Structural and histological differences between connective tissue grafts harvested from the lateral palatal mucosa or from the tuberosity area

Abstract

Tuberosity grafts had more lamina propria and less submocusa, which may be beneficial for volume augmentation.

Is a soft tissue graft harvested from the maxillary tuberosity the approach of choice in an isolated site?

“…The reason for the different clinical performance between the SCTG and tCTG has also been investigated in histologic studies and at the molecular level . Compared to the SCTG, the tCTG was found to have a denser but less vascularized lamina propria (72.79% for the tCTG vs. 51.08% for the SCTG) whereas the SCTG showed to be richer in submucosal tissue including glandular and adipose components (25.75% vs. 4.89%) .…”

“…The reason for the different clinical performance between the SCTG and tCTG has also been investigated in histologic studies and at the molecular level . Compared to the SCTG, the tCTG was found to have a denser but less vascularized lamina propria (72.79% for the tCTG vs. 51.08% for the SCTG) whereas the SCTG showed to be richer in submucosal tissue including glandular and adipose components (25.75% vs. 4.89%) . Given the evidence suggesting that high amounts of submucosa tissue in the graft may result in more graft shrinkage, less volume gain, and no or minimal effect on epithelium keratinization induction, these findings further support the rational to consider tCTG as a viable (or of higher quality) alternative to palatal CTG, especially when comparing to grafts harvested from the deep palate …”

“…In addition, tCTG was found to exhibit a higher expression of LLH2 antibodies, which are overexpressed in fibrotic tissues. Last, the tendency for higher cytokeratin formation at the epithelia in tCTGs has been speculated that it is related to the potential of inducing keratinization of the peri‐implant mucosa …”

“…Soft tissue grafts from the tuberosity are increasingly gaining popularity because of their ease in harvesting, the presence of low fatty or glandular tissue, and the richness in connective tissue fibers . Additionally, harvesting from the tuberosity presents minimal risk of intraoperative or postoperative complications, resulting in reduced patient morbidity .…”

“…9,27 Soft tissue grafts from the tuberosity are increasingly gaining popularity because of their ease in harvesting, the presence of low fatty or glandular tissue, and the richness in connective tissue fibers. 1,28,29 Additionally, harvesting from the tuberosity presents minimal risk of intraoperative or postoperative complications, resulting in reduced patient morbidity. 1,[30][31][32] The aim of this commentary is, therefore, to discuss the advantages and disadvantages of harvesting soft tissue grafts from the tuberosity and compare it to the traditional palatal grafts, while highlighting functional-, esthetic-, and patient-related outcomes.…”