher in the interdental papilla (p = 0.006). The porphyrin index increased by 67–68% (p = 0.001).

Conclusion. The combined use of laser Doppler flowmetry, oral capillaroscopy, and fluorescence spectroscopy can detect early morphological and functional changes in periodontal tissues in patients with plaque-induced gingivitis.

1. World Health Organization. Global oral health status report: towards universal health coverage for oral health by 2030. Geneva: World Health Organization; 2022. 100 p. ISBN: 978-92-4-006148-4. Available from: https://www.who.int/publications/i/item/9789240061484

2. Zhang M, Liu Y, Afzali H, Graves DT. An update on periodontal inflammation and bone loss. Frontiers in Immunology. 2024;15:1385436. https://doi.org/10.3389/fimmu.2024.1385436

3. Buset SL, Walter C, Friedmann A, Weiger R, Borgnakke WS, Zitzmann NU. Are periodontal diseases really silent? A systematic review of their effect on quality of life. Journal of Clinical Periodontology. 2016;43(4):333-344. https://doi.org/10.1111/jcpe.12517

4. Alwithanani N. Periodontal Disease and Smoking: Systematic Review. Journal of Pharmacy & Bioallied Sciences. 2023;15(Suppl 1):S64-S71. https://doi.org/10.4103/jpbs.jpbs_516_22

5. Mohajeri A, Lipsky MS, Hegde R, Chiang J, Hung M. Electronic Nicotine Delivery Systems Use and Periodontal Health-Findings from the Population Assessment of Tobacco and Health Study. Healthcare (Basel). 2024;12(1):25. https://doi.org/10.3390/healthcare12010025

6. Kusama T, Nakazawa N, Takeuchi K, Kiuchi S, Osaka K. Free Sugar Intake and Periodontal Diseases: A Systematic Review. Nutrients. 2022;14(21):4444. https://doi.org/10.3390/nu14214444

7. Orekhova L.Y, Petrov A.A., Loboda E.S., Malysheva E.Y., Kosova E.V., Kosov S.A. Functional state of the microcirculatory system in periodontal tissues in young adults with different types of smoking. Actual problems in dentistry. 2022;18(2):115-122 (In Russ.). https://doi.org/10.18481/2077-7566-2022-18-2-115-122

8. Kopetsky I.S., Polunina N.V., Pobozhieva L.V., Shevelyuk Y.V., Makeeva M.K. The prevalence of dental diseases and medical and social characteristics in young people. Russian Medicine. 2024;30(1):27-36 (In Russ.). https://doi.org/10.17816/medjrf625758

9. Stepanov E.A., Kurashvili L.V., Mikulyak N.I., Moiseev YaP, Kinzirsky AS. The features of parodentium’s microcirculation in various systemic diseases (a literature review). University proceedings. Volga region. Medical sciences. 2021;2(58):137-150 (In Russ.). https://doi.org/10.21685/2072-3032-2021-2-13

10. Stefanovska A, Bracic M, Kvernmo HD. Wavelet analysis of oscillations in the peripheral blood circulation measured by laser Doppler technique. IEEE Transactions on Biomedical Engineering. 1999;46(10):1230-1239. https://doi.org/10.1109/10.790500

11. Agafonova I.S., Ermoliev S.N., Aivazova R.A., Shimansky Sh.L., Atrushkevich V.G. Pathogenetic strategies for addressing periodontal morphological and functional disorders in plaque-induced gingivitis. Pediatric dentistry and dental prophylaxis. 2024;24(1):34-40 (In Russ.). https://doi.org/10.33925/1683-3031-2024-744

12. Orekhova L.Yu., Petrov A.A., Loboda E.S., Berezkina I.V., Shadrina K.V. Study of functional state of microcirculatory channel system in periodontal tissues in persons of different age groups. Pediatric dentistry and dental prophylaxis. 2020;20(2):88-94 (In Russ.). https://doi.org/10.33925/1683-3031-2020-20-2-88-94