Intraoral grafting of an ex vivo produced oral mucosa equivalent: a preliminary report.
The objective of this study was to assess the efficacy of the use of an ex vivo produced oral mucosa equivalent (EVPOME) for intraoral grafting procedures. Autogenous keratinocytes were harvested from a punch biopsy 4 weeks prior to surgery, placed in a serum-free culture system and seeded onto a human cadaveric dermal equivalent, AlloDerm. Thirty patients with either a premalignant or cancerous lesion were triaged into two groups, depending on the stage of disease: Group 1: EVPOME or Group 2: AlloDerm, control without an epithelial layer. Clinically, EVPOME grafts were easy to handle and showed excellent compliance on grafting. Both, EVPOME and AlloDerm grafts, showed a 100% take rate. At 6 days post-grafting, the EVPOME clinically showed changes indicating vascular ingrowth and had cytologic evidence of the persistence of grafted cultured keratinocytes on the surface. The EVPOME grafts had enhanced maturation of the underlying submucosal layer associated with rapid epithelial coverage when compared to the AlloDerm grafts at biopsies taken at 28 days post-grafting. In summary, EVPOME appears to be an acceptable oral mucosal substitute for human intraoral grafting procedures and results in a more favorable wound healing response than AlloDerm alone.
Department of Oral and Maxillofacial Surgery, Course for Oral Life Science, Niigata University Postgraduate School of Medical and Dental Sciences, Japan. kennie@umich.edu
K
K
Izumi
S E
SE
Feinberg
A
A
Iida
M
M
Yoshizawa
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D003094:Collagen / Q000627:therapeutic use; D004919:Erythroplasia / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D015603:Keratinocytes / Q000166:cytology; D007972:Leukoplakia, Oral / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation*; D009062:Mouth Neoplasms / Q000601:surgery; D011230:Precancerous Conditions / Q000601:surgery; D018709:Statistics, Nonparametric; D023822:Tissue Engineering / Q000379:methods; D020858:Tissue and Organ Harvesting; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D014945:Wound Healing
C440568:Alloderm; D001672:Biocompatible Materials; D003094:Collagen