Sauerbier Sebastian, Gutwald Ralf, Wiedmann-Al-Ahmad Margit, Lauer Günter, Schmelzeisen Rainer
Department of Oral and Craniomaxillofacial Surgery, University Hospital Freiburg, Freiburg, Germany.
Clin Oral Implants Res. 2006 Dec;17(6):625-32. doi: 10.1111/j.1600-0501.2006.01229.x.
The study series aims at testing the feasibility of the clinical application of tissue-engineered oral mucosa. The preliminary results were gathered over a period varying from 6 months to 12 years depending on the surgical method.
Tissue-engineered oral mucosa was used to cover defects in various surgical procedures like vestibuloplasty (n=42), freeing of the tongue (n=10), prelaminating the radial flap (n=5) and reconstruction of the urethra (n=16). In all interventions small samples of oral mucosa were harvested, cut into small pieces, resuspended in culture medium and seeded into a culture flask. Cultured keratinocytes were transferred onto membranes which then were used to cover mucosal defects in the oral cavity.
To gain a graft of 15 cm(2) size a mucosa biopsy of 4-8 mm(2) and 40 ml autologous patients serum is needed. Tissue-engineered oral mucosa was applied successfully in all four surgical methods. Six months after transplantation a regular epithelial layering with a histological delimitation of the stratum, epithelial crest and a strong basal membrane appeared. According to the reception site the tissue engineered oral mucosa differentiated in several ways.
Tissue-engineered oral mucosa fulfils the requirements for clinical routine. With view to healing time and outcome it does not appear to be superior to regular harvested oral mucosa transplants. Because of a smaller harvesting defect and primary wound closure at the actual operation site the patients' convenience is increased. Thus this method reduces morbidity and advances the quality of life.
本研究系列旨在测试组织工程化口腔黏膜临床应用的可行性。根据手术方法的不同，初步结果收集时间跨度为6个月至12年。
组织工程化口腔黏膜用于覆盖各种外科手术中的缺损，如前庭成形术（n = 42）、舌游离术（n = 10）、桡侧皮瓣预层压术（n = 5）和尿道重建术（n = 16）。在所有干预措施中，采集小块口腔黏膜，切成小块，重悬于培养基中并接种到培养瓶中。将培养的角质形成细胞转移到膜上，然后用于覆盖口腔黏膜缺损。
要获得面积为15平方厘米的移植物，需要4 - 8平方毫米的黏膜活检组织和40毫升患者自体血清。组织工程化口腔黏膜在所有四种手术方法中均成功应用。移植6个月后，出现了规则的上皮分层，伴有组织学上的分层界定、上皮嵴和强大的基底膜。根据接受部位的不同，组织工程化口腔黏膜有多种分化方式。
组织工程化口腔黏膜满足临床常规需求。就愈合时间和结果而言，它似乎并不优于常规采集的口腔黏膜移植。由于取材缺损较小且实际手术部位实现了一期伤口闭合，增加了患者的便利性。因此，这种方法降低了发病率，提高了生活质量。
