Maia Vinicius Tadeu Gonçalves, Kahn Sérgio, de Souza Alex Balduino, Fernandes Gustavo Vicentis de Oliveira
Periodontics, Faculty of Dental Medicine at Universidade Católica Portuguesa, Viseu, Portugal.
São Leopoldo Mandic, Rio de Janeiro, Brazil.
Clin Adv Periodontics. 2021 Sep;11(3):150-154. doi: 10.1002/cap.10151. Epub 2021 Mar 6.
The remaining epithelial layer existent in connective tissue graft (CTG) harvested from the hard palate, which underwent de-epithelization outside the oral cavity, can be histologically detected unless it is completely removed. Its presence may cause adverse esthetics results, affecting thus the color and texture of the receptor site, and an increased risk of presence of scar tissues after surgical procedures. The proposal of this study was to evaluate the CTG (histological and morphometrically) collected from the hard palate using the Harris technique, removing the epithelial layer outside the mouth, assessing the remaining presence of epithelial tissue.
Fourteen patients (14 CTGs) were included in the present case series study, therefore there were two dropouts. A small part of the tip of the graft was harvested and fixed in formalin solution for histological processing, staining, and then to be morphometrically analyzed. The epithelial tissue and CTGs were assessed by three calibrated and double-blinded professionals. All information was compiled, and the statistical analysis was performed. CTGs obtained had a width average of 1224.26 μm. There was no presence of any residual of the epithelium in three samples, whereas only one had the epithelium tissue covering the entire connective layer. Furthermore, seven samples (approximately 50%) had the presence of epithelium.
Within the limitation of this study, there was incomplete removal of the epithelial layer after harvesting the CTG using the Harris technique (44.32%), most likely due to its histological persistency, suggesting to be inaccurate the clinical removal.
从硬腭获取的结缔组织移植物（CTG）中存在的剩余上皮层，在口腔外进行了去上皮处理，除非完全去除，否则可通过组织学检测到。其存在可能会导致不良的美学结果，从而影响受体部位的颜色和质地，并增加手术后瘢痕组织出现的风险。本研究的目的是评估使用哈里斯技术从硬腭收集的CTG（组织学和形态学方面），在口腔外去除上皮层后，评估上皮组织的残留情况。
本病例系列研究纳入了14名患者（14个CTG），因此有2名退出者。取移植物尖端一小部分，固定于福尔马林溶液中进行组织学处理、染色，然后进行形态学分析。上皮组织和CTG由三名经过校准且双盲的专业人员进行评估。收集所有信息并进行统计分析。获得的CTG平均宽度为1224.26μm。三个样本中未发现任何上皮残留，而只有一个样本的上皮组织覆盖了整个结缔组织层。此外，七个样本（约50%）存在上皮组织。
在本研究的局限性内，使用哈里斯技术采集CTG后，上皮层未完全去除（44.32%），很可能是由于其组织学上的持久性，这表明临床去除并不准确。
