Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

FABRICATION OF MYOMUCOSAL FLAP USING CULTURED ORAL EPITHELIUM IN RABBIT MODEL

가토모델에서 배양 구강상피를 이용한 근-점막 피판의 형성에 관한 연구

  • Shin, Young-Min (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Chung, Hun-Jong (Department of Pediatrics, Chung-Ju Medical Hospital, Kon-Kuk University) ;
  • Ahn, Kang-Min (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Park, Hee-Jung (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Sung, Mi-Ae (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Kim, Soung-Min (Department of Oral and Maxillofacial surgery, School of Dentistry, Kangnung National University) ;
  • Hwang, Soon-Jung (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute) ;
  • Jahng, Jeong-Won (Department of Pharmacology, Yonsei Medical University) ;
  • Kim, Sung-Po (Bioland R&D center) ;
  • Yang, Eun-Kyung (Bioland R&D center) ;
  • Song, Kye-Yong (Department of Pathology, Medical School, Chungang University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Seoul National University & Dental Research Institute)
  • 신영민 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 정헌종 (건국대학교 의과대학 소아과학교실) ;
  • 안강민 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 박희정 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 성미애 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 김성민 (강릉대학교 치과대학 구강악안면외과학교실) ;
  • 황순정 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 김명진 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소) ;
  • 장정원 (연세대학교 의과대학 약리학교실) ;
  • 김성포 ((주)바이오랜드 생명공학연구소) ;
  • 양은경 ((주)바이오랜드 생명공학연구소) ;
  • 송계영 (중앙대학교 의과대학 병리학교실) ;
  • 이종호 (서울대학교 치의학대학원 구강악안면외과학교실 및 치의학연구소)
  • Published : 2005.05.31
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Abstract

Purpose : Extensive defect of oral and maxillofacial area is usually reconstructed with composite flap including skin paddle. However, if the defects are lined with only skin components, the mucosa's role in mastication and texture are not restored. Furthermore, stiffness and hair-growing prevent denture rehabilitation and good oral hygiene. This study was performed to overcome the disadvantages of composite soft tissue flaps including the skin and to make a model for myo-mucosal flaps. Materials and methods : Buccal mucosa sized $0.5\times1.0\;cm^2$ from New Zealand rabbit (around 1.5kg) was harvested and cultivated by the modification of Rheinwald and Green's keratinocyte culture method. Cultured mucosa was grafted on the fascia of latismus dorsi as form of mucosal sheet. After 7, 10, 14 days, the myomucosal flap was excised and evaluated under light microscope with H & E and immunohistochemical staining. As control group, harvested buccal mucosa from rabbit was transplanted to gracilis muscle(n=6). Results : From 7 days after prelamination, the basal layer of the grafted mucosa resembled that of normal mucosa. As control group, transplanted mucosa had original shape but there's slight inflammatory reaction. Prelaminated mucosa has 19.8$\pm$4.59 cell layers and some samples have more than 20 layers. The expression rate of PCNA was relatively strong (42.9%$\pm$14.1) at the basal layer of grafted mucosa and the laminin was found at the basal layer. On the contrary, prelaminated mucosa at 10 days showed moderate expression rate of PCNA(32.4%$\pm$4.62). We found the mucosal layer was somehow disappeared and there is strong inflammatory reaction. After 14 days prelamination, the grafted oral keratinocytes were almost disappeared and expression of PCNA was not observed. Conclusion : We can make 75 fold large mucosal($3850mm^2$) sheet from small samples of mucosa $(50mm^2)$. Epithelial sheet that grafted on the fascia of muscle underwent differentiation and proliferation. But after 10, 14 days, there was strong inflammatory reaction and the grafted mucosa was destroyed from surface layer. In rabbit model, transfer of fascio-mucosal flap should be done from 7 to 10 days after prelamination.

Keywords

References

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