Sigara İçen ve İçmeyen Hastaların Dişeti Marjininin Kapilleroskopi ile Değerlendirilmesi

Amaç: Gingival videokapilleroskopi, dişetinin mikrovasküler yapısındaki değişimlerin gözlenmesine olanak sağlayan invaziv olmayan bir yöntemdir. Dişeti dokusunda, damarsal değişimlere de neden olabilen sigara kullanımı periodontal hastalıklar için bir risk faktörüdür. Bu çalışmada; klinik olarak sağlıklı, gingivitisli ve kronik periodontitisli hastaların dişeti marjinindeki mikrodolaşıma ait değişimlerin değerlendirilmesi ve sigara kullanımının etkisinin belirlenmesi amaçlanmıştır. Materyal-Metot: Çalışmaya 129 birey katıldı. Sigara kullanan ve kullanmayan hastalar periodontal durumlarına göre; sigara kullanmayan ve klinik olarak sağlıklı dişetine sahip bireyler, grup S (n=23); sigara içen ve klinik olarak sağlıklı dişetine sahip bireyler, grup SS (n=20); sigara kullanmayan gingivitisli hastalar, grup G (n=25), sigara içen gingivitisli hastalar, grup GS (n=20), sigara içmeyen kronik periodontitisli hastalar, grup P (n=20) ve sigara içen kronik periodontitisli hastalar, grup PS (n=21) olarak gruplandırıldı. Periodontal klinik parametreler kaydedildi. Gingival videokapillaroskopi yöntemi ile x200 büyütmede görüntüler elde edildi. Elde edilen görüntüler kapiller sayısı ve alanı açısından bir bilgisayar programı yardımıyla analiz edildi. Bulgular: S, SS, GS ve PS gruplarında kapiller sayısı, G ve P gruplarına göre anlamlı olarak düşük bulundu (p<0,003). Damar alanı hesaplamalarında gruplar arasında anlamlı farklılık izlendi ve sırasıyla S-SS<PS-GS<P-G şeklinde olduğu belirlendi (p<0,003). Sonuç: Sigara içen bireylerde kapiller sayısının periodontal hastalık varlığında artmadığı, sigara içmeyen gingivitis ve periodontitisli gruplardan düşük olduğu gözlendi. Sigaraya bağlı artmış periodontal yıkım, sigara içen bireylerdeki mikrovasküler etkilenimlerden kaynaklanıyor olabilir.

Anahtar Kelimeler:

sigara içme, kapilleroskopi, periodontal hastalıklar

Capillaroscopic evaluation of smoking and non-smoking patients’ gingival margin

Objective: Gingival videocapillaroscopy is a non-invasive method to observe the changes in the gingival microvasculature. Smoking, which may cause vascular changes in gingiva, is a risk factor for periodontal diseases. This study aimed to observe the gingival capillary characteristics of healthy, gingivitis and chronic periodontitis patients and the effect of smoking status on microcirculation.Material-Methods: One-hundred twenty-nine patients participated in the study. Smoking and non-smoking patients were categorized in three groups based on the periodontal status as follows; group S (n=23), non-smoking patients with clinically healthy gingiva; group SS (n=20), smoking patients with clinically healthy gingiva; group G (n=25), non-smoking patients with gingivitis; group GS (n=20), smoking patients with gingivitis; group P (n=20), non-smoking patients with chronic periodontitis and group PS (n=21), smoking patients with chronic periodontitis. Periodontal clinical parameters were recorded. Gingival videocapillaroscopy was used to investigate the characteristics of microcirculation with x200 magnification. Obtained images were analyzed for the capillary number and area by a software program. Results: Number of capillaries were significantly lower in S, SS, SG and SP groups compared to G and P groups (p<0,003). Vascular area calculations showed significant differences between the groups and were S-SS <PS-GS <P-G, respectively (p <0.003).Conclusion: It was observed that the number of smokers capillaries did not increase in the presence of periodontal disease and the capillary area of smoking patients with gingivitis and periodontitis was lower than the non-smoker gingivitis and periodontitis groups. Increased periodontal destruction caused by smoking may be due to microvascular effects.

Keywords:

capillaroscopy, periodontal diseases, smoking,

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