Use of capillaroscopy to assess the architecture of gingival microvessels in healthy subjects

Background & Aim: Traumatic events at gingival margin (such as invasive prosthetic restoration or aggressive toothbrushing procedures) may cause injuries to the gingival tissue and induce alteration of periodontal microcirculation leading in some cases to aesthetic issues. Aims of the present study were: (i) to propose a non-invasive and standardized method to investigate by capillaroscopy the architecture of gingival microvessels, (ii) to quantify C in the healthy gingiva, (iii) to assess the reliability and repeatability of this method. Methods: 12 young volunteers with healthy periodontal tissue and without dental prosthetic restorations were recruited. On the vestibular side of upper incisors, the acquisition of microphotographs (x200) of free-gingiva and of the attached gingiva at 2–3 mm apically was performed by capillaroscopy. For each subject, two analyses were performed at 3 weeks of distance for repeatability assessment. On each image, organization and architecture of gingival microvessels were described. Amount and percentage of microvessels per mm2 were calculated in 10 randomly selected microphotographs. Method error and repeatability were computed. Results: In attached gingiva vessels appeared as tortuous capillary loops perpendicular to the epithelial surface. At level of free gingival line, vessels got linear and parallel to the arch of gingival margin. In free gingiva capillaries ran superficially and parallel to the epithelial surface, toward the margin and fell back with a loop on the tooth side. A mean of 49.8 (+- 9.5) microvessels for mm^2 was found. Capillaries represented the 10.3% (+-3.5) of the attached gingiva. The method of quantification resulted repeatable (Wilcoxon signed-rank test, p > 0.05). Conclusion: Capillaroscopy is a non-invasive repeatable method to observe gingival capillaries. This method may be proposed in clinical practice to detect and monitor changes or abnormalities after placement of prosthetic margins.