Histological and histomorphometric study of human palatal mucosa: Implications for connective tissue graft harvesting.


Journal

Journal of clinical periodontology
ISSN: 1600-051X
Titre abrégé: J Clin Periodontol
Pays: United States
ID NLM: 0425123

Informations de publication

Date de publication:
06 2023
Historique:
received: 08 02 2023
accepted: 23 02 2023
medline: 16 5 2023
pubmed: 6 3 2023
entrez: 5 3 2023
Statut: ppublish

Résumé

To analyse the histological structure and histomorphometric characteristics of human hard palatal mucosa in order to determine the donor site of choice for connective tissue grafts from a histological point of view. Palatal mucosa samples from six cadaver heads were harvested at four sites: incisal, premolar, molar and tuberosity. Histological and immunohistochemical techniques were performed, as was histomorphometric analysis. In the current study, we found that the density and size of cells were higher in the superficial papillary layer, whereas the thickness of the collagen bundles increased in the reticular layer. Excluding the epithelium, the mean percentage of lamina propria (LP) and submucosa (SM) was 37% and 63%, respectively (p < .001). LP thickness showed similar values in the incisal, premolar and molar regions, and a significantly greater thickness in tuberosity (p < .001). The thickness of SM increased from incisal to premolar and molar, disappearing in the tuberosity (p < .001). As dense connective tissue of LP is the tissue of choice for connective tissue grafts, the best donor site from a histological point of view is tuberosity because it is composed only of a thick LP without the presence of a loose submucosal layer.

Identifiants

pubmed: 36872046
doi: 10.1111/jcpe.13800
doi:

Substances chimiques

Collagen 9007-34-5

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

784-795

Informations de copyright

© 2023 The Authors. Journal of Clinical Periodontology published by John Wiley & Sons Ltd.

Références

Amin, P. N., Bissada, N. F., Ricchetti, P. A., Silva, A. P. B., & Demko, C. A. (2018). Tuberosity versus palatal donor sites for soft tissue grafting: A split-mouth clinical study. Quintessence International, 49, 589-598. https://doi.org/10.3290/j.qi.a40510
Azar, E. L., Rojas, M. A., Mandalunis, P., Gualtieri, A., & Carranza, N. (2019). Histological evaluation of subepithelial connective tissue grafts harvested by two different techniques: Preliminary study in humans. Acta Odontológica Latinoamericana, 32, 10-16.
Bertl, K., Pifl, M., Hirtler, L., Rendl, B., Nürnberger, S., Stavropoulos, A., & Ulm, C. (2015). Relative composition of fibrous connective and fatty/glandular tissue in connective tissue grafts depends on the harvesting technique but not the gonor site of the hard palate. Journal of Periodontology, 86, 1331-1339. https://doi.org/10.1902/jop.2015.150346
Cepeda-Emiliani, A., Gándara-Cortés, M., Otero-Alén, M., García, H., Suárez-Quintanilla, J., García-Caballero, T., Gallego, R., & García-Caballero, L. (2022). Immunohistological study of the density and distribution of human penile neural tissue: Gradient hypothesis. International Journal of Impotence Research. https://doi.org/10.1038/s41443-022-00561-9. Online ahead of print.
Chambrone, L., Sukekava, F., Araújo, M. G., Pustiglioni, F. E., Chambrone, L. A., & Lima, L. A. (2010). Root-coverage procedures for the treatment of localized recession-type defects: A Cochrane systematic review. Journal of Periodontology, 81, 452-478. https://doi.org/10.1902/jop.2010.090540
Chambrone, L., & Tatakis, D. N. (2015). Periodontal soft tissue root coverage procedures: A systematic review from the AAP Regeneration Workshop. Journal of Periodontology, 86, S8-S51. https://doi.org/10.1902/jop.2015.130674
Chambrone, L., & Tatakis, D. N. (2016). Long-term outcomes of untreated buccal gingival recessions: A systematic review and meta-analysis. Journal of Periodontology, 87, 796-808. https://doi.org/10.1902/jop.2016.150625
Chambrone, L. A., & Chambrone, L. (2006). Subepithelial connective tissue grafts in the treatment of multiple recession-type defects. Journal of Periodontology, 77, 909-916. https://doi.org/10.1902/jop.2006.050249
Cho, K. H., Yu, S. K., Lee, M. H., Lee, D. S., & Kim, H. J. (2013). Histological assessment of the palatal mucosa and greater palatine artery with reference to subepithelial connective tissue grafting. Anatomy and Cell Biology, 46, 171-176. https://doi.org/10.5115/acb.2013.46.3.171
Cortellini, P., & Bissada, N. F. (2018). Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. Journal of Periodontology, 89, S204-S213. https://doi.org/10.1002/JPER.16-0671
de Castro, L. A., Vêncio, E. F., & Mendonça, E. F. (2007). Epithelial inclusion cyst after free gingival graft: A case report. International Journal of Periodontics and Restorative Dentistry, 27, 465-469.
Dellavia, C., Ricci, G., Pettinari, L., Allievi, C., Grizzi, F., & Gagliano, N. (2014). Human palatal and tuberosity mucosa as donor sites for ridge augmentation. The International Journal of Periodontics & Restorative Dentistry, 34, 179-186. https://doi.org/10.11607/prd.1929
Diallo, D., Zaitouna, M., Alsaid, B., Quillard, J., Ba, N., Allodji, R. S., Benoit, G., Bedretdinova, D., & Bessede, T. (2015). The visceromotor and somatic afferent nerves of the penis. Journal of Sexual Medicine, 12, 1120-1127. https://doi.org/10.1111/jsm.12851
Gil Escalante, M., & Tatakis, D. N. (2015). Gingival cyst of the adult as early sequela of connective tissue grafting. Case Report in Dentistry, 2015, 473689. https://doi.org/10.1155/2015/473689
Harris, R. J. (2003). Histologic evaluation of connective tissue grafts in humans. The International Journal of Periodontics & Restorative Dentistry, 23, 575-583.
Kassab, M. M., & Cohen, R. E. (2003). The etiology and prevalence of gingival recession. The Journal of the American Dental Association, 134, 220-225. https://doi.org/10.14219/jada.archive.2003.0137
Kim, D. M., & Neiva, R. (2015). Periodontal soft tissue non-root coverage procedures: A systematic review from the AAP Regeneration Workshop. Journal of Periodontology, 86, S56-S72. https://doi.org/10.1902/jop.2015.130684
Marques de Mattos, P., Papalexiou, V., Tramontina, V. A., Kim, S. H., Luczyszyn, S. M., Bettega, P. V. C., & Batista Rodrigues Johann, A. C. (2019). Evaluation of 2 techniques of epithelial removal in subepithelial connective tissue graft surgery: A comparative histological study. Journal of Periodontal & Implant Science, 50, 2-13. https://doi.org/10.5051/jpis.2020.50.1.2
Merijohn, G. K. (2016). Management and prevention of gingival recession. Periodontology, 2000(71), 228-242. https://doi.org/10.1111/prd.12115
Miller, P. D., Jr. (1988). Regenerative and reconstructive periodontal plastic surgery. Mucogingival surgery. Dental Clinics of North America, 32, 287-306.
Ouhayoun, J. P., Sawaf, M. H., Gofflaux, J. C., Etienne, D., & Forest, N. (1988). Re-epithelialization of a palatal connective tissue graft transplanted in a non-keratinized alveolar mucosa: A histological and biochemical study in humans. Journal of Periodontal Research, 23, 127-133. https://doi.org/10.1111/j.1600-0765.1988.tb01345.x
Parashis, A. O., & Tatakis, D. N. (2007). Subepithelial connective tissue graft for root coverage: A case report of an unusual late complication of epithelial origin. Journal of Periodontology, 78, 2051-2056. https://doi.org/10.1902/jop.2007.070099
Ramesh, K. S. V., Swetha, P., Krishnan, V., Mythili, R., Alla, R. K., & Manikandan, D. (2014). Assessment of thickness of palatal masticatory mucosa and maximum graft dimensions at palatal vault associated with age and gender-A clinical study. Journal of Clinical and Diagnostic Research, 8, ZC09-13. https://doi.org/10.7860/JCDR/2014/8703.4314
Ramos-Pilco, E., Condori, S. Y., & Alarcón, M. A. (2020). Palate or tuberosity, which is the best donor site for a soft tissue graft? A systematic review. International Journal of OdontoStomatology, 14, 602-609.
Roccuzzo, M., Bunino, M., Needleman, I., & Sanz, M. (2002). Periodontal plastic surgery for treatment of localized gingival recessions: A systematic review. Journal of Clinical Periodontology, 29, 178-194. https://doi.org/10.1034/j.1600-051x.29.s3.11.x
Rojo, E., Stroppa, G., Sanz-Martín, I., González-Martín, O., Alemany, A. S., & Nart, J. (2018). Soft tissue volume gain around dental implants using autogenous subepithelial connective tissue grafts harvested from the lateral palate or tuberosity area. A randomized controlled clinical study. Journal of Clinical Periodontology, 45, 495-503. https://doi.org/10.1111/jcpe.12869
Rojo, E., Stroppa, G., Sanz-Martín, I., González-Martín, O., & Nart, J. (2020). Soft tissue stability around dental implants after soft tissue grafting from the lateral palate or the tuberosity area-A randomized controlled clinical study. Journal of Clinical Periodontology, 47, 892-899. https://doi.org/10.1111/jcpe.13292
Sanz, M., Simion, M., & Working Group 3 of the European Workshop on Periodontology. (2014). Surgical techniques on periodontal plastic surgery and soft tissue regeneration: Consensus report of Group 3 of the 10th European Workshop on Periodontology. Journal of Clinical Periodontology, 41, S92-S97. https://doi.org/10.1111/jcpe.12215
Sanz-Martín, I., Rojo, E., Maldonado, E., Stroppa, G., Nart, J., & Sanz, M. (2019). Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area. Clinical Oral Investigations, 23, 957-964. https://doi.org/10.1007/s00784-018-2516-9
Sculean, A., Gruber, R., & Bosshardt, D. D. (2014). Soft tissue wound healing around teeth and dental implants. Journal of Clinical Periodontology, 41, S6-S22. https://doi.org/10.1111/jcpe.12206
Tavelli, L., Barootchi, S., Greenwell, H., & Wang, H. L. (2019). Is a soft tissue graft harvested from the maxillary tuberosity the approach of choice in an isolated site? Journal of Periodontology, 90, 821-825. https://doi.org/10.1002/JPER.18-0615
Tavelli, L., Barootchi, S., Stefanini, M., Zucchelli, G., Giannobile, W. V., & Wang, H. L. (2022). Wound healing dynamics, morbidity, and complications of palatal soft-tissue harvesting. Periodontol 2000. https://doi.org/10.1111/prd.12466. Online ahead of print.
Yu, S. K., Lee, B. H., Lee, M. H., Cho, K. H., Kim, D. K., & Kim, H. J. (2013). Histomorphometric analysis of the palatal mucosa associated with periodontal plastic surgery on cadavers. Surgical and Radiologic Anatomy, 35, 463-469. https://doi.org/10.1007/s00276-012-1066-0
Zucchelli, G., & Mounssif, I. (2015). Periodontal plastic surgery. Periodontology, 2000(68), 333-368. https://doi.org/10.1111/prd.12059
Zucchelli, G., Tavelli, L., McGuire, M. K., Rasperini, G., Feinberg, S. E., Wang, H. L., & Giannobile, W. V. (2020). Autogenous soft tissue grafting for periodontal and peri-implant plastic surgical reconstruction. Journal of Periodontology, 91, 9-16. https://doi.org/10.1002/JPER.19-0350
Zuhr, O., Bäumer, D., & Hürzeler, M. (2014). The addition of soft tissue replacement grafts in plastic periodontal and implant surgery: Critical elements in design and execution. Journal of Clinical Periodontology, 41, S123-S142. https://doi.org/10.1111/jcpe.12185

Auteurs

Lucía García-Caballero (L)

Department of Morphological Sciences (Histology Area), School of Medicine and Dentistry, University of Santiago de Compostela and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

Marina Gándara (M)

Department of Morphological Sciences (Histology Area), School of Medicine and Dentistry, University of Santiago de Compostela and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

Alfonso Cepeda-Emiliani (A)

Department of Morphological Sciences (Histology Area), School of Medicine and Dentistry, University of Santiago de Compostela and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

Rosalía Gallego (R)

Department of Morphological Sciences (Histology Area), School of Medicine and Dentistry, University of Santiago de Compostela and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

Francisco Gude (F)

Epidemiology Unit, University Clinical Hospital and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

Juan Suárez-Quintanilla (J)

Department of Morphological Sciences (Anatomy and Embryology Area), School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.

Isabel Ramos-Barbosa (I)

Orthodontic Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain.

Juan Blanco-Carrión (J)

Periodontology Unit, School of Medicine and Dentistry, University of Santiago de Compostela, and Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain.

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