Effect of smoking on gingival microvasculature: A histological study

BACKGROUND: Smoking has been reported as a major risk factor for periodontal disease. Studies have demonstrated decreased bleeding on probing and reduced inflammatory response among smokers, which has been attributed to the alterations in gingival microvasculature, gingival epithelium. In previous investigations, vascular and epithelial changes have been studied in the gingival tissues of smokers suffering from periodontitis and compared with healthy periodontium of non smokers. Inflammation is known to cause vascular and epithelial changes in the gingiva on its own in the absence of smoking. Hence, in the present investigation, an attempt is made to study and to compare the vascular and epithelial changes in the gingiva of smokers and non smokers suffering from chronic periodontitis. AIM OF STUDY: The purpose of this study was to evaluate the vascular and epithelial changes in gingiva of smokers and non smokers with chronic periodontitis. STUDY DESIGN: Cross sectional study MATERIALS AND METHODS: Gingival biopsies were obtained from 33 male patients (18 smokers and 15 non smokers) who were undergoing periodontal therapy or extraction. The sections were stained with eosin and hematoxylin. Vascular density, area of the lumen, and epithelial thickness were assessed using histomorphometric image analysis. STATISTICAL METHOD: Data was analyzed using student unpaired ‘t’ test, Karl Pearsons correlation, and Chi-square test. RESULTS: The mean blood vessel density for smokers was 12.388±6.472 and for non smokers was 14.800±4.91. The mean lumen area of the vessels among smokers and non smokers was 19.290±8.775 μm(2) and 20.044±7.896 μm(2), respectively. The mean epithelial thickness among smokers was 150.551±32.994 μ and 134.941±30.63 μ for non smokers. CONCLUSION: Based on the present histomorphometric study, it could be concluded that smokers have less vascular density and reduced lumen area and increased epithelial thickness than non smokers. However, these changes were not statistically significant.