Palatal Tissue Research Articles

Palatal Pedicle Connective Tissue for Reconstruction of Through‐and‐Through Soft Tissue Defects in Esthetic Zone Around a Dental Implant: An 8‐Year Follow‐Up Case Report

Soft tissue management for immediate implant placement in the esthetic zone is crucial for successful treatment outcomes. Several surgical and restorative techniques have been proposed to treat unesthetic implant soft tissue defects or dehiscence. However, there is a scarcity of clinical evidence on addressing complications associated with through‐and‐through soft tissue defect (TTSD). In this case, a 61‐year‐old female patient, who underwent immediate implant placement at the right central incisor 3 months prior, presented with chronic peri‐implant mucosal infection and soft tissue recession of TTSD in 2015. The palatal pedicle connective tissue flap (PPCTF) was utilized to provide horizontal and vertical soft tissue augmentation and to cover the defect in combination with the labial contour collapse. At the 8‐year follow‐up, favorable white and pink esthetic outcomes were observed, and the pink esthetic score (PES) for soft tissue around the implant achieved 9 points, indicating satisfactory esthetic and functional results. The findings from this case study suggest that soft tissue augmentation techniques, such as PPCTF grafts, can provide a reliable and innovative method for both soft tissue augmentation and reconstruction of TTSD, resulting in long‐lasting functional and esthetic outcomes and stable ideal PES scores.

Secondary Healing of Palatal Fistula by Simple Palatal Plate Obturator after Excision of Pleomorphic AdenomaA Case Report

Pleomorphic adenomas are the most common benign mixed tumours of the salivary glands. They typically occur at the junction between the hard and soft palate, but can also be found in the upper lip, buccal mucosa, floor of the mouth, tonsils, pharynx, and retromolartrigone. The present case of a 55-year-old woman focuses on the use of a palatal plate obturator to treat a soft palatal fistula that developed after the removal of a pleomorphic adenoma from the palate. By applying a self-cure resin to the posterior border of the palatal plate obturator, the postoperative issue of a palatal fistula was successfully managed. To aid in the healing of the palatal tissue and provide a scaffold for the regeneration of the surrounding palatal tissue, relief was applied to the intaglio surface of the palatal plate.

Ultrasonographic analysis of palatal donor site healing accelerated with platelet-rich fibrin following subepithelial connective tissue harvesting.

Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

Effects of maxillofacial prosthetic treatment on oral health-related quality of life and masticatory ability of patients with head and neck tumors.

Using multivariate analysis, this study investigated the effectiveness of maxillofacial prosthetic treatment in relation to oral health-related quality of life (OHR-QoL), masticatory ability (food intake status score and gum-jelly test score) and related factors in patients who had undergone surgery for head and neck tumors. The study cohort comprised 112 patients who underwent surgical resection and prosthetic treatment among 224 patients with head and neck tumors seen at the Maxillofacial Prosthetics Clinic of Tohoku University Hospital in a 2-year period. Correlations between OHR-QoL, food intake status score, and gum-jelly test score (criterion variables), and age, sex, maxillary defect, tongue/soft tissue defect, reconstructive surgery, and chemoradiotherapy (explanatory variables) were investigated, and the data were examined statistically. Maxillary defect, tongue and soft palate tissue defect, and chemoradiotherapy were identified as factors that hindered the effectiveness of maxillofacial prosthetic treatment for improvement of the OHR-QoL, food intake status score, and gum-jelly test score. On the other hand, reconstructive surgery was a factor that facilitated the improvement of OHR-QoL and masticatory ability with maxillofacial prosthetic treatment. The factors identified to be related to the success or failure of maxillofacial prosthetic treatment suggest the importance of combining prosthetic intervention with surgical reconstruction.

STUDY OF SOFT PALATE DIMENSION AND NASOPHARYNGEAL DEPTH (NEED’S RATIO) USING LATERAL CEPHALOMETRICS X- RAY

Background: Soft palate is a tissue mass that hangs behind the hard palate mainly to seal the pharyngeal airway. The length of the soft palate should be adequate to close the pharyngeal depth. Failure to completely seal leads to velopharyngeal insufficiency while longer palatal length leads to obstructive sleep apnea. This study aimed to find the need’s ratio among the general Nepalese population. Methods: Lateral cephalograms of 591 of 17 years and above cases without any history of palatal surgery, orthodontic treatment or congenital defect were studied. The length of the soft palate, pharyngeal depth and thickness of the palatal tissue was measured using VLX computer program in lateral cephalograms obtained from gendex orthoralix 9200. The ratio of palatal length pharyngeal depth was calculated as Need’s ratio. Results: Soft palate length was 33.27 + 7.74 and 24.82 + 4.53 respectively. The Need’s ratio calculated is 0.75. The rat tail shape of soft palate was highly prevalent 173 (28.3%) while S shape was least 51 (8.6%) . Crook type of soft palate has highest Need’s ratio. Conclusions: The mean Need’s ratio of Nepalese population is 0.75. Need’s ratio also varies from shape of the soft palate.

Local Defense Factors in Cleft-Affected Palate in Children before and during Milk Dentition Age: A Pilot Study.

One of the most frequent congenital orofacial defects is the cleft lip and palate. Local tissue defense factors are known to be important in immune response and inflammatory and healing processes in the cleft tissue; however, they have only been researched in older children during mixed dentition. Thus, the aim of this study is to assess the distribution of LL-37, CD-163, IL-10, HBD-2, HBD-3, and HBD-4 in children before and during milk dentition. The unique and rare material of palate tissue was obtained from 13 patients during veloplastic surgeries during the time span of 20 years. Immunohistochemistry, light microscopy, semi-quantitative evaluation, and non-parametric statistical analysis were used. A significant decrease in HBD-3 and HBD-4 in the connective tissue was found, as well as several mutual statistically significant and strong correlations between HBD-2, HBD-3, HBD-4, and LL-37. Deficiency of HBD-3 and HBD-4 suggests promotion of chronic inflammation. The scarcity of HBD-4 could be connected to the different signaling pathways of dental pulp cells. Mutual correlations imply changes in the epithelial barrier, amplified healing efficiency, and increased antibacterial line of defense. Deprivation of changes in IL-10 quantity points to possible suppression of the factor. The presence of similar CD-163 immunoreactive substances produced by M2 macrophages was also observed.

Upregulated LncRNA-Meg3 modulates the proliferation and survival of MEPM cells via interacting with Smad signaling in TCDD-induced cleft palate

Exposure to the environmental contaminant 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) in utero can result in high rates of cleft palate (CP) formation, yet the underlying mechanisms remain to be characterized. In vivo, the lncRNA Meg3 was upregulated following TCDD treatment in CP-associated murine embryonic palatal tissue, with concomitant changes in proliferative and apoptotic activity in these murine embryonic palatal mesenchymal (MEPM) cells. Meg3 can modulate the TGF-β/Smad to control the proliferation, survival, and differentiation of cells. Accordingly, TCCD and TGF-β1 were herein used to treat MEPM cells in vitro, revealing that while TCDD exposure altered the proliferative activity and apoptotic death of these cells, exogenous TGF-β1 exposure antagonized these effects via TGF-β/Smad signaling. TCDD promoted Meg3 upregulation, whereas TGF-β1 suppressed TCDD-driven upregulation of this lncRNA. Meg3 was additionally determined to directly interact with Smad2, with significant Meg3 enrichment in Smad2-immunoprecipitates following TCDD treatment. When Meg3 was silenced, the impact of TCDD on Smad signaling, proliferative activity, and apoptosis were ablated, while the effects of exogenous TGF-β1 were unchanged. This supports a model wherein Meg3 is upregulated in TCDD-exposed palatal tissue whereupon it can interact with Smad2 to suppress Smad-dependent signaling, thus controlling MEPM cell proliferation and apoptosis, contributing to TCDD-induced CP, which provides a theoretical support for the precautions of cleft palate induced by TCDD.

Oral Wound Healing: A Scoping Review and Proposal of a New Index for Palatal Mucosa.

The aim of this scoping review was to evaluate the wound healing indices available in literature and propose a new intra-oral wound healing index to assess the healing of palatal mucosa. A PubMed database search was conducted to identify relevant studies using the search strategy: ('Oral Wound healing') OR ('Palatal tissue healing') OR ('Healing indices in Oral and Maxillofacial Surgery') OR ('Palatal wound healing') OR ('Complications in wound healing'). A qualitative and quantitative synthesis of the results was done and data was presented following the PRISMA-ScR guidelines. The search resulted in 9 articles published between 2019 and 2022, which were eligible for inclusion in the study. The data revealed that the indices currently available for the assessment of intra-oral healing were limited and primarily concerned with the assessment of gingival and periodontal tissues. The healing indices devised for gingival and periodontal tissues cannot be applied to palatal healing due to the differences in clinical and histological aspects. Therefore, a new index to monitor the healing response specifically for the soft tissues in the palate has been proposed. This maybe particularly useful in cleft palate repair and other procedures performed over the palatal tissues.

The influence of zinc on apoptosis and cell proliferation in palatal shelves during the fusion phase in mice and identification of a special protein family based on gene expression in cleft palate

Objective: To investigate the effect of the trace element zinc (Zn) on apoptosis and cell proliferation in palate shelvesduring the fusion phase, and to screen candidate genes of the Zn-finger special protein (Sp) family that were differentially expressed between the cleft palate and the normal palate to explore the mechanism of Zn in the development of cleft palate. Methods: Zn-rich, normal-Zn, low-Zn, and Zn-deficient diets were fed to female mice and, for the resultant fetuses, paraffin slices of their heads were made at embryonicdays 14.5 and 16.5. Using terminaldeoxynucleotidyltransferase-mediated dUTP nick-end labeling, the number of apoptotic cells in the palatal shelves was counted, and cell proliferation activity was detected using proliferating cell nuclear antigen staining. Total RNA from the palatal shelves of fetal mice was extracted from the Zn-rich diet, normal Zn-diet, and Zn-deficient-diet groups. We used microarray analysis to examine the expression of genes to identify intergroup differential gene expression and polymerase chain reaction tests to validate the results. Results: At ED14.5, the incidence of cleft palate in the regular zinc group, zinc rich group, low zinc group, and zinc deficient group was 8% (3/36), 2% (1/39), 29% (12/41), and 39% (15/38), respectively. The HE staining results at ED14.5 showed that both the left and right palatal processes in the zinc group had been lifted up and were in contact and connected with each other. In the zinc deficiency group, the left and right palatine processes remained vertically downwards on both sides of the tongue, ultimately forming cleft palate; In the low zinc group, the left and right palatine processes were raised but not in contact, ultimately resulting in cleft palate. There is no significant difference between the zinc rich group and the regular zinc group. At ED14.5, the positive rates of proliferative cells in the palatal process of fetal mice in the regular zinc group (80.29% ± 7.39%) and the zinc rich group (87.69% ± 6.62%) were significantly higher than those in the zinc deficient group (56.05% ± 16.13%) and the low zinc group (56.22% ± 9.61%) (t=4.32, P<0.05). The apoptosis index of fetal rat palatal process cells in the zinc deficient group (38.80% ± 3.10%) and the low zinc group (28.80% ± 6.19%) were significantly higher than those in the regular zinc group (16.80% ± 1.82%) (t=19.35, P<0.001; t=5.81, P<0.001). There were 663 differentially expressed genes in the zinc rich group and the zinc deficient group, with 513 up-regulated genes and 150 down-regulated genes, among which Sp5 was found to be located. The real time PCR results showed that compared with the regular zinc group (2.22 ± 0.36), the expression level of Sp5mRNA in the palatal process tissue of the zinc deficient group (1.23 ± 0.38) significantly increased (P<0.05), while the zinc rich group (3.68 ± 0.90) significantly decreased (P<0.05). Conclusions: Trace element Zn content was found to be closely related to the occurrence of cleft palate in mice offspring, with a lack of Zn leading to cleft palate.

MicroRNAs in Small Extracellular Vesicles from Amniotic Fluid and Maternal Plasma Associated with Fetal Palate Development in Mice.

Cleft palate (CP) is a common congenital birth defect. Cellular and morphological processes change dynamically during palatogenesis, and any disturbance in this process could result in CP. However, the molecular mechanisms steering this fundamental phase remain unclear. One study suggesting a role for miRNAs in palate development via maternal small extracellular vesicles (SEVs) drew our attention to their potential involvement in palatogenesis. In this study, we used an in vitro model to determine how SEVs derived from amniotic fluid (ASVs) and maternal plasma (MSVs) influence the biological behaviors of mouse embryonic palatal mesenchyme (MEPM) cells and medial edge epithelial (MEE) cells; we also compared time-dependent differential expression (DE) miRNAs in ASVs and MSVs with the DE mRNAs in palate tissue from E13.5 to E15.5 to study the dynamic co-regulation of miRNAs and mRNAs during palatogenesis in vivo. Our results demonstrate that some pivotal biological activities, such as MEPM proliferation, migration, osteogenesis, and MEE apoptosis, might be directed, in part, by stage-specific MSVs and ASVs. We further identified interconnected networks and key miRNAs such as miR-744-5p, miR-323-5p, and miR-3102-5p, offering a roadmap for mechanistic investigations and the identification of early CP biomarkers.

Trueness and precision of complete arch dentate digital models produced by intraoral and desktop scanners: An ex-vivo study

ObjectivesThe study aimed to compare the trueness and precision of five intraoral scanners (Emerald S, iTero Element 5D, Medit i700, Primescan, and Trios 4) and two indirect digitization techniques for both teeth and soft tissues on fresh mandibular and maxillary cadaver jaws. MethodsThe maxilla and mandible of a fully dentate cadaver were scanned by the ATOS industrial scanner to create a master model. Then, the specimens were scanned eight times by each intraoral scanner (IOS). In addition, 8 polyvinylsiloxane (PVS) impressions were made and digitized with a Medit T710 desktop scanner. Stone models were then poured and again scanned with the desktop scanner. All IOS, PVS, and stone models were compared to the master model to calculate the mean absolute surface deviation for mandibular teeth, maxillary teeth, and palate. ResultsFor mandibular teeth, the PVS trueness was only significantly better than the Medit i700 (p < 0.001) and Primescan (p < 0.05). In maxillary teeth, the PVS trueness was significantly better than all IOSs (p < 0.05–0.001); the stone trueness was significantly better than Emerald S (p < 0.01), Medit i700 (p < 0.001) and Primescan (p < 0.01). In the palate, PVS and stone trueness were significantly lower than the iTero Element 5D (p < 0.01) and Trios 4 (p < p < 0.01). Stone trueness was significantly lower than the Medit i700 (p < 0.05). The precision in the palate was significantly lower for PVS and stone than for Emerald S (p < 0.01, p < 0.05), iTero Element 5D (p < 0.01, p < 0.01), Primescan (p < 0.001, p < 0.001), and Trios 4 (p < 0.001, p < 0.01). Significant differences in trueness between the IOSs were observed only in the mandibular teeth. The Medit i700 performed worse than Emerald S (p < 0.01) and iTero Element 5D (p < 0.01). For mandibular teeth, the Medit i700 was significantly more precise than Primescan (p < 0.01) and the Emerald S (p < 0.05). The Trios 4 was significantly less precise than Emerald S (p < 0.05). The precision of Medit i700 was significantly worse than iTero Element 5D (p < 0.01) for maxillary teeth, as well as the Primescan (p < 0.01) and Trios 4 (p < 0.05) for the palate. ConclusionsIn general, indirectly digitized models from PVS impressions had higher trueness than IOS for maxillary teeth; precision between the two methods was similar. IOS was more accurate for palatal tissues. The differences in trueness and precision for mandibular teeth between the various techniques were negligible. Clinical significanceAll investigated IOSs and indirect digitization could be used for complete arch scanning in mandibular and maxillary dentate arches. However, direct optical digitization is preferable for the palate due to the low accuracy of physical impression techniques for soft tissues.

Three-dimensional mapping of the greater palatine artery location and physiology.

To develop a novel technique for localizing and reconstructing the greater palatine artery (GPA) using three-dimensional (3D) technology. A miniaturized intraoral ultrasound transducer was used to imaging landmarks including the GPA, gingival margin (GM), and palatal masticatory mucosa (PMM). A 5-mm-thick solid hydrogel couplant was integrated to replace traditional ultrasound gel and avoid bubbles when moving the transducer. A panorama image provided the relative localization of landmarks including the GPA, PMM, and hard palate. Short- and long-axis imaging of GPA was performed in five subjects including 3D mapping of GPA branches and surrounding tissues in a volume of 10 mm × 8 mm × 10 mm. Full-mouth Doppler imaging was also demonstrated on both the dorsal and ventral tongue as well as buccal mucosa and sublingual region on two subjects. This study can measure the vertical distance from the GM to the GPA and depth from PMM to GPA and visualize the GPA localization in a 3D manner, which is critical to evaluate the available volume of palatal donor tissues and avoid sectioning of GPA during surgical harvesting of the tissues. Finally, the transducer's small size facilitates full-mouth Doppler imaging with the potential to improve the assessment, diagnosis, and management of oral mucosa.

Single-cell Transcriptomics Reveals Activation of Macrophages in All-trans Retinoic Acid (atRA)-induced Cleft Palate.

Cleft palate is among the most common birth defects with an impact on swallowing and speaking and is difficult to diagnose with ultrasound during pregnancy. In this study, we systematically capture the cellular composition of all-trans retinoic acid (atRA)-exposed and normal embryonic gestation 16.5 days mouse palate by the single-cell RNA sequencing technique. The authors identified 14 major cell types with the largest proportion of fibroblasts. The proportion of myeloid cells in atRA-exposed palate was markedly higher than those in the normal palate tissue, especially M1-like macrophages and monocytes. The upregulated genes of the different expression genes between atRA-exposed palate and normal palate tissue were linked to the biological processes of leukocyte chemotaxis and migration. Protein TLR2, CXCR4, THBS1, MRC1, transcription factor encoding genes Cebpb, Fos, Jun, Rela, and signaling pathway IL-17 and phagosome were found to be significantly involved in these processes. Subsequently, cellular communication network analysis suggested that myeloid-centered cell interactions SELL, SELPLG, MIF, CXCL, ANNEXIN, THBS, and NECTIN were significantly more activated in atRA-exposed palate. Overall, we delineate the single-cell landscape of atRA-induced cleft palate, revealing the effects of overexposure to atRA during palate tissue development and providing insights for the diagnosis of cleft palate.

Exploring Newer Alternatives to Soft-tissue Autografts for Managing Gingival Recession

ABSTRACT Gingival recession is often associated with unesthetic appearance, inadequate width of attached gingiva, hypersensitivity, and difficulty in maintaining optimal oral hygiene. Thus, the ultimate aim of recession management is to attain complete root coverage that includes diverse surgical techniques with adjunctive scaffolds and graft materials. Soft-tissue autografts are of great importance in clinical practice for managing these mucogingival deformities and providing better esthetics and function around teeth and implants. Subepithelial connective tissue graft is the “gold standard” for recession coverage. However, obtaining these autografts can sometimes be difficult due to various disadvantages such as decreased patient compliance, a limited amount of donor tissue, inadequate donor tissue in case of shallow or thin palatal tissues, and the need for multiple surgical procedures to harvest adequate donor graft tissue. To overcome these disadvantages, various alternatives have been introduced. This review aims to provide systematically compiled data on the available alternatives of soft-tissue autografts that can be used for managing gingival recession.

Green Synthesis of Gold Nanoparticles with Curcumin or Açai in the Tissue Repair of Palatal Wounds.

This study aimed to evaluate and compare the effects of treatment with gold nanoparticles (GNPs) reduced with Curcumin (Curcuma longa L.) or Açai (Euterpe oleracea) to a standard commercial treatment of the pharmacological type (Omcilon®) and an electrophysical agent (photobiomodulation) in the palatal wounds of rats. As for the in vitro assay, a cell viability test was performed to assess the toxicity of the synthesized nanoparticles. In vivo assay: 60 Wistar rats were divided into five groups (n = 12): I. Palatal Wound (PW); II. PW + Photobiomodulation (PBM); III. PW + Omcilon®; IV. PW + GNPs-Cur (0.025 mg/mL); V. PW + GNPs-Açai (0.025 mg/mL). Animals were first anesthetized, and circular lesions in the palatine mucosa were induced using a 4 mm-diameter punch. The first treatment session started 24 h after the injury and occurred daily for 5 days. The animals were euthanized, and the palatal mucosa tissue was removed for histological, biochemical, and molecular analysis. GNPs-Açai were able to significantly reduce pro-inflammatory cytokines and increase anti-inflammatory ones, reduce oxidant markers, and reduce inflammatory infiltrate while increasing the collagen area and contraction rate of the wound, along with an improved visual qualification. The present study demonstrated that the proposed therapies of GNPs synthesized greenly, thus associating their effects with those of plants, favor the tissue repair process in palatal wounds.

Immunohistological profiling confirms salivary gland-like nature of the tubarial glands and suggests closest resemblance to the palatal salivary glands

Background and purposeHigh label uptake in 68 Ga-PSMA-11 PET/CT recently identified a bilateral nasopharyngeal structure as a salivary gland (SG)-like additional ‘area of interest’, to be considered in conditions affecting SGs. These structures were termed ‘tubarial glands’. We aimed to further characterize their histological and immunohistochemical position compared to established SGs. MethodsTubarial gland tissue was compared with parotid, submandibular, sublingual, palatal and labial SGs tissue using immunohistological techniques. ResultsExpression of acinar cell-associated aquaporin-5 (AQP5) was detected in tubarial glands, in an apical location associated in control, established SGs with polarized, secretory acinar cells. Keratin14 (KRT14) expression in cells peripheral to AQP5+ clusters also suggested presence of myoepithelial cells. α-amylase, prolactin-induced protein, proline rich protein Haelll subfamily 2, and Muc5B expression suggests mucous acinar cell presence, and presence of muco-serous acinar cells peripheral to putative mucous acinar cells. Expression of adrenergic receptor-β1 by acinar-like cells of the tubarial gland suggests ability to transduce sympathetic neuronal signaling. In terms of ductal architecture, tubarial glands contained large excretory-like ducts (similar to all other SGs), and squamous ducts, comprised of intermingled KRT14+ and KRT7+ cells. These squamous ducts were also observed in palatal, sublingual and labial SGs. No striated or intercalated ducts were observed, similar to palatal SGs. ConclusionBased on histological and immunohistochemical analyses, the tubarial glands resemble SGs. They most convincingly echo characteristics of the palatal SGs in terms of ductal cells, and both the palatal and labial SGs when considering acinar cells.

Ballistic injury to the neck in a soldier injured in the war in Ukraine

Introduction and relevance: Penetrating neck trauma results in a 10% mortality rate for patients and management can be challenging, often requiring a multidisciplinary approach.Methods: This is a case report of a 33-year-old male patient who received a neck gunshot through the oral cavity during close combat on the south front of the Ukrainian-Russian war in January 2023.Clinical discussion: A CT scan revealed a foreign body in the neck on the right side, between the mastoid process and the right jaw angle. A CT scan with contrast revealed a foreign body in the neck – a bullet – and helped with observing relations to surrounding tissues and following the bullet’s trajectory. The multidisciplinary team performed surgery for foreign body removal. As a first step, carotid arteries and the internal jugular vein were dissected and looped to control potential bleeding. The bullet was 7.62 caliber. The patient recovered well with minimal postoperative complications, including hypoglossal and facial nerve neuropathy, which resolved in two weeks.Conclusion: The proximity gunshot resulted in unexpectedly moderate tissue injury, but regardless of the relatively low destruction of palate tissue, the location of the foreign body near carotid arteries made the surgery approach challenging.

High throughput miRNA sequencing and bioinformatics analysis identify the mesenchymal cell proliferation and apoptosis related miRNAs during fetal mice palate development.

Palatogenesis requires a precise spatiotemporal regulation of gene expression. Recent studies indicate that microRNAs (miRNAs) are key factors in normal palatogenesis. The present study aimed to explain the regulatory mechanisms of miRNAs during palate development. Pregnant ICR mice were choose at embryonic day 10.5 (E10.5). Hemotoxylin and eosin (H&E) staining was used to observe the morphological changes during the development of palatal process at embryonic day (E)13.5, E14.0, E14.5, E15.0 and E15.5. The fetal palatal tissues were collected at E13.5, E14.0, E14.5 and E15.0 to explore miRNA expression and function by high throughput sequencing and bioinformatic analysis. Mfuzz cluster analysis was used to look for miRNAs related to the fetal mice palate formation. The target genes of miRNAs were predicted by miRWalk. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was performed base on target genes. The mesenchymal cell proliferation and apoptosis related miRNAs-genes networks were predicted and constructed using miRWalk and Cytoscape software. The expression of mesenchymal cell proliferation and apoptosis related miRNAs at the E13.5, E14.0, E14.5, and E15.0 was detected by a quantitative real-time PCR (RT-qPCR) assay. H&E staining found that the palatal process grows vertically along the sides of the tongue at E13.5, the position of the tongue begins to descend and the bilateral palatal processes rise above the tongue at E14.0, the palatal process grows horizontally at E14.5, there is palatal contact fusion at E15.0, and the palatal suture disappeared at E15.5. Nine clusters of miRNA expression changes were identified in the fetal mice palate formation progression, including two reducing trends, two rising trends and five disordered trends. Next, the heatmap showed the miRNA expression from Clusters 4, 6, 9, 12 in the E13.5, E14.0, E14.5 and E15.0 groups. GO functional and KEGG pathway enrichment analysis found target genes of miRNAs in clusters involved in regulation of mesenchymal phenotype and the mitogen-activated protein kinase (MAPK) signaling pathway. Next, mesenchymal phenotype related miRNA-genes networks were constructed. The heatmap showing that the mesenchymal phenotype related miRNA expression of Clusters 4, 6, 9 and 12 at E13.5, E14.0, E14.5 and E15.0. Furthermore, the mesenchymal cell proliferation and apoptosis related miRNA-gene networks were identified in Clusters 6 and 12, including mmu-miR-504-3p-Hnf1b, etc. The expression level of mesenchymal cell proliferation and apoptosis related miRNAs at the E13.5, E14.0, E14.5, and E15.0 was verified by a RT-qPCR assay. For the first time, we identified that clear dynamic miRNA expression during palate development. Furthermore, we demonstrated that mesenchymal cell proliferation and apoptosis related miRNAs, genes and the MAPK signaling pathway are important during fetal mice palate development.

Determination of Palatal Soft Tissue Thickness and Safe Zone for Palatal Soft Tissue Harvest Using CBCT: A Retrospective Study.

Our decision to conduct this study was motivated by the dearth of knowledge on geographical variations in the thickness of the palatal masticatory mucosa. The aim of the present study is to comprehensively analyze the palatal mucosal thickness and indicate the safety zone for palatal soft tissue harvesting using cone beam computed tomography (CBCT). Material and Methods. As this was a retrospective analysis of cases previously reported to the hospital, written consent was not acquired. The analysis was carried out on 30 CBCT images. Two examiners evaluated the images separately to avoid bias. Measurements were done from the midportion of the cementoenamel junction (CEJ) to the midpalatal suture in a horizontal line. Measurements were recorded from the maxillary canine, first premolar, second premolar, first molar, and second molar and were marked in axial and coronal sections at distances of 3, 6, and 9 mm from the CEJ. The relationship between palate soft tissue thickness in relation to each tooth, palatal vault angle, teeth, and the greater palatine grove was evaluated. Differences in the palatal mucosal thickness according to age, gender, and tooth site were evaluated. Categorical data were presented as frequencies and percentages. Numerical data are presented as mean and standard deviation values. They are explored for normality using Shapiro-Wilk's test. Data are normally distributed and are analyzed using one-way ANOVA followed by Tukey's post hoc test for independent variables and paired t-test for repeated measures. The significance level is set at p ≤ 0.05 for all tests. Statistical analysis is performed with R statistical analysis software version 4.1.3 for Windows. For sex and nationality, there was no significant association (p > 0.05), while for age, cases 35 years and older had significantly higher mucosal thickness than cases younger than 35 years old (p < 0.001). For all teeth, the association was statistically significant (p < 0.001). For the canine and first premolar, cases with deep angles had significantly higher mean values than those with moderate angles (p < 0.001). For other teeth, cases with deep angles had significantly higher mean values than other angles (p < 0.001). Palatal mucosal thickness varied significantly from the canine to the second molar; the most appropriate site for graft harvesting is the canine to second premolar area which is 9-12 mm from the midpalatal suture aspect and is considered a safe zone for harvesting palatal graft.

The effect of connective tissue graft or a collagen matrix on epithelial differentiation around teeth and implants: a preclinical study in minipigs

ObjectivesThis study aimed to histologically evaluate the healing at 8 weeks after coronally advanced flap (CAF) with either a superficial (SCTG) or deep palatal connective tissue graft (DCTG), or a collagen matrix (CM) to cover recession defects at teeth and implants.Material and methodsOne mandibular side of 6 miniature pigs received each 3 titanium implants 12 weeks after extraction. Eight weeks later, recession defects were created around implants and contralateral premolars and 4 weeks later randomly subjected to CAF + SCTG, CAF + DCTG, or CAF + CM. After 8 weeks, block biopsies were histologically analyzed.ResultsFor the primary outcome, i.e., keratinization of the epithelium, all teeth and implants exhibited a keratinized epithelium with no histological differences among them also not in terms of statistically significant differences in length (SCTG 0.86 ± 0.92 mm, DCTG 1.13 ± 0.62 mm, and Cm, 1.44 ± 0.76 mm). Pocket formation was histologically seen at all teeth, around most implants with SCTG and DCTG, however not in the CM implant group. The connective tissue grafts showed hardly signs of degradation, whereas the CM was partly degraded and integrated in connective tissue. The mean gain in gingival height was similar in all experimental groups (SCTG 3.89 ± 0.80 mm, DCTG 4.01 ± 1.40 mm, CM 4.21 ± 0.64 mm). Statistically significant differences were found in the height of the junctional epithelium between the control teeth and the connective tissue groups (p = 0.009 and 0.044).ConclusionsIn this animal model, the use of either a superficial or deep connective tissue graft or a collagen membrane did not seem to have any impact on the epithelial keratinization around both teeth and implants. All procedures (CAF + SCTG/DCTG/CM) resulted in a long JE that was even longer at implants.Clinical relevanceDeep/superficial palatal connective tissue graft yielded similar keratinization around teeth/implants. Given the absence of pocket formation and inflammatory processes at implants when using a CM, CAF + CM might bear potential clinical benefits.