Vascular Patterns and Perfusion of Mucogingival Tissues and Their Relation to Periodontal Flap Design

摘要

This investigation sought to describe the three dimensional microvascular anatomy of the periodontium utilizing silicone Microfil and acrylic perfusion techniques. A second aim of this study was to evaluate vascular response to surgical injury utilizing fluorescein angiography and laser doppler velocimetry. A total of seven Rhesus monkeys were used in this study. Four Rhesus monkeys were sacrificed followed by carotid artery cannulation, exsanguination, rinsing, and vascular perfusion of the head utilizing either Batson's 17 corrosion casting medium or silicone Microfil. Batson's perfused specimens (2) were then prepared for scanning electron microscopy and the Microfil specimens (2) were subjected to both hematoxylin and eosin and cleared section analysis. In order to evaluate vascular response to surgical injury, three monkeys were studied with fluorescein angiography and laser doppler velocimetry following three different periodontal flap designs (narrow pedicle, wide pedicle, and envelope flap). Recordings were made at three time intervals (pre-surgery, post flap reflection and replacement, and following flap suturing), and at three tatooed tissue locations (coronal flap margin, base of flap, and midway between the previous two measurements). The findings in this study suggest that the location of vertical incisions at the junction of thick and thin tissues (i.e., at tooth line angles) is associated with the best post surgical perfusion. Tissue thickness appears to be just as important to flap survival as the width to length ratio of flaps. Thesis.