title: Tissue-engineered oral mucosa grafts for intraoral lining reconstruction of the maxilla and mandible with a fibula flap.
abstract: OBJECTIVE
  Many types of soft tissue grafts have been used for grafting or prelaminating bone flaps for intraoral lining reconstruction. The best results are achieved when prelaminating free flaps with mucosal grafts. We suggest a new approach to obtain keratinized mucosa over a fibula flap using full-thickness, engineered, autologous oral mucosa.
  
  
  METHODS
  We report on a pilot study for grafting fibula flaps for mandibular and maxilla reconstruction with full-thickness tissue-engineered autologous oral mucosa. We describe 2 different techniques: prelaminating the fibula flap and second-stage grafting of the fibula after mandibular reconstruction. Preparation of the full-thickness tissue-engineered oral mucosa is also described.
  
  
  RESULTS
  The clinical outcome of the tissue-engineered intraoral lining reconstruction and response after implant placement are reported. A peri-implant granulation tissue response was not observed when prelaminating the fibula, and little response was observed when intraoral grafting was performed.
  
  
  CONCLUSIONS
  Tissue engineering represents an alternative method by which to obtain sufficient autologous tissue for reconstructing mucosal oral defects. The full-thickness engineered autologous oral mucosa offers definite advantages in terms of reconstruction planning, donor site morbidity, and quality of the intraoral soft tissue reconstruction, thereby restoring native tissue and avoiding peri-implant tissue complications.
authors.affiliation: Staff Surgeon, Oral and Maxillofacial Surgery Unit, Department of Plastic and Maxillofacial Surgery, University Hospital Clínic, Barcelona University, Barcelona, Spain. Electronic address: rsieira@clinic.ub.edu.
authors.forename: Ramón
authors.initials: R
authors.lastname: Sieira Gil
authors.affiliation: Staff Surgeon, Oral and Maxillofacial Surgery Unit, Department of Plastic and Maxillofacial Surgery, University Hospital Clínic, Barcelona University, Barcelona, Spain.
authors.forename: Carles Martí
authors.initials: CM
authors.lastname: Pagés
authors.affiliation: Staff surgeon, Oral and Maxillofacial Surgery Unit, Department of Pediatric Surgery, University Hospital Sant Joan de Déu, Barcelona University, Esplugues de Llobregat, Barcelona, Spain.
authors.forename: Eloy García
authors.initials: EG
authors.lastname: Díez
authors.affiliation: Attending physician, El Centro de Investigación Biomédica en Red de Enfermedades Raras U714, Unidad de Cultivos Celulares e Ingeniería Tisular, Centro Comunitario de Sangre y Tejidos del Principado de Asturias, Oviedo, Spain.
authors.forename: Sara
authors.initials: S
authors.lastname: Llames
authors.affiliation: Staff Surgeon, Oral and Maxillofacial Surgery Unit, Department of Plastic and Maxillofacial Surgery, University Hospital Clínic, Barcelona University, Barcelona, Spain.
authors.forename: Ada Ferrer
authors.initials: AF
authors.lastname: Fuertes
authors.affiliation: Attending dentist, Clinica Vilagran, Private Dental Practice, Badalona, Barcelona, Spain.
authors.forename: Jesús Lopez
authors.initials: JL
authors.lastname: Vilagran
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods; D064592:Autografts / Q000637:transplantation; D016025:Bone Transplantation / Q000379:methods*; D018277:Carcinoma, Mucoepidermoid / Q000601:surgery; D018929:Cell Culture Techniques; D003758:Dental Implantation, Endosseous / Q000379:methods; D005260:Female; D005347:Fibroblasts / Q000502:physiology; D005360:Fibula / Q000637:transplantation; D005500:Follow-Up Studies; D058752:Free Tissue Flaps / Q000637:transplantation*; D006801:Humans; D007575:Jaw, Edentulous / Q000601:surgery; D015603:Keratinocytes / Q000502:physiology; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D009061:Mouth Mucosa / Q000166:cytology / Q000637:transplantation*; D010865:Pilot Projects; D019651:Plastic Surgery Procedures / Q000379:methods*; D023822:Tissue Engineering / Q000379:methods*; D054457:Tissue Scaffolds; D016896:Treatment Outcome