ORAL MUCOSAL TISSUE

ENGINEERING-A promising prospect for the mucosally challenged..

Why not skin grafts?Donor site morbidity.

Skin grafts differ from oral mucosa in consistency, color, growth and keratinisation patterns.

Original characteristics of skin is not lost completely.

What is it? Vacanti and Langer defined tissue engineering as “ A combination of principles and methods of life

sciences with that of engineering to develop materials and methods to repair damaged or diseased tissues ,to create entire tissue replacements. ”

Oral mucosal tissue engineering.

  Tissue engineering of oral mucosa combines cells, materials and engineering to produce a three-dimensional reconstruction of oral mucosa.

It is meant to simulate the real anatomical structure and function of oral mucosa

Tissue engineered oral mucosa shows promise for clinical use, such as the replacement of soft tissue defects in the oral cavity. These defects can be divided into two major categories:

Tooth-related defects

Non tooth-related defects

Tissue engineered oral mucosa are of two types based on the type of cell layer produced.

Partial thickness tissue engineered oral mucosa

Full thickness tissue engineered oral mucosa

PARTIAL THICKNESS TISSUE ENGINEERED MUCOSA

MONOLAYER EPITHELIAL SHEETS:Advantages:-

1. For the study of its responses to stimuli 2. To manufacture multilayer cultures.

Disadvantages:-1. Fragile2. difficult to handle3. likely to contract without a supporting matrix

MULTILAYER EPITHELIAL SHEETS: 1.signs of differentiation 2.signs of keratinisation.

Monolayer epithelial sheets

Multilayer epithelial sheets.

FULL THICKNESS TISSUE ENGINEERED MUCOSA

It uses a combination of:

•Lamina propria: oral fibroblasts scaffold fibroblast differentiation medium.

•Basement membrane: 1.Type IV collagen 2.Laminin

3.Fibronectin 4.Integrin

•Stratified squamous epithelium:Oral keratinocytes keratinocyte growth factors

S.C.A.F.F.O.L.D.S

Perfect

Environmen

tProvidesStrengthBiod

egradabl

e

Guides the growth of

cells.

Rate of

degradation

=rate of

regeneration

FUNCTIONS OF SCAFFOLDS.

TYPES OF SCAFFOLD

S

NATURALLY DERIVED

COLLAGEN BASED

FIBRIN BASEDHYBRID

SYNTHETIC

GELATIN BASED

E V P O M E- Ex Vivo Produced Oral Mucosal Equivalent

EVPOME - How is it done?

a. Oral keratinocytes

b.0.04% trypsinsolution

c.Serum free culturemediumd.Alloderm

e. Air-liquid interface 1-2weeks

7 days

a. EVPOME used to reconstruct oral defects .

b. Early repair and healingWith minimal scar formation

One month after the placement of EVPOME

I.

II.

COMPLICATIONS.

Complexity of oral tissues

Easy shrinkage

Easy ulceration

Time consuming growth of keratinocytes

Ethical issues

REFERENCES.1.Intraoral Grafting of Tissue-Engineered Human Oral MucosaKenji Izumi, DDS, PhD, Rodrigo F. Neiva, DDS, MS, and Stephen E. Feinberg, DDS, MS, PhD3   2. Tissue-engineered oral mucosa: a review of

the scientific literature.   Moharamzadeh K, Brook IM, Van Noort R, Scutt AM, Thornhill MH (2007)

3.Tissue Engineering: Fundamentals and ApplicationsBy Yoshito Ikada