Table 2.
Wound healing assessment by Laser Doppler flowmetry.
| Author (year) | Study design | Aim | Indication | Time evaluated | Results | Clinical relevance |
|---|---|---|---|---|---|---|
| Heitzer et al., 2025 | Pre-clinical | Compare the hemostyptic properties and gingival healing after tooth extraction in rodent under rivaroxaban therapy over 10 days | Hemostyptic properties and gingival healing between novel polyurethane based adhesive VIVO and gelatin sponge (GESP) | 1 time point | Increase mean blood flow for both treatments | VIVO demonstrated effective hemostasis and favorable gingival healing following tooth extraction under continuous rivaroxaban therapy |
| Katz et al., 2024 | Clinical | Evaluate peri-implant tissue perfusion (blood flow) in implants placed in pristine bone, avascular, and microvascular grafts | Gingiva; perfusion in different bone types in dental implants | 1 time point | No differences found in gingival blood flow in either pristine or avascular bone or microvascular grafts | Perfusion was similar between implants in native and augmented sites, though those in avascular or microvascular grafts showed increased peri-implant inflammation |
| Diehl et al., 2022 | Clinical | Assess microcirculation and the expression patterns of wound-healing related implants in type 2 diabetes mellitus patients | Periodontitis | 3 months | Wound healing after implant surgery was similar in healthy patients and T2DM | Considered hydrophilic surface titanium zirconium with reduced diameter for T2DM patients |
| Liu et al., 2022 | Pre-clinical | Measure changes in blood flow rate using advanced PRF in early-stage gingival regeneration after tooth extraction | Gingival tissue regeneration | 1 time point | Gingival blood flow was higher with A-PRF | A-PRF may be beneficial for gingival tissue regeneration |
| Miron et al., 2022 | Clinical | Evaluate microcirculation at marginal gingiva after change of toothbrush | Periodontal health | 14 days | New toothbrushes in adolescents with healthy gingiva can increase gingival blood flow | Changing the toothbrush in less than a month could be a factor in gingival micro irritation |
| Svetlana et al., 2022 | Clinical | Determine and compare dental pulp and gingival blood flow | Radiotherapy | 6 months | RT cause a significant acute gingival blood flow | Protect teeth before radiotherapy to avoid ischemia of soft tissues |
| Komaki et al., 2022 | Clinical | Investigate the hemodynamics of gingival microcirculation | Occlusal trauma | During and after clenching | Ischemia was present during clenching followed by reactive hyperemia by the release of clenching | Occlusal trauma should be prevented to avoid detrimental effects on periodontal tissues due to compression of the vascular network of the periodontal membrane |
| Laredo-Naranjo et al., 2021 | Clinical | Identify gingival microcirculation | Orthodontic treatment | 30 days | Longitudinal evaluation showed increased perfusion in Nitinol arches three times greater than basal flow | Identification of inflammatory process in treatment is crucial to discontinue the use of harmful methods |
| Yamamoto et al., 2021 | Pre-clinical | Assess changes in peri-implant vascular network and blood flow | Peri-implant tissue inflammation | 90 days | Significant increase in blood flow around implants with an inflamed blood vessels invade the bone marrow through the bone margin of the alveolar bone | Analysis of gingival microcirculation of tissues may aid the pathological analysis in clinical setting |
| Kuraji et al., 2019 | Pre-clinical | Evaluate temporal changes in gingival blood flow during disease progression | Periodontitis | 28 days | Levels of alveolar bone loss, gene expression and immunostained VEGF- positive vessels correlated with increase changes in gingival blood flow. | Dynamic alteration of gingival blood flow was demonstrated during disease progression, inflammation, vasculogenesis and alveolar bone resorption |
| Alssum et al., 2017 | Clinical | Assess gingival blood perfusion and wound fluid | Post extraction regenerative | 120 days | Transient increases in angiogenic and prolonged hyperemia of soft tissue | Soft tissue ischemia-reperfusion model does not determine radiographic bone changes |
| Kaner et al., 2017 | Clinical | Characterize early phase of wound healing after periodontal surgery with and without Enamel matrix derivative (EMD) | Early wound healing after periodontal surgery | 2 weeks before surgery and 14 days after surgery | Significantly decrease at the papillary base with increased blood flow until day 14. Group without EDM showed decreased blood flow at day 1 when compared | Detection of changes in microcirculation after surgery with differentiation between surgical techniques |
| Ogino et al., 2017 | Clinical | Examined the extent of reactive hyperemia effect on GBF in denture-supporting mucosa during chewing | Biting force | After simulated biting or chewing for 30 s at 8 time points | Significant correlation between GBF chewing and the extent of reactive hyperemia | Slow chewing induced less GBF than regular or fast chewing in denture-supporting mucosa. Subject with less reactive hyperemia had less GBF in denture-supporting mucosa |
| Tatarakis et al., 2017 | Clinical | Assess early healing process using a xenogenic collagen matrix (CMX) or connective tissue graft (CTG) | Root recession coverage | 30 days | CTG showed a vascular homogeneous pattern whereas CMX had a second phase of increased blood flow at 14 days | Identify early vascular response and assessing maturity of surgical wound |
| Le Bars et al., 2016 | Clinical | Measure the microcirculation of the healthy palatal mucosa at three specific points, and to test the reproducibility and sensitivity of the LDF | Palatal mucosa (median raphe (MR), Schroeder area (SA), retro incisive papilla (RP) | 3 min | Palatal blood flow differed significantly from other surfaces. SA showed the highest GBF values followed by RP and MR | LDF can help to detect the onset of pathological alterations of the palatal mucosa |
| Reuther et al., 2016 | Clinical | Investigate the effect of electronic cigarettes (with nicotine and without) on blood flow in the buccal mucosa | Electronic cigarette smoking | After 5 min of vaping. Intervals at 5 min for 30 min | Wide variation in results and a small but significant rise in nicotine vaping but fell to baseline within 30 min | Electronic cigarettes may influence blood flow in the oral mucosa |
| Svalestad et al., 2014 | Clinical | Evaluate the effect of hyperbaric oxygen therapy (HBOT) on vascular function | Gingival mucosa | 6 months | Vascular capacity increased by HBOT, and effect persists up to 6 months | A significant increase in maximal blood flow may indicate a vascular bed with improved healing capacity |
| Kawaai et al., 2013 | Clinical | Assess the oral mucosal blood flow during sedation with dexmedetomidine | Palatal | 0, 5, 10, 12, 22 and 32 min after the start of the infusion | GBF decreased significantly after the start of the infusion of dexmedetomidine | LDF showed decreased levels of GBF by the mediating effect of dexmedetomidine on a-2 adrenoceptors |
| Kozlov and Ibragim 2011 | Clinical | Examine GBF in patients with varying degrees of inflammation in health, gingivitis and periodontitis | Periodontal disease | 1 time point | Changes in micro vessels lead to the development of blood flow stagnation in post capillaries and local stasis in the gingival tissues | LDF can estimate the severity of the disorders of the microcirculation in the gingiva in the development of periodontitis |
| Okada et al., 2010 | Clinical | Determine the effect of the number of biting forces on change in blood flow in denture-supporting maxillary mucosa. | Biting force | BL, at rest (1, 4, 8, 12 min) | GBF showed statistically significant differences at pre-loading and loading | There was an increase in mean blood flow during intermittent loading relative to at pre-loading |
| Sakr et al., 2010 | Clinical | Characterize the buccal microvascular response in patients with septic shock | Septic shock | Every 2 s for 5 min and after 1 week | GBF increased during the 2nd day of septic shock and decreased after. Non septic patients GBF was significantly greater superficially | LDF may be useful for tracing microvascular alterations in critically ill patients |
| Svalestad et al., 2010 | Clinical | Evaluate reproducibility of LDF for assessing microvascular blood flow after radiotherapy and hyperbaric oxygen therapy | Mandibular mucosa | 6 weeks | Blood flow increased when compared to basal flow after heat provocation | LDF showed reproducibility in longitudinal studies |
| Singh et al., 2008 | Clinical | Comparison between blood flow in the tongue and oral mucosa with 2 LDF probes | Intraoral cavity | 3 time points (0, 6 and 24 h) | Measurements by the 2 probes were correlated significantly but the standard deviations were large | LDF measurements showed large variations between probes |
| Retzpei et al., 2007a | Clinical | Compared gingival blood flow responses followed simplified papilla preservation (test) and modified Widman flap (control) | Periodontal access flap | 60 days | Results present an ischemia-reperfusion flap model with papilla preservation flap with faster recovery. A peak hyperemic response resolved by day 4 (test) but persisted until day 7 (control) | LDF may present clinical applicability in recording dynamic changes in the microcirculatory blood perfusion. Papilla preservation flap may be associated with faster recovery of gingival blood flow post-operatively |
| Retzepi et. 2007b | Clinical | Investigate pattern of gingival blood flow changes after periodontal access flap surgery | Periodontal access flap surgery | 60 days | Different areas of the flaps consistently showed an ischemic-hyperemia patterns of perfusion alteration during wound healing | This technique may be useful in representing the dynamic nature of flaps blood flow reperfusion |
| Rodriguez-Martinez et al., 2006 | Clinical | Explore possible association between an index of gingival microvascular perfusion response to compression of alveolar mucosa | Periodontitis | 2 measurements 4 min apart | Microvascular density, dilation, elongation and organize capillary network has a positive correlation with clinical measurement and increased reactive hyperemia | Increase or decrease in gingival perfusion could indicate clinical predominance of gingivitis or periodontitis |
| Donos et al., 2005 | Clinical | Evaluate the applicability of the LDF in recording changes in gingival blood flow | Periodontal surgery | 60 days | GBF increases in comparison to baseline values until the 7th day. By the 15th day, 30th, and 60th gingival blood flow values were similar to the baseline | LDF might present clinical applicability in recording changes in gingival blood flow following periodontal surgery |
| Kocabalkan and Turgut 2005 | Clinical | Investigate the influence resin base materials on the blood flow of underlying mucosa | Biting forces | Baseline (BL), 1 week, 1, 3 and 6 months | Soft lining and hard acrylic: Mean GBF in mucosa after 1 week was significantly lower than baseline and at 6 months after return to normality Hard: GBF in molar region increased after 6 months compared to BL |
Dentures hinders blood flow to supporting tissues |
| Patino-Marin et al., 2004 | Clinical | Systematize a procedure that allows characterization of perfusion response pattern to topical and transitory compression | Attached gingiva | 2 measurements 5 min apart | Gingival compression propitiated an induced flow debt followed by increased flow after compression is released | Microvascular responses are reproducible indices of perfusion response whose validation under pathological circumstances remains to be evaluated |
| Kerdvongbundit et al., 2003 | Clinical | Evaluate dynamic changes in the micromorphology and microcirculation of healthy and inflamed human gingiva | Gingival surfaces (free and attached gingiva, interdental papilla and alveolar mucosa) | 15 min with 90 s intervals | GBF in healthy and gingivitis was significantly different. After treatment at 1 and 3 months GBF showed significant differences | LDF can be used to record GBF before and after inflammation reduction |
| Kemppainen et al., 2003 | Clinical | Study capsaicin-evoked blood flow responses in maxillary gingiva | Alveolar mucosa and attached gingiva | 4–15 s | Significant higher blood flow during the stimulation period and 3 min after | Alveolar mucosa is more sensitive to chemical irritants than attached gingiva |
| Akazawa and Sakurai 2002 | Clinical | Investigate the influence of the continuous compression because of light clenching on the GBF of the denture underlying mucosa in tissue-supported or tooth-tissue-supported dentures | Biting force | Baseline and 5, 10, 20, 30 and 60 s | GBF in mucosa underlying the denture showed statistically significant correlation between recovery and loading time | Continuous clenching results in ischemia and delays the recovery of GBF in the mucosa after the release of compression |
| Ambrosini et al., 2002 | Clinical | Evaluation of the modifications occurring in human gingival blood flow following periosteal stimulation | Surface of the gingival graft | Intervals of 1 week | Increased blood flow was shown at 7 days after periosteal stimulation | Detects alterations of the vascularization several hours before the clinical symptoms become apparent during wound healing monitoring |
| Vag and Fazekas 2002 | Clinical | Monitor reactions of marginal gingiva during prosthetic rehabilitation | Prosthetic rehabilitation | 6 weeks | Significant correlation was found between gingival index and increased blood flow | Monitoring gingival blood flow may provide valuable information of the healing process of inflamed marginal gingiva |
| Kerdvongbundit and Vongsavan et al., 2002 | Clinical | Evaluate the microcirculation in the gingiva of healthy and gingivitis patients | Gingival surfaces (free gingiva, interdental gingiva, attached gingiva, and alveolar mucosa) | 90 s intervals for 15 min | Blood flow in the maxillary anterior gingiva showed significant differences from the mandibular anterior gingiva in the interdental gingiva, attached gingiva, and alveolar mucosa | GBF in the maxillary anterior gingiva was greater than that in the mandibular anterior gingiva. GBF was lower in free gingiva and higher in alveolar mucosa |
| Kerdvongbundit and Vongsavan et al., 2002 | Clinical | Evaluate the microcirculation in patients with moderate gingivitis, periodontitis, and healthy gingiva | Gingival surfaces (free and attached gingiva, interdental papilla and alveolar mucosa) | 90 s intervals for at least 15 min | GBF in moderate gingivitis and periodontitis showed similar values and were higher than those in healthy gingiva | GBF in patients with periodontitis and gingivitis revealed significant differences when compared to healthy patients |
| Heckmann et al., 2001 | Clinical | Study oral mucosal blood flow in burning mouth syndrome (BMS) patients | Hard palate, the tip of the tongue, midline of the oral vestibule, and lip | 2 min | BMS patients exhibited a higher significantly response on the hard palate compared to healthy patients | Higher vascular reactivity in patients with burning mouth syndrome when compared to healthy patients |
| Matsuki et al., 2001 | Clinical | Measure gingival blood flow under different water temperatures and evaluate reproducibility | Marginal gingiva | 5 days | Warm water (36 and 50°C showed a significant increase in blood flow and flow went to baseline (after 3 and 4 min, respectively). Cold water (4°C) showed decreased blood flow and level went to baseline after 2 min. | LDF showed acceptable reproducibility with no significant effect from the probe angle |
| Heckmann et al., 2000 | Clinical | Study the changes of blood flow after the effects of painful stimulation using dry ice (CO2) | Hard palate, lip and oral vestibule | Baseline and 2 min | Mucosal blood flow increased significantly at all sited after dry ice application | Mucosal blood flow varies at different mucosal sites. Tongue blood flow changes were the least pronounced |
| Ahn and Pogrel 1998 | Clinical | Determine if 2% lidocaine with 1:100,000 epinephrine decreases the blood flow in gingival tissues | Gingival margin | Recording during 15 min and 1 min at 10 intervals | Significant decrease of GBF (maximum decrease 51%) with gradual return to baseline up to 35 min. | Gingival effects may be of relevance with soft tissue surgical procedures |
| Perry et al., 1997 | Clinical | Quantify changes in blood flow following tooth brushing | Tooth brushing | 4 weeks | Tooth bruising for 3 and 10 s significantly increased blood flow | LDF showed to be a non-invasive tool to understand dynamics of blood flow |
| Ketabi and Hirsch 1997 | Clinical | Determine vascular responses in the gingiva of smokers and non-smokers after anesthetic injection | Local anesthetic | 15 min | Significant decrease of GBF (average 46%) in the gingiva. Statistically significance for GBF recovery between smokers and non-smokers | LDF showed that recovery of GBF is longer in smokers than in non-smokers. |
| Schmid-Schönbein et al., 1997 | Clinical | Identify vascular temporal patterns in mucosal microcirculation in maxillary gingiva with laser Doppler anemometry (LDA) | Gingivitis | 12.5 min | Dynamic fluctuation relates to physiological events synchronized to neurodynamic activity or ventilatory influences, gravitational effects or arterial o venous pressure | Analysis of data obtained in the study allows temporal pattern characteristics for future diagnostic procedures |
| Herlofson et al., 1996 | Clinical | Test the oral mucosa irritant potential of toothpaste detergent (sodium lauryl sulfate) | Gingiva | 10–15 min | GBF increased significantly from the second to ninth minute | LDF may be a useful non-invasive technique for intraoral testing of different agents of intraoral use |
| Hinrichs et al., 1995 | Clinical | (1) Determine gingival blood flow in the gingival sulcus after probing and injection of local anesthetic. (2) Determine reproducibility of measurements |
Periodontal probing and after local anesthetic injection | Baseline, 1 and 2 months | (1) Increased blood flow was seen after probing whereas blood flow decreased after local anesthetic injection with vasoconstrictor. (2) Intrasulcular measurements were reproducible at 1 and 2 months |
LDF is a non-invasive and reproducible tool capable of detecting alterations in blood flow in different time points |
| Dodson et al., 1994 | Clinical | Assess value of intraoperative maxillary blood perfusion and describe pattern of blood flow changes during Le Fort I osteotomy | Orthognathic surgery | Intraoperative (10 s intervals) | Significant decrease of GBF of 64% during the fracture and mobilization compared to preoperative values | LDF is a feasible and valuable tool for measuring intraoperative maxillary blood flow dynamics |
| Hoke et al., 1994 | Clinical | Develop a protocol for quantification of blood flow | Intraoral cavity | 30 s intervals in 3 time points | High flows were in the buccal mucosa, vestibule and tongue. Medium flows were found in the attached gingiva | Intraoral tissue blood flow varies by site and be quantified non-invasively |
| Matheny and Johnson et al., 1993 | Clinical | Determine the changes that occur in the gingival microcirculation during the development of experimental gingivitis | Gingivitis | 2 time points | Significant decrease in gingival regional BF in gingivitis patients | Gingival microcirculation exhibited a dynamic change in response to the development and progression of gingivitis |
| Baab et al., et al., 1990 | Clinical | Gingival blood flow and temperature were monitored continuously before and after cooling via a twin probe placed in the gingival sulcus | Periodontitis | 5 min | Patients with periodontitis | Periodontitis patients showed significantly faster recovery of GBF than controls |
| Baab and Öberg 1987 | Clinical | Study the acute effects of cigarette smoking on gingival blood flow | Tobacco smoking | 5 min after smoking | Higher GBF during smoking | GBF increased significantly after smoking and stayed high during 5 min after |
| Baab et al., 1986 | Clinical | Measure gingival blood flow after different stimuli: warm and cold water, pressure and biting force | Soft tissue measurements (free and attached gingiva, interdental papilla, alveolar mucosa) | Intervals of 30 s for water, 3 min for pressure and 1 min after biting force | No significant differences of blood flow after water stimuli (warm or cold), and pressure. Significant difference with occlusal biting force of 5 N | LDF is a non-invasive promising tool to study GBF |