Surgical Application of Human Amniotic Membrane and Amnion-Chorion Membrane in the Oral Cavity and Efficacy Evaluation: Corollary With Ophthalmological and Wound Healing Experiences.

Aurélien Louvrier,Halima Kerdjoudj,Florelle Gindraux,Philippe Marchetti,Mathilde Fenelon,Brice Chatelain,Nicola Hofman,Christophe Meyer,Francisco J Nicolas,Fabienne Pouthier,Sébastien Laurence,Stéphane Odet,Cédric Mauprivez,Anne-Sophie Gauthier,Narcisse Zwetyenga,Xavier Lafarge,Jean-Christophe Fricain

doi:10.3389/fbioe.2021.685128

Abstract

Due to its intrinsic properties, there has been growing interest in human amniotic membrane (hAM) in recent years particularly for the treatment of ocular surface disorders and for wound healing. Herein, we investigate the potential use of hAM and amnion-chorion membrane (ACM) in oral surgery. Based on our analysis of the literature, it appears that their applications are very poorly defined. There are two options: implantation or use as a cover material graft. The oral cavity is submitted to various mechanical and biological stimulations that impair membrane stability and maintenance. Thus, some devices have been combined with the graft to secure its positioning and protect it in this location. This current opinion paper addresses in detail suitable procedures for hAM and ACM utilization in soft and hard tissue reconstruction in the oral cavity. We address their implantation and/or use as a covering, storage format, application side, size and number, multilayer use or folding, suture or use of additional protective covers, re-application and resorption/fate. We gathered evidence on pre- and post-surgical care and evaluation tools. Finally, we integrated ophthalmological and wound healing practices into the collected information. This review aims to help practitioners and researchers better understand the application of hAM and ACM in the oral cavity, a place less easily accessible than ocular or cutaneous surfaces. Additionally, it could be a useful reference in the generation of new ideas for the development of innovative protective covering, suturing or handling devices in this specific indication. Finally, this overview could be considered as a position paper to guide investigators to fulfill all the identified criteria in the future.

Highlights

The human amniotic membrane, or amnion, is the innermost layer of fetal membranes
After extracting the teeth and raising full-thickness flaps, the sockets were filled with demineralized freeze-dried bone allograft (FDBA) (DFDBA) covered with amnion-chorion membrane (ACM), which was tucked in the vestibular and lingual parts of the flap; the gingiva was sutured above it (Faraj et al, 2020)
We reported in in vivo studies that F-human amniotic membrane (hAM) and decellularized then lyophilized hAM (D-hAM) were significantly stronger than cryopreserved hAM (C-hAM) and lyophilized hAM (L-hAM)

Summary

Introduction

The human amniotic membrane (hAM), or amnion, is the innermost layer of fetal membranes. The thickness of human term amnion varies among individuals and depends on the location of the sample (70–180 μm thick) (Chen et al, 2012; Gremare et al, 2019) Both amnion and chorion contain mesenchymal stromal cells (MSCs) (Parolini et al, 2008) and variable quantity of growth factors depending on the fetal membranes (McQuilling et al, 2017) and/or the preservation methods (Russo et al, 2011; McQuilling et al, 2017). It has a low immunogenicity (Kubo et al, 2001), which makes it suitable as an allograft

Objectives

Methods

Findings

Conclusion