Epithelial Thickness of the Palatal Mucosa: A Histomorphometric Study in Koreans

Abstract

Subepithelial connective tissue grafting (SCTG) is a frequently used method in the field of periodontal plastic surgery. There are relatively few reports defining epithelial thickness criteria for palatal mucosal SCTG. The aim of this study was to histologically measure the epithelial thickness of the palatal mucosa in a sample of Korean patients, with the goal of minimizing epithelium-associated complications after root coverage procedures. A total of 30 Korean patients (12 males and 18 females) were enrolled in this study. To measure epithelial thicknesses, palatal mucosa adjacent to premolars and molars was obtained during procurement of SCTG. The effects of donor site, age and gender on the thickness of the epithelium were assessed and compared by histomorphometric analysis. The mean epithelial thickness of the palatal mucosa in our 30 patients was 430.63 lm, ranging from 113 to 823 lm. Epithelial thickness was not associated with donor site or age, but there were significant differences between genders, with males having much thicker palates than females.

Histological assessment of the palatal mucosa and greater palatine artery with reference to subepithelial connective tissue grafting

“…This indicates that residual epithelium on the graft causes the postoperative complications, which makes it especially important to know the epithelial thickness of the palatal mucosa in order to obtain a uniform LP composed of connective tissue and having the minimum amount of residual epithelium [12]. …”

“…In the present study the epithelial thickness was found to decrease from the canine distal (0.41 mm) to the posterior molar tooth, and toward the midpalatal suture. This difference in the epithelial thickness might be due to the spicy and salty diet of the Koreans [12], increased keratinized epithelial layer upon aging [19], and tissue atrophy after formalin fixation during histological preparation [20]. Therefore, there is a need to analyze differences in epithelial thicknesses according to race and age and to increase the number of samples in future studies.…”

“…Recent studies on epithelial thickness have been conducted by collecting mucous membranes from patients and using optical coherence tomography [12, 13], but evaluations of the LP thickness-which is an important factor in autologous grafting-are still inadequate. Therefore, this study aimed to measure the thickness of the epithelium and LP of the palatal mucosa and to elucidate the location of the GPA to provide the anatomical basis for subepithelial connective tissue grafting by using histomorphometric analysis.…”

Anatomical assessment of the palatal mucosa for connective tissue grafts

“…입천장 점막의 조직학적 구성을 살펴보면, 크게 세 층으 로 구분된다. 먼저, 구강상피(oral epithelium)는 다른 부위에 비하여 상대적으로 두꺼운 각질화된 중층편평상피(keratinized stratified squamous epithelium)로 이루어져 마모에 잘 견딜 수 있다 [3]. 그 아래에는 이를 지지해주는 결합조직(connective tissue)인 고유판(lamina propria)이 있다.…”

“…이 두 층 아래에 이러한 점막을 지배하는 신경 과 큰 혈관을 함유하는 성긴 지방조직(adipose tissue)이나 샘조 직(glandular tissue)을 함유하는 섬유성 점막밑층(submucosa layer)이 있어 아래 있는 뼈로부터 구강점막을 분리시키고 기계 적 압력에 대한 완충 작용을 한다 [1,2]. 또한 샘조직은 점막 표면 에 도관을 직접 내어 쉬지 않고 천천히 분비되어 큰 침샘이 기능 을 하지 않는 밤에 특히 구강점막을 보호하고 적셔주는데 중요 한 역할을 한다 [3]. 이러한 Identical superscripted letters indicate statistically significant differences among the tooth sites at the indicated measurement item (p<0.05).…”