MICROVASCULAR DYSFUNCTION IN HYPERTENSIVE DENTURE WEARERS: A COMPREHENSIVE REVIEW OF DOPPLER AND OPTICAL COHERENCE TOMOGRAPHY FINDINGS

Abstract

Hypertension is a major global health burden and an established cause of microvascular dysfunction. Although its systemic consequences are well described, its influence on the oral mucosa, especially in complete denture wearers, remains under recognized. The denture bearing mucosa depends on a rich subepithelial vascular plexus for perfusion, cushioning during mechanical loading, and tissue repair. In individuals with hypertension, chronic endothelial dysfunction, reduced capillary density, impaired nitric oxide signaling, and increased vascular stiffness can compromise mucosal integrity and resilience. These alterations predispose denture wearers to soreness, ulceration, delayed healing, and reduced tolerance to prostheses. Recent advances in diagnostic imaging, particularly Doppler ultrasonography and optical coherence tomography, provide noninvasive methods to assess oral microvascular health. Doppler imaging quantifies perfusion parameters such as peak systolic velocity, end diastolic velocity, and resistive index, which reflect vascular resistance and endothelial status. Optical coherence tomography offers high resolution visualization of epithelial and subepithelial structures, enabling assessment of microvascular loops, epithelial thickness, and early ischemic changes. This narrative review summarizes current evidence on hypertension associated microvascular alterations in the oral mucosa and their relevance to denture biomechanics. It highlights the diagnostic value of Doppler ultrasonography and optical coherence tomography in detecting subtle mucosal vascular compromise and discusses how prosthodontic approaches may be adapted for hypertensive patients. Understanding oral microvascular dysfunction is essential for improving denture therapy outcomes and for recognizing the oral cavity as a potential indicator of systemic vascular health.