Laser Doppler flowmetry for the early diagnosis of localized traumatic periodontitis

BACKGROUND: Laser Doppler flowmetry is an effective method for the diagnosis of initial periodontitis. AIM: To evaluate the microcirculation using laser Doppler flowmetry in patients with mild and moderate localized traumatic periodontitis. METHODS: We evaluated the periodontium in patients with mild (102 participants) and moderate (67 participants) localized periodontitis. We performed a standard physical examination and used laser Doppler flowmetry to investigate the level and intensity of periodontal circulation and microvascular vasomotor activity (general microcirculation index, standard deviation of perfusion fluctuations, coefficient of variation, and shunting index). The data were processed using statistical methods (Fisher’s exact test, Student’s t test, risk ratio calculation). RESULTS: We recorded a reduction in the average periodontal perfusion in both mild and moderate localized periodontitis in the lesion region compared with the test region (an area of clinically healthy periodontium on the contralateral jaw). For example, in mild periodontitis, perfusion was 10.4 ± 2.01 PFU in the lesion region and 15.28 ± 1.16 PFU in the test region (p 0.001); in moderate periodontitis, perfusion was 7.01 ± 0.97 PFU and 13.98 ± 0.83 PFU, respectively (p 0.001). The coefficient of variation was also lower in the lesion region: 12.16 ± 2.2 and 13.56 ± 5.0 (p 0.001) in mild periodontitis and 10.32 ± 1.63 and 15.54 ± 3.8 (p 0.001) in moderate periodontitis. We identified a lower standard deviation: in mild periodontitis, it was 1.38 ± 0.32 in the lesion region and 1.59 ± 0.65 in the test region (p 0.001), and in moderate periodontitis, it was 1.35 ± 0.17 and 1.65 ± 0.44, respectively (p 0.001). In addition, we observed an increased number of functional arteriole-venular shunts: in mild periodontitis, this number was 1.20 ± 0.08 in the lesion region and 0.84 ± 0.05 in the test region (p 0.001), and in moderate periodontitis, it was 1.09 ± 0.09 and 0.91 ± 0.12, respectively (p 0.001). CONCLUSION: Abnormal microcirculation in localized traumatic periodontitis occurs even at the initial stage of the disease (i.e., at the preclinical level). Regardless of the severity, tissue perfusion in the lesion region is reduced and the number of functional capillaries is decreased, leading to congestion in the periodontium.