禁煙は歯肉血流と歯肉包液を増加させる

Smoking cessation increases gingival blood flow and gingival crevicular fluid.

• Toshiya Morozumi
• Takehiko Kubota
• Tadashi Sato
• Kazuhiro Okuda
• Hiromasa Yoshie

抄録

目的:

本研究の目的は、禁煙が歯肉血流（GBF）および歯肉クレヴィキュラー液（GCF）に及ぼす影響を調べることであった。

OBJECTIVES: The purpose of the present study was to determine the effect of smoking cessation on gingival blood flow (GBF) and gingival crevicular fluid (GCF).

材料および方法:

歯周病および全身疾患の臨床症状のない男性喫煙者16名（22～39歳（25.3+/-4.0歳））を募集した。実験は、禁煙前（ベースライン）と禁煙後1、3、5日目、禁煙後1、2、4、8週間目に行った。喫煙・禁煙の状態は呼気一酸化炭素（CO）濃度、血清ニコチン・コチニン濃度で確認した。レーザードップラー流量計を用いて、左上顎中切歯の歯肉縁の3部位（歯肉縁中側の側面と両側の歯間乳頭）の相対血流を連続的に記録した。GCFは左上顎中切歯の中唇側と後唇側で採取し、体積はペリオトロン6000(R)システムを用いて計算した。23～27歳(24.4+/-1.2)の11名の禁煙対照者(女性4名、男性7名)を対象に、GBF以外は同様の測定を行った。

MATERIAL AND METHODS: Sixteen male smokers (aged 22-39 (25.3+/-4.0) years), with no clinical signs of periodontal and systemic diseases, were recruited. The experiment was performed before (baseline) and at 1, 3 and 5 days, and at 1, 2, 4 and 8 weeks after smoking cessation. The status of smoking and smoking cessation was verified by exhaled carbon monoxide (CO) concentration, and by serum nicotine and cotinine concentrations. A laser Doppler flowmeter was used to record relative blood flow continuously, on three gingival sites of the left maxillary central incisor (mid-labial aspect of the gingival margin and bilateral interdental papillae). The GCF was collected at the mesio- and disto-labial aspects of the left maxillary central incisor and the volume was calculated by the Periotron 6000(R) system. The same measurements except for the GBF were performed on 11 non-smoking controls (four females and seven males), aged 23-27 (24.4+/-1.2) years.

結果:

喫煙者16人中11人が8週間の禁煙に成功した。禁煙後1日目の測定では、ベースライン時よりも有意に低いCO濃度が認められた（p＜0.01）。また、2回目の測定時にはニコチンとコチニンの濃度が著しく低下していました。喫煙者のGBF率は、禁煙後3日目でベースライン時と比較して有意に高かった（p＜0.01）。GCF量は禁煙後5日目にベースラインと比較して有意に増加したが（p＜0.01）、禁煙後2週間までは非喫煙者と比較して有意に低かった（p＜0.01）。

RESULTS: Eleven of 16 smokers successfully completed smoking cessation for 8 weeks. At 1 day after smoking cessation, there was a significantly lower CO concentration than at baseline (p<0.01). Also, nicotine and cotinine concentrations markedly decreased at the second measurement. The GBF rate of smokers was significantly higher at 3 days after smoking cessation compared to the baseline (p<0.01). While the GCF volume was significantly increased at 5 days after smoking cessation compared to the baseline (p<0.01), it was significantly lower than that of non-smokers until 2 weeks after smoking cessation (p<0.01).

結論:

禁煙初期には歯肉微小循環が正常に回復し、歯肉組織の代謝・リモデリングが活性化され、歯周健康に寄与する可能性があることが示された。

CONCLUSION: The results show that the gingival microcirculation recovers to normal in the early stages of smoking cessation, which could activate the gingival tissues metabolism/remodeling, and contribute to periodontal health.